CGGT in bereaved caregivers
|Principal Investigator: KatherineSupiano|
|Keywords: Complicated grief , dementia care giving , Group Counseling||Department: COLLEGE OF NURSING|
|IRB Number: 00071400||Co Investigator:|
|Specialty: Nurse Practitioner, Social Work, Psychology, Counseling|
Specific Aim 1: Evaluate the impact of complicated grief group therapy (CGGT) on clinical outcomes of bereaved dementia caregivers experiencing complicated grief (CG), using a randomized controlled attention wait-list design.
Hypothesis: Bereaved dementia caregivers with CG who complete CGGT will demonstrate significantly greater reduction in CG as measured by the Inventory of Complicated Grief (ICG6) and the Brief Grief Questionnaire (BGQ4), and will demonstrate cumulative weekly improvement as measured by the Clinical Global Impression Scale (CGI7), in comparison to participants in the attention wait-list control group.
Specific Aim 2: Identify and interpret individual participant change in complicated grief (CG Δ) by describing individual treatment responses on weekly basis (Aim 2a - Description Aim), determining relationship between facilitator-reported change and participant CG Δ (Aim 2b - Explanation Aim), and determining sensitivity of facilitator-reported change as predictor (Aim 2c - Prediction Aim).
Hypothesis A: Treatment response to CGGT will vary by individual depending on pre-death risk factors & individual symptom profile.
Hypothesis B: Facilitators anticipate, discern and report change in grief in advance of participant report of CG Δ.
Hypothesis C: Facilitator reported change is a sensitive, leading indicator of participant CG Δ.
Participants: Study participants will be caregivers of significant family member/friend diagnosed with dementia who died more than 6 months prior to recruitment. Interested individuals who meet diagnostic criteria (minimum score of 5 on a screening BGQ, and minimum score of 30 on ICG) will be mailed the approved Informed Consent document. All interested qualifying participants will receive CGGT. Participants who return the completed consent document will be randomly assigned to the wait-list attention-control group or the experimental treatment group. Randomization will be accomplished using randomization software in blocks of 4 with assignments made by blinded study personnel. Participation will be voluntary. Participants who withdraw will be offered alternative care, if desired. Intent-to-treat analyses will be performed on non-completers who will be contacted by evaluators to determine reasons for withdrawal and will be administered a terminal ICG, BGQ, and facilitator assessed CGI. One treatment element of CGGT requires the inclusion of a supportive family member or friend for each participant into the treatment group on two occasions. Supportive others, as selected by group participants, will complete a separate Informed Consent document. Please note: number of participants is 60 group participants and 60 supportive others.
The following factors will exclude interested individuals from participating: active suicidality (likely hospitalization), active substance abuse, current or past psychosis, uncontrolled medical illness, or pending lawsuit related to the death.