AUTHOR=Wagner Birgit , Rosenberg Nicole , Hofmann Laura , Maass Ulrike 

TITLE=Web-Based Bereavement Care: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Psychiatry

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.00525

DOI=10.3389/fpsyt.2020.00525

ISSN=1664-0640

ABSTRACT=<sec><title>Background</title><p>Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a systematic summary of the effectiveness of online interventions for people experiencing bereavement is still missing.</p></sec><sec><title>Objective</title><p>A systematic literature search was conducted by four reviewers who reviewed and meta-analytically summarized the evidence for web-based interventions for bereaved people.</p></sec><sec><title>Methods</title><p>Systematic searches (PubMed, Web of Science, PsycInfo, PsycArticles, Medline, and CINAHL) resulted in seven randomized controlled trials (<italic>N</italic> = 1,257) that addressed adults having experienced bereavement using internet-based interventions. We used random effects models to summarize treatment effects for between-group comparisons (treatment <italic>vs.</italic> control at post) and stability over time (post <italic>vs.</italic> follow-up).</p></sec><sec><title>Results</title><p>All web-based interventions were based on cognitive behavioral therapy (CBT). In comparison with control groups, the interventions showed moderate (<italic>g</italic> = .54) to large effects (<italic>g</italic> = .86) for symptoms of grief and posttraumatic stress disorder (PTSD), respectively. The effect for depression was small (<italic>g</italic> = .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for grief symptoms and more individual feedback increased effects for depression. Other moderators (<italic>i.e.</italic> dropout rate, time since loss, exposure) did not significantly reduce moderate degrees of heterogeneity between the studies.</p></sec><sec><title>Limitations</title><p>The number of includable studies was low in this review resulting to lower power for moderator analyses in particular.</p></sec><sec><title>Conclusions</title><p>Overall, the results of web-based bereavement interventions are promising, and its low-threshold approach might reduce barriers to bereavement care. Nonetheless, future research should further examine potential moderators and specific treatment components (<italic>e.g.</italic> exposure, feedback) and compare interventions with active controls.</p></sec>