Family-Focused Therapy May Stave Off Pathological Grief

Intervention best suited for sullen, intermediate functioning families of terminally ill patient

THURSDAY, July 27 (HealthDay News) -- Family-focused grief therapy that begins during the palliative care of terminally ill patients and continues into bereavement may prevent pathological grief, particularly among families with an intermediate level of functioning, according to a study in the July issue of the American Journal of Psychiatry. However, care is needed to prevent conflict in hostile families, the authors note.

David W. Kissane, M.D., of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues screened 257 families of patients dying from cancer using the Family Relationships Index. They found that 183 (71 percent) were at risk and 81 of those (44 percent) participated in the trial. Families were randomly assigned to family-focused grief therapy, which comprises up to 13 sessions, or a control condition.

Families that participated in the family-focused therapy showed a reduction in distress at 13 months. Individuals with high baseline scores on the Brief Symptom Inventory and Beck Depression Inventory showed significant improvements in distress and depression. And while depression was unchanged in hostile families, sullen families and those with intermediate functioning tended to improve overall. Intermediate families exhibit moderate cohesiveness, but are still prone to psychosocial morbidity.

"Families with a sullen or intermediate class of functioning are particularly suitable for preventive intervention with family-focused grief therapy, while members of hostile families may be better helped individually," the study authors conclude.

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