Family-Focused Therapy Continued Into Bereavement Benefits High-Risk Families

Key Points

  • Family-focused grief therapy reduced the severity of complicated grief among high-risk families of dying cancer patients.
  • Prolonged grief disorder was less frequent in individuals receiving 10 sessions of therapy.

Family-focused grief therapy continued into bereavement reduced the severity of complicated grief and the risk of prolonged grief disorder among high-risk families of dying cancer patients, according to a report by Kissane et in the Journal of Clinical Oncology.

Study Details

In the trial, families of patients with advanced cancer at Memorial Sloan Kettering Cancer Center or three related community hospice programs were screened using the Family Relationships Index to identify risk from dysfunctional relationships. A total of 170 eligible families, including 620 persons, were stratified by levels of family dysfunction consisting of low-communication, low-involvement, and high-conflict categories and were randomized to receive standard care (55 families, 187 individuals) or 6 (59 families, 213 individuals) or 10 sessions (56 families, 220 individuals) of manualized family-focused grief therapy.

Family members had follow-up at 6 and 13 months of bereavement. Primary outcomes were results of the Complicated Grief Inventory-Abbreviated (CGI) and the Beck Depression Inventory II (BDI).

Outcomes

Results on the CGI showed a significant treatment effect (P = .032) and a treatment by family-type interaction (P < .001). Post hoc analysis showed that the results were explained by better outcome in the 10-session vs standard-care groups for low-communication families vs low-involvement families (adjusted P < .001) and for high-conflict families vs low-involvement families (adjusted P = .039).

Additional analysis showed better outcomes for 10 sessions vs standard care for low-communication families at 6 months (adjusted P = .0104) and 13 months (adjusted P = .017). A similar pattern was observed for high-conflict families, although the differences were not statistically significant. Results on the BDI indicated no significant treatment effect of treatment by family-type interaction.

Overall, a prolonged grief disorder was identified at 13 months in 15.5% of individuals in the standard-care group vs 3.3% of the 10-session group (P = .048).

The investigators concluded: “Family-focused therapy delivered to high-risk families during palliative care and continued into bereavement reduced the severity of complicated grief and the development of prolonged grief disorder.”

The study was supported by the National Cancer Institute.

David W. Kissane, MD, of Monash University, Victoria, Australia, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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