Doctor of Philosophy

dissertationThis randomized controlled trial evaluated the efficacy of complicated grief group therapy (CGGT) in the treatment of older adults meeting clinical criteria for complicated grief, as compared to a sample of older adults receiving modified grief support grouptreatment as usual (TAU). The CGGT intervention was an adaptation of complicated grief therapy administered as group therapy. A total of 39 participants were randomly assigned to conditions. Twenty-six participants completed the 16 week intervention; CGGT n = 12, TAU n = 14. Primary outcome measures included the Prolonged Grief Disorder Scale (PG-13), the Brief Grief Questionnaire (BGQ), and the Clinical Global Impressions Scale (CGI). Participants who received CGGT demonstrated higher treatment response than participants receiving TAU. While participants in both groups showed improvement in measures of complicated grief, participants in the CGGT group realized significantly greater improvement. More importantly, when complicated grief was measured on PG-13, nearly half of CGGT participants realized clinically significant improvement. On the BGQ , all 12 of the CGGT completers had scores upon follow-up that, had they scored at that level at pretest, would have disqualified them for study enrollment. This high level of clinical significance suggests that those in the CGGT group were effectively treated for complicated grief. This study offers evidence that CGGT holds promise for treatment of complicated grief in older adults and merits further inquiry in other populations

Effectiveness of Writing Groups in Nursing Homes

We examine the effect of participation in an 8-week writing group in six nursing homes. Pretest and posttest assessments of cognitive and affective functional status were administered to 62 participants and 54 control subjects. We asked writing-group participants about previous writing experience and perceived ability to convey feelings, ideas, life experiences, and memories to others. Weekly assessments were conducted on eight group process measures. Findings suggest that participation in writing groups may reduce depression, particularly among residents with higher cognitive ability and greater depression. Significantly more participants than control subjects report an ability to relate feelings and ideas to other residents and staff. Improvement in group process measures is greatest for cognitively impaired participants and those with high physical function scores. There is considerable improve ment in residents for whom writing-group participation frequently is considered inappropriate: those without writing experience, the depressed, and the cognitively impaired.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67030/2/10.1177_073346488900800308.pd