The Efficacy of Bereavement Interventions: A Systematic Umbrella Review.

Abstract

Learning objectives: After participating in this CME activity, the psychiatrist should be better able to:• Summarize findings from systematic reviews and meta-analyses on the efficacy of psychotherapeutic bereavement interventions.• Identify and apply key moderating factors (e.g., symptom severity, timing, age, gender) that influence intervention outcomes.• Analyze methodological limitations in the bereavement literature, including study design and review quality issues.

Abstract: In recent decades, there have been diverse reviews published on intervention program value for bereaved people. The variation and multiplicity of such reviews makes it difficult to obtain an overview of what is known about treatment effectiveness. In this systematic umbrella review, we explore the current knowledge base on psychotherapeutic bereavement intervention program efficacy. Thirty-three quantitative systematic reviews and/or meta-analyses published between January 2001 and October 2021 were included. Quality was assessed using the Assessment of Multiple Systematic Reviews criteria. Intervention efficacy was determined by rating overall conclusions into three categories according to strength of evidence: positive-unconditional, positive-conditional, and negative-no evidence. Our results indicate that bereavement interventions are generally helpful. Seven reviews indicated positive-unconditional support for bereavement interventions. Twenty-four reviews found positive-conditional support (i.e., some evidence of value, but efficacy did not apply in all circumstances or was constrained by database weaknesses or weak effects), and only two reviews indicated negative-no evidence for support. Notably, conclusions were generally limited by poor review quality and methodological concerns (e.g., lack of randomized controlled trials and follow-up studies). As such, we call for future empirical studies and review articles to abide by methodological quality standards. Furthermore, we recommend further study of the subgroup variables and intervention features that contribute to treatment efficacy.