Cognitive therapy may be more effective than grief counseling

Strong feelings of grief are normal and healthy after the death of someone you love but recent research from UNSW suggests that some people grieve for so long that it becomes a significant mental illness.

Estimates are that between 10 and 15 per cent of bereaved people experience an intense, prolonged sadness arising from longing or yearning for the deceased - so much so that their overall health is impaired, they withdraw socially, become depressed and even suicidal. As well, there's growing recognition that traditional grief counseling may not help.

However, other recent findings suggest that such people can recover with Cognitive Behavior Therapy, an approach already shown to be more effective than medication for a range of psychological problems, including anxiety and traumatic stress.

Now a team of Auystralian researchers and counselors is conducting further studies to evaluate the treatment more fully.

"In recent years there has been new interest in the finding that losing a loved one by death can cause real mental health problems," says Professor Richard Bryant, an expert in grief and trauma at the University of New South Wales School of Psychology. "For decades, people have suggested that grieving for the loss of a loved one is a normal human experience that everyone recovers from. Many grief counsellors have resisted the claim that loss can create significant psychological problems."

"Most people initially experience intense sadness that arises from longing or yearning for the deceased but if these reactions persist six months after the death their grief can become complicated or stalled, preventing them from moving on with their lives. There's already considerable evidence that people with this disorder suffer marked impairment beyond the effects of depression or other disorders that have often been used to describe this condition."

The idea that grief can lead to mental illness is controversial in medical and counseling circles, with vigorous and emotive debate arising from a proposal to formally classify the condition in forthcoming revisions of diagnostic manuals as a psychiatric disorder in its own right, known as prolonged grief disorder. "Many grief counselors resist the idea that we can 'medicalize' grief reactions in this way," Bryant says. "The debate has been intensified by increasing evidence that grief counseling is often not effective. In contrast, the introduction of strictly defined disorder opens new opportunities to treat people suffering the effects of prolonged grief."