A 12-month follow-up of a pilot randomized controlled trial examining co-designed unguided internet cognitive behavior therapy for grieving adolescents
Grief is a prevalent experience in adolescence. Outcomes were explored 6 and 12 months after unguided internet cognitive behavior therapy intervention for grieving adolescents (M = 17.04 years, SD = 1.04). The primary outcome was anxiety symptoms and secondary outcomes were well-beingand symptoms of depression, prolonged grief and posttraumatic stress disorder (PTSD). Of the 49 adolescents randomized at pre-intervention, 18% completed the 6-month follow-up and 27% completed the 12-month follow-up. Intent-to-treat analysis indicated no significant effects of time for the primary outcome of anxiety symptoms, or secondary outcomes of prolonged grief and PTSD symptoms. However, at 12-month follow-up, participants had significantly lower depressive symptoms and higher well-being compared to pre-intervention. Clinical significance analysis showed more participants recovered or improved, compared to those who deteriorated. The study was limited by high attrition, a small sample size and no control group. Future research should include larger samples over long follow-up periods.
Authors
- Chris Hall (ORCID: https://orcid.org/0000-0003-4758-8051)
- Sarah Jane Egan (ORCID: https://orcid.org/0000-0002-3715-4009)
- Maarten C. Eisma (ORCID: https://orcid.org/0000-0002-6109-2274)
- Elizabeth Bills (ORCID: https://orcid.org/0000-0003-3018-5192)
- Danyelle Greene (ORCID: https://orcid.org/0000-0001-9568-449X)
- Jennifer Wild (ORCID: https://orcid.org/0000-0001-5463-1711)
- Michael Duffy (ORCID: https://orcid.org/0000-0003-2194-2411)
- Amy O’Brien (ORCID: https://orcid.org/0000-0002-8615-9682)
- Paul A. Boelen (ORCID: https://orcid.org/0000-0003-4125-4739)
- Kirsten V. Smith (ORCID: https://orcid.org/0000-0002-6973-2846)
- Thomas Callaghan (ORCID: https://orcid.org/0000-0002-2186-3337)
- Lauren J. Breen (ORCID: https://orcid.org/0000-0002-0463-0363)
- David Trickey (ORCID: https://orcid.org/0000-0001-7836-5147)
- Shravan Raghav (ORCID: https://orcid.org/0009-0009-8610-230X)
- Sian Belinda Pauley-Gadd (ORCID: https://orcid.org/0009-0008-8865-1567)
- Nicholas C. Payne (ORCID: https://orcid.org/0009-0008-1804-1456)
- Hayden Wilson
- Bronwyn Myers
Institutions
- South African Medical Research Council (ZA)
- Queen's University Belfast (GB)
- University of Cape Town (ZA)
- The University of Queensland (AU)
- The University of Melbourne (AU)
- University of Groningen (NL)
- University of Phoenix (US)
- Murdoch University (AU)
- Utrecht University (NL)
- Curtin University (AU)
- University of Oxford (GB)
- Arq Psychotrauma Expert Group (NL)
- WA Country Health Service (AU)
- Relief International (US)
- Center for Independent Living (US)
- University College London (GB)
Publication Details
- Journal
- Death Studies
- Published
- 2026-07-22
- DOI
- https://doi.org/10.1080/07481187.2026.2704573
- Primary Topic
- Grief, Bereavement, and Mental Health
- Type
- article
- Field-Weighted Citation Impact
- 0.00