Grief & Loss
Prolonged Grief Disorder (DSM-5-TR, new in TR)
Normal and complicated grief following bereavement, other losses, or life transitions. Prolonged grief disorder is now a DSM-5-TR diagnosis. Most grief does not require clinical intervention; therapy indicated when grief becomes prolonged or debilitating.
Prevalence: ~10% of bereaved adults develop prolonged grief (Lundorff et al., 2017, pooled across 14 studies); higher after violent or sudden loss
Clinical Picture
Grief is not a disorder; it's the natural human response to loss. Most grief does not require clinical treatment; it requires time, community, and the willingness to feel what needs to be felt. Therapy becomes relevant when grief is complicated: when it becomes prolonged, when it's disenfranchised (not recognized by others), when it intersects with trauma (as in sudden or violent loss), or when pre-existing attachment patterns make the loss unbearable. The DSM-5-TR's addition of Prolonged Grief Disorder as a diagnosis has been controversial, with some arguing it pathologizes normal suffering.
Treatment Considerations
Prolonged Grief Disorder Treatment (Shear), published and trialed under its original name Complicated Grief Treatment, has the strongest evidence for prolonged grief disorder. Psychodynamic approaches attend to the internal relationship with the lost person and the meaning-making process. Existential approaches sit with grief as a confrontation with mortality, finitude, and meaning. Narrative approaches help the bereaved revision their relationship with the deceased without relinquishing the bond. For traumatic bereavement (suicide, homicide, accident), trauma-processing may need to precede or accompany grief work. Grief groups can provide normalization and community that individual therapy cannot.
Approaches and Evidence
Of 20 associated approaches, 1 have completed assessments for this topic, 0 have source checks awaiting assessment, and 19 have neither recorded yet. Each completed assessment states its population and rationale; source checks alone do not establish effectiveness. These categories describe different findings and review stages; they are not a ranking of treatments. 2 frameworks are shown separately.
Randomized studies (1)
These assessments describe randomized studies in the stated population. Randomized studies may include pilot or null findings; this label alone does not establish benefit.
Prolonged Grief Disorder Treatment
M. Katherine Shear · 2005
Reviewed population: Bereaved adults aged 18–95 with clinically primary complicated grief in the 2016 trial; 16-session CGT added to placebo plus structured clinical management.
Shear et al. (2016) randomized 395 adults to citalopram or placebo, with or without CGT. At 20 weeks, CGT plus placebo improved grief-response rates compared with placebo plus clinical management. Adding citalopram did not significantly improve the grief-response outcome, although depressive symptoms improved. This was not an IPT comparison. Missing assessments remained a limitation despite statistical adjustment; the sample was predominantly White, female and well educated. The historical complicated-grief criteria are not identical to current PGD criteria. Findings do not grade routine early bereavement, every grief therapy or suicide prevention.
Reviewed
Guidelines and official sources (1)
1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Prolonged Grief Disorder: patient and family information
Discussed in the source
The association discusses prolonged-grief therapy in patient information. This is distinct from a clinical practice guideline, and DSM recognition of the diagnosis is not treatment endorsement.
Scope: Information about prolonged grief disorder and treatment approaches.
Assessment not yet completed (19)
No completed assessment or source check for this topic is recorded yet.
Accelerated Resolution Therapy
Laney Rosenzweig · 2008
Adaptive Disclosure
Brett Litz & colleagues · 2017
Advanced Integrative Therapy
Asha Clinton · 2002
Analytical Psychology
Carl Jung · 1913
Art Therapy
Naumburg / Kramer · 1940
Eye Movement Desensitization and Reprocessing
Francine Shapiro · 1989
Existential Psychotherapy
Rollo May / Irvin Yalom · 1958
Gestalt Therapy
Fritz & Laura Perls · 1951
Interpersonal Psychotherapy
Klerman / Weissman · 1984
Life Review Therapy
Robert Butler · 1963
Logotherapy
Viktor Frankl · 1946
Music Therapy
Nordoff / Robbins · 1950
Person-Centered Therapy
Carl Rogers · 1951
Play Therapy
Virginia Axline · 1947
Process Group Therapy
Irvin Yalom · 1970
Sandtray Therapy
Dora Kalff (Jungian) / Various · 1956
Supportive Psychotherapy
Various (Rockland, Winston) · 1950
Trauma-Focused Cognitive Behavioral Therapy
Cohen / Mannarino / Deblinger · 2006
Transpersonal Psychology
Abraham Maslow / Stanislav Grof · 1969
Associated Frameworks (2)
These are conceptual or research frameworks. They are not ranked as treatment evidence.
Dual Process Model of Grief
Margaret Stroebe & Henk Schut · 1999
Worden's Task Model of Mourning
J. William Worden · 1982
Cases Featuring Associated Approaches
These teaching cases share approach links with this topic. They may illustrate a different presenting concern.
Reading This Page
Why are these approaches listed with Grief & Loss?
The catalogue associates 20 approaches and 2 frameworks with this topic. These links support learning and comparison; association alone is not a treatment recommendation or evidence of effectiveness.
How should I read the evidence assessments?
Assessments are specific to the population and scope stated on each card. They include a rationale, source links, and a review date. An overall review of an approach does not automatically apply to this condition, and a randomized-study label does not by itself mean that a study found benefit.
What does "Assessment not yet completed" mean?
A condition-specific assessment has not been recorded. Approaches with checked sources appear in a separate assessment-pending group; a checked source can support, oppose, or discuss an intervention without recommending it. Neither pending group means that no research exists or that the approach is ineffective. Frameworks are shown separately.
Sources and Review Scope
Source links and dates on assessment cards apply to the stated population and rationale. The clinical overview and prevalence text above are separate authored content; an approach's evidence label does not verify those statements. Recorded narrative notes and citations remain available on individual modality pages, with their review status identified. The bibliography provides further reading.