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BACKGROUND: The present meta-analysis investigates the efficacy of psychosocial interventions in bereaved children and adolescents. METHOD: We conducted a systematic review searching PsycINFO, PsycARTICLES, PubMed, MEDLINE, PSYNDEX, Web of Science, CINAHL and ERIC. Random-effects meta-analyses examined the effect of interventions on symptoms of grief, posttraumatic stress disorder (PTSD) and depression in controlled and uncontrolled studies. RESULTS: We included 39 studies (n = 5.578). Post-treatment, preventive interventions demonstrated a significant effect on grief (uncontrolled studies: g = 0.29, 95%CI [0.09;0.48]; controlled studies: g = 0.18, 95%CI [0.03;0.32]). For symptoms of PTSD and depression, only uncontrolled preventive studies yielded significant effects (PTSD: g = 0.24, 95%CI [0.11;0.36]; depression: g = 0.28, 95%CI [0.10;0.45]). Interventions targeting youth with increased grief-related distress demonstrated a significant effect in uncontrolled studies on grief (g = 1.25, 95%CI [0.94;1.57]), PTSD (g = 1.33, 95%CI [0.85;1.82]) and depression (g = 0.61, 95%CI [0.45;0.77]). A controlled effect size could only be calculated for PTSD symptoms (g = 0.71, 95%CI [0.15;1.27]). LIMITATIONS: Interventions varied widely, contributing to high heterogeneity. Only a small number of studies with mostly limited quality could be analysed. CONCLUSIONS: Psychosocial interventions may ameliorate grief symptoms in bereaved youth, especially when targeting youth with elevated grief distress. However, the effects observed in uncontrolled studies are substantially reduced when controlling for the natural course of bereavement. Given the increasing number of children worldwide bereaved through ongoing crises, research on interventions is surprisingly sparse.
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Bereaved persons seeking help in bereavement counselling report generally high client satisfaction. However, qualitative research suggests that some clients also indicate dissatisfying experiences and negative effects. The aim of this study was to investigate the contribution of content-, counsellor- and client-related characteristics and negative effects to client satisfaction. Bereaved participants (n = 53) who had completed bereavement counselling were recruited either online or via counselling organizations. In an online survey, they provided information about client-, loss- and counselling-related variables, present grief severity, negative effects of counselling and client satisfaction. In a hierarchical linear regression analysis controlling for recruitment strategy, online-recruited participants were less satisfied. In a second step additionally considering number of sessions, grief severity and negative effects, experiencing more negative effects predicted lower client satisfaction. The results indicate that negative effects could play an important role for client satisfaction. More research is needed to investigate this phenomenon.
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Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling.Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design.Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format.Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth.Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed.
Pandemic-associated risk factors for PGD have become more important topics in grief counselling during COVID-19.Risk factors include especially a lack of social support, limited possibility to accompany a dying significant other and absence of traditional grief rituals.Future research is needed to investigate whether monitoring and addressing these risk factors can improve bereavement care.