Course in Complicated Grief Treatment (CGT)
Complicated grief affects 7 percent of people who have lost a significant other. The prevalence is much higher among parents who have lost a child, as well as when the cause of death is sudden and violent. There is insufficient knowledge about and capacity for practicing treatment tailored to complicated grief conditions. For one, this is a problem for the many people bereaved by suicide.
NSSF offers CGT training as part of the work to improve the forms of treatment available to the bereaved experiencing complicated grief.
Complicated Grief Treatment (CGT) was developed by Dr. Katherine Shear, professor of psychiatry at Columbia University in New York, where Dr. Shear is also the leader of the Center for Complicated Grief. In Norway, the National Centre for Suicide Research and Prevention (NSSF) has established a close collaboration with Dr. Shear and her colleagues, and there are already two classes of trained CGT therapists in Norway.
What is Complicated Grief?
It is normal to experience sudden grief after the loss of someone close, but complicated grief is different. Complicated grief is an intense and long-term type of grief that does not decrease with time, and that affects the bereaved’s thoughts and behavior in such a way that it significantly reduces his or her quality of life and level of functioning.
The word “complicated” refers to aspects of the grief that interfere with the natural healing process. These factors can be tied to:
- the bereaved
- what type of relationship the bereaved had to the deceased
- the circumstances of the death
- things happening after the death
People with complicated grief have trouble facing the loss they have suffered as well as regaining a normal life with meaning.
Recognizing Complicated Grief
If a person has more than three of the following symptoms for more than six months after a person’s death, he or she may be suffering from complicated grief:
- a strong feeling of longing after the deceased
- an intense feeling of loneliness, even while in the company of others
- a strong feeling of anger or bitterness related to the death
- feeling that life is meaningless or empty without the deceased
- thinking about the deceased so much that it interferes with actions or relationships
- a strong sense of disbelief about the death or serious trouble accepting the death
- feeling shocked, paralyzed, drowsy, or emotionally numb
- difficulties trying to care about or trust others
- feeling very emotionally or physically active when confronted with the loss
- avoiding people, places, or things that may evoke a memory of the deceased
- a strong urge to look at, touch, listen to or smell things to feel close to the deceased
Complicated Grief Treatment
Complicated Grief Treatment (CGT) is based on attachment theory in order to understand grief as a natural process that develops normally unless hindered by so-called complicating factors. This process entails reconciling oneself with the irrevocable from the loss and its consequences, at the same time as life goals and plans are redefined. The treatment is typically delivered in 16 sessions over the course of 4 months. The treatment focuses on:
- information about grief, complicated grief, and CGT
- use of daily monitoring of grief intensity
- involvement of a significant other
- strengthening interpersonal functioning
- working on personal goals and self-care
- systematic exposure to the loss as well as places and activities that are avoided
- working with memories
The treatment is successful when psychological impediments to the grief process are identified and cleared away so that normal healing can continue and symptoms gradually diminish. The treatment is developed for adults, but it can also be used for adolescents.
Prof. dr.med. Lars Mehlum, NSSF, UiO
Prof. dr. Kathrine Shear, Columbia University, NY
Prof. dr.med. Lars Mehlum, NSSF, UiO
For more information, please contact Ina Bekkevold-Jernberg, phone: (+47) 977 94 824