Supporting kids in loss: A randomised controlled trial of a co-produced unguided internet cognitive behaviour therapy intervention for grieving children

Bereavement is a common experience in childhood. Unguided internet cognitive behaviour therapy (CBT) was tested in a sample of 96 grieving children aged 6–12 years ( M = 8.51, SD = 3.62). The intervention was intended for use by children who had experienced either bereavement or non-bereavement loss. Children were not required to have an elevated level of prolonged grief to enter the trial. The primary outcome of anxiety and secondary outcomes of well-being, and symptoms of depression, posttraumatic stress disorder (PTSD), and prolonged grief were examined at pre- and post-intervention and one month follow-up compared to waitlist control. There were no significant changes in primary or secondary outcomes; however, treatment completion was low, with 33.33% of children reporting use of the intervention. Clinical significance analysis indicated significantly more intervention participants improved on prolonged grief symptoms compared to control. However, given low uptake, results for clinical significance on prolonged grief symptoms are preliminary and should be viewed with caution. Qualitative findings indicated numerous components children and parents/caregivers liked but also suggested areas to modify and barriers to engagement. Future research should improve intervention uptake and efficacy. Trial Registration: The trial was prospectively registered with ISRCTN on 21 March 2025 ( www.isrctn.com/ISRCTN12771259 ).