Complicated Grief Therapy (CGT)

Complicated grief therapy (CGT). This treatment is a new treatment approach drawing from attachment theory and including techniques from cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and exposure therapy (Wetherell, 2012). The treatment 's objectives focus on two main areas; loss processing (the CBT element) and restoration of adaptive functioning (the IPT element) with the main components of treatment being: (1) establishing lay of the land, (2) promoting self-regulation, (3) building connections, (4) setting aspirational goals, (5) revisiting the world, (6) storytelling, and (7) using memory (M. K. Shear, 2015). Notably, a core element of CGT is imaginal revisiting where the bereaved tells their story of the loss of their

A key aim of CBT in treating complicated grief is to target dysfunctional thoughts and behaviours by focusing on reducing feelings of distress and suffering to enable the bereaved to move towards acceptance of the loss and revision of their future (Boelen, 2008). To accomplish this aim, negative cognitions need to be identified and changed, and avoidance behaviours need to be confronted (Boelen, de Keijser, van den Hout, & van den Bout, 2007). Similarly to CGT, imaginal revisiting is one technique CBT uses to confront the reality of the loss as well as to reduce anxious avoidance (Boelen, 2008). In addition, to address negative cognitions, cognitive restructuring is used in CBT to identify, challenge and alter unhelpful thoughts (Boelen, 2008). Socratic questioning, is a strategy of cognitive restructuring where the utility and validity of negative cognitions are addressed. To reduce avoidance behaviour in complicated grief, exposure therapy (ET) focuses on gradually exposing the bereaved to aspects of the loss (Boelen et al., 2007). Research proposes that avoiding reminders of the loss is a maintaining factor in CG therefore this may be resolved through confronting these reminders in ET which reduces the need to engage in avoidance behaviours (Boelen et al., 2007). This treatment is in contradiction to IPT yet consistent with CGT. Supportive counselling. This treatment is non-specific and unlike CBT does not address cognitions. The treatment encourages the bereaved to discuss emotional, social and daily living difficulties to reduce emotional burden and receive support (Boelen et al., 2007). In comparison to all treatments previously discussed, supportive counselling tends to be not structured, allowing the bereaved to control what areas of difficulties are to be