Web-Based Interactive Multimedia CBT Bereavement Support Program

DESCRIPTION (provided by applicant): Reactions to bereavement can be personally painful and typically interfere with social and occupational functioning. While most individuals eventually adapt to their loss, 10-20% of the bereaved experience significant reactions including major depressive symptoms similar to post traumatic stress disorder. Moreover, bereavement can precipitate other health problems. With 4 million employees experiencing the loss of a loved one each year, the cost of bereavement to American business is over 44.5 billion in increased health utilization, absenteeism, reduced productivity (presenteeism), and errors/accidents due to poor concentration. The teaching of cognitive-behavioral coping skills shows promise as a method to decrease distress and promote social/occupational functioning. The proposed Web-based CBT intervention will integrate and operationalize prevailing grief theories in a cost-effective, multimedia bereavement support program. It will incorporate proven adult education and e-Learning instructional design principles with behavioral change theory to support employees following the death of a loved one. Access will be delivered over the Internet as an adjunct service of Employee Assistance Providers (EAP) and EAP Call Centers. It will tailor the presented materials according to the user's grief context: expectedness of the death, the nature of the death (traumatic vs. natural), and whether the relationship to the deceased was that of parent or older relative, spouse, adult child, sibling, friend, or coworker. Learning and personal support will be enhanced with tailored video testimonials/stories, as well as multimedia presentation of content and self-assessment tracking tools. The finished program will offer interactive exercises and activities to teach cognitive-behavioral coping skills that focus on: (a) personal grieving styles; (b) normal reactions to grief; (c) physical self-care; (d) cognitive-behavior coping strategies; (e) rumination; (f) reconstruction of meaning; and (g) reconstruction of identity without the deceased. In addition, the program will include modules to address specific needs and support of: (a) Human Resources Managers; (b) supervisors of bereaved employees; and (c) EAP and Call Center Counselors. The Phase I prototype program showed significant effects in a randomized trial on the Internet. The Phase II product will be developed for Internet or Intranet application accessible via standard web browsers and will be evaluated with a large randomized trial. PUBLIC HEALTH RELEVANCE: Reactions to bereavement can be personally painful and typically interfere with social and occupational functioning. While most individuals eventually adapt to their loss, 10-20% of the bereaved experience significant reactions including major depressive symptoms similar to post traumatic stress disorder. Moreover, bereavement can precipitate other health problems. With 4 million employees experiencing the loss of a loved one each year, the cost of bereavement to American business is over 44.5 billion in increased health utilization, absenteeism, reduced productivity (presenteeism) and errors/accidents due to poor concentration.