Training In CBT & Other Evidence-Based Psychological Therapies
Introduction
There is increasing recognition that individuals suffering from prolonged grief reactions can benefit from psychological therapy to help them resolve the loss and reconnect to wellbeing. One evidence-based therapy shown to be effective in randomized controlled trials is Prolonged Grief Disorder Therapy (PGDT). Developed by Kathy Shear at The Center for Prolonged Grief Disorder at Columbia University, this 16-session model targets grief symptoms directly and was developed in tandem with the validation of the prolonged grief disorder (PGD) diagnosis. A recent implementation pilot in a UK NHS Talking Therapies context has shown PGDT can effectively treat PGD alongside comorbid depression, anxiety and/or PTSD (Goff et al., submitted).
The event will be equivalent to 2.3/4 hrs of CPD.
Content
This workshop will provide an overview of prolonged grief disorder, including prevalence, comorbidities and prognosis. The workshop will then consider how to assess a grief reaction and determine if intervention is warranted. The PGDT model and the range of interventions offered within the therapy will be introduced, including grief monitoring, imaginal revisiting, situational revisiting and an imaginal conversation with memories work. Attendees will develop an understanding of the interventions, the dual process model of loss, and how the therapy is informed by attachment and self-determination theories. Attendees will also gain an insight into how the treatment model aims to help individuals accept the loss and foster continuing bonds with the deceased. Through memories work, reconnecting with rewarding activities, and returning to core values, individuals can find wellbeing in a world changed by loss. This is achieved by combining elements of CBT, interpersonal therapy (IPT) and motivational interviewing. Ways to integrate a training and supervision pathway for PGDT will be briefly explored.
Learning Objectives
• To become familiar with Prolonged Grief Disorder (PGD) as a diagnostic construct
• To develop an awareness of the evidence base for PGDT
• To consider when PGDT is clinically indicated (in the context of co-existing conditions)
• To gain insight into using Prolonged Grief Disorder Therapy (PGDT) to treat PGD
Training Modalities
Didactic content, demonstrations, discussions and Q&A
Key References
Goff, S., Carson, J., Ladwa, A., Colletta, M., Topicu, R., Shear, K., & Dunn, B. D. (2024). An evaluation of a pilot high intensity treatment pathway for prolonged grief reactions in a Devon NHS Talking Therapies Service. (Submitted for publication)
Kobak, K., Shear M. K., Skritskaya N. A., Bloom C., & Bottex G. (2023). A Web-Based Therapist Training Tutorial on Prolonged Grief Disorder Therapy: Pre-Post Assessment Study. JMIR Medical Education, 9, e44246. https://doi.org/10.2196/44246
Lundorff, M., Holmgren, H., Zachariae, R., Faver-Vestergaard, I., & O’Connor, M. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders, 212, 138-149. https://doi.org/10.1016/j.jad.2017.01.03
Shear, M. K., Muldberg, S., & Periyakoil, V. (2017). Supporting patients who are bereaved. British Medical Journal, 358:j2854. https://doi.org/10.1136/bmj.j2854
Shear, M. K., Skritskaya, N., & Bloom, C. (2022). Prolonged grief disorder therapy (PGDT). In U. Schnyder & M. Cloitre (Eds.), Evidence based treatments for trauma-related psychological disorders: A practical guide for clinicians (2nd ed., pp. 329–344). Springer Nature Switzerland AG.
Stroebe, M. & Schut, H. (1999). The dual process model of coping with bereavement: rationale and description. Death Studies, 23(3), 197-224. https://doi.org/10.1080/074811899201046
About the presenter
Sarah Goff
Sarah is a professional lead in an NHS-Talking Therapies Service in Devon and is a BABCP accredited CBT practitioner and supervisor. Sarah has worked in adult mental health services, across a range of settings for 31 years, practicing CBT for over 25 years. Sarah has an interest in working with grief and has introduced a clinical pathway into the Devon NHS Talking Therapies - service, offering PGDT as part of routine care within the service. A recent service evaluation has evaluated clinical outcomes for patients who have been offered PGDT (in press).
Megan Colletta
Megan is a clinical research therapist at the University of Exeter Mood Disorder Centre and psychotherapist in private practice. She received her MSW from the University of California, Berkeley in Community Mental Health in 2008, training in integrative psychotherapy, and specialized in CBT for complex PTSD at the Department of Veteran's Affairs. Megan has a passion for providing integrative, evidence-based therapy and was trained in Prolonged Grief Disorder therapy by the team at Columbia University and later provided supervision within the Devon NHS TT service in an initial pilot trial.
Barney Dunn
Barney is a Professor of clinical psychology at the University of Exeter, with an interest in developing and evaluating novel treatments for mental health conditions for use in primary care and secondary care settings. He has been involved in evaluating the pilot implementation of PGDT in Devon NHS-TT settings and written guidance on how to support bereavement during the covid pandemic.
Who should attend
This workshop is suitable for clinicians working with adults presenting with stuck or persistent grief across a range of settings. It will assume basic familiarity with high intensity therapy approaches used in NHS-TT settings, for example, CBT.