CG research began in the 1990s when researchers found grief symptoms did not respond to effective treatment for depression.
Researchers in Pittsburgh studying late life depression found that grief symptoms did not seem to respond to antidepressant medication and showed little response to interpersonal therapy, a treatment that is very effective for depression. This group showed that grief and depression symptoms could be differentiated and developed a questionnaire called the Inventory of Complicated Grief. This well-constructed scale allowed our group to reliably identify people with CG and to begin work to develop and test a treatment approach.
We began by observing that CG symptoms bear some resemblance to both depression and PTSD. Complicated grief treatment used a combination of elements of interpersonal therapy proven efficacious for depression and prolonged exposure used for PTSD. This approach showed promising results when first tested on a group of 21 individuals who responded with significant improvement in CG symptoms as well as anxiety and depression.
In 2000 we received NIMH funding to test CGT in a rigorous randomized controlled trial, the gold standard for establishing efficacy of a treatment intervention.
Ninety five adults with a mean age of about 45 participated in this study. They were randomly assigned (by chance) to receive 16 weekly sessions of CGT or standard interpersonal psychotherapy (IPT). Results showed that CGT was almost twice as effective as IPT.
We subsequently received another NIMH grant to replicate this study in older adults.
One hundred fifty one adults with a mean age of about 66 participated in this study. Results were similar with about 30% response rate to IPT compared to 70% with CGT.
A recently completed multi-site study provides further strong support for CGT efficacy.
Three hundred ninety five people with complicated grief were treated at one of four research sites in a study designed to determine the efficacy of an antidepressant with or without CGT.