An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation

Abstract

Objective: To determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer.

Method: Parents who lost a child to cancer and who were between six months and six years after loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60-90 minutes in length, either in person or through videoconferencing. Parents were administered measures of prolonged grief disorder symptoms, meaning in life, and other assessments of psychological adjustment preintervention, mid-intervention, postintervention, and at three months postintervention. Descriptive data from both the in-person and videoconferencing open trial were pooled.ResultEight of 11 (72%) enrolled parents started the MCGT intervention, and six of eight (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed postintervention longitudinal improvements in prolonged grief (d = 1.70), sense of meaning (d = 2.11), depression (d = 0.84), hopelessness (d = 1.01), continuing bonds with their child (d = 1.26), posttraumatic growth (ds = 0.29-1.33), positive affect (d = 0.99), and various health-related quality of life domains (d = 0.46-0.71). Most treatment gains were either maintained or increased at the three-month follow-up assessment.Significance of resultsOverall, preliminary data suggest that this 16-session, manualized cognitive-behavioral-existential intervention is feasible, acceptable, and associated with transdiagnostic improvements in psychological functioning among parents who have lost a child to cancer. Future research should examine MCGT with a larger sample in a randomized controlled trial.

Keywords: Bereaved parents; Existential; Meaning; Prolonged grief; Psychotherapy.

Figures

Figure 1.. Changes in prolonged grief, depression, and hopelessness over time

Note. The figure depicts mean change in each measure, at each timepoint, relative to baseline. Pairwise complete data are used to maximize sample size, thus not all participants included for T2 analysis were available for T3 and T4 analysis. For interpretation of size of effects, see individual measure ranges in Table 1. PGD = Prolonged grief symptoms. T1 = Pre-intervention. T2 = Mid-intervention. T3 = Post-intervention. T4 = 3 months post-intervention.

Figure 2.. Changes in meaning, growth, continuing bonds and positive affect over time

Note. The figure depicts mean change in each measure, at each timepoint, relative to baseline. Pairwise complete data are used to maximize sample size, thus not all participants included for T2 analysis were available for T3 and T4 analysis. For interpretation of size of effects, see individual measure ranges in Table 1. LAP-R PMI = Life Attitude Profile-Revised Personal Meaning Index. MQOL = McGill Quality of Life Meaning Item. T1 = Pre-intervention. T2 = Mid-intervention. T3 = Post-intervention. T4 = 3 months post-intervention.