Integrative Cognitive-Behavioral Therapy for Prolonged Grief Disorder: Introduction of a Treatment Manual

This paper introduces the integrative cognitive-behavioral treatment manual for prolonged grief disorder. This outpatient treatment manual is suited for persons who suffer from severe, disabling, and persistent grief reactions for more than 6 months after the loss of a loved person. The treatment aims at resolving grief complications and adjusting to the environment without the deceased. Cognitive-behavioral treatment strategies are combined with systemic and gestalt therapy techniques. 20 weekly sessions are divided into 3 phases. The first phase concentrates on stabilizing and motivating. The second phase allows for different foci: feelings of guilt, adjustment to new living conditions, attachment to the deceased, or avoidance. Employed techniques are prolonged exposure, cognitive restructuring, and empty-chair work. In vivo exposition is applied if necessary. The third phase focuses on future prospects while maintaining a healthy bond to the deceased, and relapse prevention. Up to 5 optional sessions directed toward special or critical situations (e.g., anniversaries) can be added. Altogether, the manual facilitates a customizable and effective treatment of prolonged grief disorder.