Integrated Multimedia CBT Bereavement Support

DESCRIPTION (provided by applicant): It is considered "normal" for an individual grieving the death of a loved one to present with symptoms of depression during the first two months post loss. Nevertheless, these manifestations of bereavement are painful and disrupt social-occupational functioning and quality of life. Moreover, while most will adapt over time, 10-20% are likely to evolve into "complicated grief which can include a major depressive episode or symptoms similar to post traumatic stress disorder. 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. Researchers cite five prevailing theories of grief/bereavement: attachment theory, cognitive stress theory, meaning reconstruction, the dual process model of grief and the social-functioning perspective. We propose to integrate and operationalize these theories in a cost-effective, multimedia bereavement support program that uses interactive video to teach cognitive-behavioral coping skills. The program will be delivered over the Internet as an adjunct service of Employee Assistance Provider Call Centers. Phase I will focus on skills pertaining to rumination, sleep disturbance, transformation of the bond/attachment and reconstruction of a new identity/life separate from the deceased. It will be tailored for employees who have lost a parent or older relative to expected, natural causes. Evaluation will include a randomized control trial with 80 employees. Phase II will be expanded to tailor to the needs of bereaved employees based on the 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, child, friend, sibling, or coworker. It will also be evaluated with a randomized control trial, however from a much larger sample of 400+ bereaved employees.