A pilot feasibility randomised controlled trial of an online cancer bereavement group

Background Bereavement following the death of a loved one from cancer presents unique challenges related to anticipatory stressors, caregiving demands, and the illness trajectory. Although online bereavement interventions may improve access to support, evidence for therapist-led online groups remains limited. This pilot randomised controlled trial evaluated the feasibility, acceptability and preliminary effectiveness of an online therapeutic group intervention for adults bereaved by cancer. Methods In this longitudinal pilot RCT, adults bereaved by cancer were randomised to receive the intervention immediately or following a three-month wait-list period. The intervention comprised eight online group sessions delivered over 12 weeks, integrating trauma-informed cognitive behavioural therapy, compassion-focused therapy and psychoeducation. Primary outcomes were feasibility and acceptability. Secondary outcomes included prolonged grief, depression, anxiety, post-traumatic stress, self-compassion, and social disconnection, assessed at baseline, post-intervention, and three-month follow-up. Results Of 124 randomised participants, 100 (80.6%) commenced the allocated intervention and 97 contributed sufficient data for primary analyses. The study met pre-specified feasibility and acceptability criteria, although patterns of attrition differed according to trial stage. Non-commencement following allocation was higher in the immediate intervention groups (27.0 vs 11.5%) whereas withdrawal after intervention commencement was higher in the waitlist group (24.1% vs 10.9%). Exploratory between-group analyses suggested greater improvements in prolonged grief (d = −1.87), post-traumatic stress (d = −1.55), depression (d = −1.03), anxiety (d = −0.71), and self-compassion (d = 1.15) in the immediate intervention group compared with waitlist controls. No statistically significant between-group difference was observed for social disconnection (d = −0.49). Conclusions Therapist-led online bereavement groups appear feasible and acceptable for adults bereaved by cancer and show promise for improving psychological outcomes. A fully powered RCT is warranted to establish efficacy.