Trajectories of complicated grief during online cognitive behavioural therapy : an uncontrolled trial

Little is known about the course of complicated grief (CG) symptoms during treatment. This study aimed to analyse the course of CG symptoms during an internet-based cognitive behavioural treatment (iCBT) and identify CG trajectories. Predictors of CG trajectories were examined to identify individuals who were likely to benefit or worsen during treatment.In a sample of 1880 Dutch bereaved individuals undergoing iCBT, a latent profile analysis (LPA) was conducted. The Inventory of Complicated Grief (ICG; Prigerson et al., 1995) measured symptoms before and after treatment. A multinomial regression analysed factors such as age, gender, and type of treatment to predict trajectory membership. Five trajectories emerged: moderate CG large improvement (35.0%), high CG moderate improvement (30.4%), high CG small improvement (16.8%), low CG moderate improvement (12.2%), and a high CG small worsening trajectory (5.5%). Age and gender were significantly related to CG trajectories.Most individuals experienced a decrease in CG symptoms, suggesting standalone iCBT seems effective. Individuals who experienced a slight decrease or increase in symptoms might benefit from additional support, like face-to-face therapy or an extended iCBT. Future research should explore additional moderating factors in grief recovery and the influence of gender on CG during iCBT.