Emotion-focused therapy in the treatment of prolonged grief disorder: study protocol for a randomized controlled trial

Abstract Background Prolonged grief disorder (PGD) impacts various dimensions of the bereaved person’s life, such as psychological, social, and/or health domains. Psychological interventions, particularly those beyond the cognitive-behavioral approach, are essential to address these difficulties. This is especially relevant given that not all interventions are effective for all bereaved individuals, leaving a subset of people without adequate help. Emotion-Focused therapy (EFT) offers a promising alternative to support individuals suffering from PGD. Methods/design This protocol describes a two-arm randomized controlled trial designed to evaluate the efficacy of EFT compared to a self-help control group for grief complications. The study will recruit 128 adults who meet eligibility criteria through the Clinical Psychology Unit of Pontifical Comillas University (UNINPSI) and the university’s networks. Participants will be randomly assigned to one of the two conditions. The EFT condition will include between eight and ten face-to-face weekly sessions. The self-help control group will consist of ten sessions of a self-help intervention based on EFT. Grief symptoms, anxiety, depression, trauma, and psychological distress will be measured using validated instruments (e.g., PG-13-R or CORE-10) before the intervention, during (at 3 weeks after the start), at the end of the intervention (at 12 weeks after the start, post-treatment), at 5 months, and at 12 months after the beginning of the intervention as follow-up assessments. In addition, grief and psychological distress will be assessed in all sessions (using the PG-13-R and CORE-10), and the therapeutic alliance will be measured in sessions 3 and 8 (using the WAI-S). A pilot study will precede the trial in order to adjust procedures and ensure adherence to the assessment protocol. Discussion This study aims to establish the feasibility and comparative efficacy of EFT versus the self-help control group for PGD, hypothesizing that the EFT condition will demonstrate superior effectiveness at the different assessment points. The findings will expand the evidence base on therapeutic approaches to effectively support individuals with PGD. Trial registrations ClinicalTrials.gov NCT07207512. Registered on 3 October 2025.