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

Published online by Cambridge University Press:  26 January 2019

Wendy G. Lichtenthal ,
Corinne Catarozoli ,
Melissa Masterson ,
Elizabeth Slivjak ,
Elizabeth Schofield ,
Kailey E. Roberts ,
Robert A. Neimeyer ,
Lori Wiener ,
Holly G. Prigerson  and
David W. Kissane
...Show all authors
Wendy G. Lichtenthal*
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY Weill Cornell Medicine, New York, NY
Corinne Catarozoli
Affiliation:
Weill Cornell Medicine, New York, NY
Melissa Masterson
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY
Elizabeth Slivjak
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY
Elizabeth Schofield
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY
Kailey E. Roberts
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY
Robert A. Neimeyer
Affiliation:
The University of Memphis, Memphis, TN
Lori Wiener
Affiliation:
National Cancer Institute, Bethesda, MD
Holly G. Prigerson
Affiliation:
Weill Cornell Medicine, New York, NY
David W. Kissane
Affiliation:
The University of Notre Dame Australia, Fremantle, Western Australia Monash University, Melbourne, Australia
Yuelin Li
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY
William Breitbart
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, NY Weill Cornell Medicine, New York, NY
*
Author for correspondence: Wendy G. Lichtenthal, Ph.D., Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, New York 10022. Email: [email protected]
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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.

Result

Eight 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 results

Overall, 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

MeaningProlonged griefExistentialBereaved parentsPsychotherapy
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 1 , February 2019 , pp. 2 - 12
Copyright
Copyright © Cambridge University Press 2019 

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