Mediators of Outcome in Complicated Grief Treatment
Corresponding Author
Kim Glickman
York College of the City University of New York
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
M. Katherine Shear
Columbia University
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Melanie M. Wall
Columbia University
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Kim Glickman
York College of the City University of New York
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
M. Katherine Shear
Columbia University
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Melanie M. Wall
Columbia University
Please address correspondence to: Kim Glickman, PhD, LCSW, Department of Social Work, School of Health Sciences and Professional Programs, York College of the City University of New York, 94-20 Guy R. Brewer Blvd., Jamaica, New York 11451. E-mail: [email protected]
M. Katherine Shear, MD, Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, 1255 Amsterdam Avenue New York, NY 10027. E-mail: [email protected]
Melanie M. Wall, PhD, Department of Biostatistics in the Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 48, New York, NY 10032. E-mail: [email protected]
Search for more papers by this authorAbstract
Objective
In this study, we examined the mechanisms of action of complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief.
Method
We explored 3 putative mediators (guilt/self-blame related to the deceased, negative thoughts about the future, and avoidance) among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (n = 34) in a previously reported randomized controlled trial. Antidepressant use was examined as a moderator of mediation effects.
Results
A reduction in guilt/self-blame, negative thoughts about the future, and avoidance behavior each mediated the relationship between treatment group and complicated grief outcomes. Reduction in avoidance emerged as an independent mediator after controlling for all mediators.
Conclusion
Reducing avoidance of situations and emotions connected to the loss seems to be a key mechanism of change in CGT. Revising counterfactual thinking around troubling aspects of the death may also play a role in facilitating effective adaptation to loss.
Supporting Information
| Filename | Description |
|---|---|
| jclp22384-sup-0001-Table-2.docx47.8 KB | Table 2. Results of moderation analysis (standardized): interaction between mediators and antidepressant use on outcome |
| jclp22384-sup-0002-Table-1.docx40 KB | Table 1. Results of mutually adjusted standardized regression for all mediators |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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