In the treatment of disturbed grief (prolonged grief disorder, persistent complex
bereavement disorder), online interventions are at least as useful as face-to-face
interventions
Bos, H (6167055)
Loss and Psychotrauma (201500816)
Word count: 1211
, People with disturbed grief, such as prolonged grief disorder (PGD) and persistent complex
bereavement disorder (PCBD), experience grief reactions that are notably dysfunctional,
persistence and pervasive, following a loss (Boelen & Smid, 2017; Lundorff et al., 2017). An
effective treatment for disturbed grief is cognitive behavior therapy (CBT), including
components of exposure, cognitive restructuring and graded activation. Typically, CBT is
given as a face-to-face treatment (Boelen et al., 2021). However, in recent years, online
interventions have been introduced as effective treatments for bereaved people (Wagner et al.,
2020). There are different settings of online interventions (Kaiser et al., 2021), which range
from therapist-guided to unguided interventions (Eisma et al., 2015). Furthermore, they have
a number of advantages that overcome certain obstacles to receiving help in face-to-face
interventions (Wagner et al., 2020). Therefore, in the treatment of disturbed grief, online
interventions may at least be as useful as face-to-face interventions.
The first advantage of an online intervention for disturbed grief is the anonymity it can
offer. Public stigma towards mental illness is associated with reduced help seeking behavior
and disruption of mental health treatment (Eisma, 2018). Public stigma is defined as a large
social group undergoing labelling and negative stereotypes about and against a stigmatized
group (Eisma et al., 2019; Eisma, 2018). People experiencing severe loss-related distress have
a higher perception of stigmatizing reactions (Eisma, 2018). Perceived stigma is related to a
negative attitude towards help seeking and seeking formal care, because of fear of negative
reactions and discrimination (Pattyn et al., 2014). A meta-analysis of Clark-Gordon et al.
(2019) showed a positive relationship between self-disclosure and anonymity. Bereaved
people may feel less ashamed or vulnerable in online treatment when disclosing their
emotions and thoughts (Lenferink et al., 2020). Therefore, an online intervention for disturbed
grief that is relatively anonymous, can overcome feelings of stigma and shame, and
encourages bereaved people to seek treatment (Wagner et al., 2020).
