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. 2021 Nov 24;12(1):1987687.
doi: 10.1080/20008198.2021.1987687. eCollection 2021.

Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial

L Reitsma  1 , P A Boelen  1   2 , J de Keijser  3 , L I M Lenferink  1   3   4
Affiliations
Free PMC article

Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial

L Reitsma et al. Eur J Psychotraumatol. .
Free PMC article

Abstract
in English, Spanish, Chinese

Background: Losing a loved one during the COVID-19 pandemic is a potentially traumatic loss that may result in symptoms of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression. To date, grief-specific cognitive-behavioural therapy (CBT) has mostly been delivered through individual face-to-face formats, while studies have shown that online treatment also yields promising results. Offering treatment online is now more than ever relevant during the pan demic and may offer important benefits compared with face-to-face CBT, such as lower costs and higher accessibility. Our expectation is that grief-specific online CBT is effective in reducing PCBD, PTSD, and depression symptoms.

Objective: Our aim is to evaluate the short-term and long-term effectiveness of grief-specific online CBT in reducing PCBD, PTSD, and depression symptom-levels for adults who lost a loved one during the COVID-19 pandemic.

Method: This study consists of two parts. In part 1, a two-armed (unguided online CBT versus waitlist controls) randomized controlled trial will be conducted. In part 2, a two-armed (guided online CBT versus unguided online CBT) controlled trial will be conducted. Symptoms of PCBD, PTSD, and depression will be assessed via telephone interviews at pre-treatment/pre-waiting period, post-treatment/post-waiting period, and six months post-treatment. Potential participants are people who lost a loved one at least three months earlier during the COVID-19 pandemic with clinically relevant levels of PCBD, PTSD, and/or depression. Analysis of covariance and multilevel modelling will be performed.

Discussion: This is one of the first studies examining the effectiveness of online grief-specific CBT. More research is needed before implementing online grief-specific CBT into clinical practice.

Antecedentes: Perder a un ser querido durante la pandemia de COVID-19 es una pérdida potencialmente traumática que puede resultar en síntomas de trastorno de duelo complejo persistente (PCBD en su sigla en inglés), trastorno de estrés postraumático (TEPT) y depresión. Hasta la fecha, la terapia cognitivo-conductual (TCC) específica para el duelo se ha proporcionado principalmente a través de formatos individuales cara a cara, mientras que los estudios han demostrado que el tratamiento en línea también produce resultados prometedores. Ofrecer tratamiento en línea es ahora más relevante que nunca durante la pandemia y puede ofrecer importantes beneficios en comparación con la TCC presencial, como menores costos y mayor accesibilidad. Nuestra expectativa es que la TCC en línea específica para el duelo sea eficaz para reducir el PCBD, el TEPT y los síntomas de depresión.Objetivo: Nuestro objetivo es evaluar la efectividad a corto y largo plazo de la TCC en línea específica para el duelo en la reducción de los niveles de PCBD, TEPT y síntomas de depresión en adultos que perdieron a un ser querido durante la pandemia de COVID-19.Método: Este estudio consta de dos partes. En la parte 1, se llevará a cabo un ensayo controlado aleatorio de dos brazos (TCC en línea no guiado versus controles con la lista de espera). En la parte 2, se llevará a cabo un ensayo controlado de dos brazos (TCC en línea guiada versus TCC en línea no guiada). Los síntomas de PCBD, TEPT y depresión se evaluarán mediante entrevistas telefónicas en el período de pretratamiento/pre-espera, post-tratamiento/post-período de espera y seis meses post-tratamiento. Los participantes potenciales son personas que perdieron a un ser querido al menos tres meses antes durante la pandemia de COVID-19 con niveles clínicamente relevantes de PCBD, TEPT y/o depresión. Se realizarán análisis de covarianza y modelado multinivel.Discusión: Este es uno de los primeros estudios que examinan la efectividad de la TCC en línea específica para el duelo. Se necesita más investigación antes de implementar la TCC en línea específica para el duelo en la práctica clínica.

背景: 在 COVID-19 疫情期间丧亲是一种潜在的创伤性损失, 可能导致持续性复杂丧亲症 (PCBD), 创伤后应激障碍 (PTSD) 和抑郁症状。迄今为止, 哀伤特定的认知行为疗法 (CBT) 主要通过个人面对面的形式提供, 而研究表明, 在线治疗也产生了有前景的结果。提供在线治疗在疫情期间比以往任何时候都更切题, 并且相较于面对面的 CBT, 可能提供重要的好处, 例如成本更低和易获得性更高。我们的期望是哀伤特定的在线 CBT 可有效减少 PCBD, PTSD 和抑郁症状。目的: 我们旨在评估哀伤特定的在线 CBT 在减少 COVID-19 疫情期间成年丧亲者PCBD, PTSD 和抑郁症状水平方面的短期和长期有效性。方法: 本研究由两部分组成。在第 1 部分中, 将进行一项双臂随机对照试验 (无指导的在线 CBT 与等候名单对照) 。在第 2 部分中, 将进行一项双臂对照试验 (指导性在线 CBT 与非指导性在线 CBT) 。PCBD, PTSD 和抑郁症的症状将通过电话访谈在治疗前/等待期, 治疗后/等待期和治疗后六个月进行评估。潜在参与者是在 COVID-19 疫情期间至少三个月前丧亲且具有临床相关水平的 PCBD, PTSD 和/或抑郁的人。将进行协方差分析和多级建模。讨论: 这是考查哀伤特定在线 CBT 有效性的首批研究之一。在将哀伤特定在线 CBT 应用于临床实践之前, 需要进行更多的研究。.

Keywords: CBT; Coronavirus; bereavement; depression; grief; online treatment; posttraumatic stress.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Design of the randomized controlled trial
Figure 2.
Figure 2.
Design of the controlled trial
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Grants and funding

Part 1 was supported by the COVID-19 Fund of the Faculty of Social and Behavioural Sciences of Utrecht University and part 2 by Fonds Slachtofferhulp.