Prolonged Grief Treatment
What is PGT?
Prolonged Grief Treatment (PGT) is a treatment specifically designed to help people who feel stuck in their grief. The treatment has a specified time frame and targets 6 Healing Milestones. Therapists trained to do this treatment are skilled in meeting grievers where they are and helping them learn ways to accept their new reality and restore their wellbeing through gentle guidance. The therapy includes sharing and discussing information about grief and adapting to loss and the use of a series of activities that promote experiential learning along as well.
The Evidence-Base for PGT
The efficacy of PGT was tested in 3 carefully conducted research studies funded by the National Institute of Mental Health. One was focused on older adults and the other two on adults of any age. Since Prolonged Grief is most often confused with depression, we compared PGT to well established efficacious treatment for depression. More specifically, two of the studies compared PGT to Interpersonal Psychotherapy (IPT) for Depression, and one evaluated whether antidepressant medication was effective for grief when administered by a grief-informed physician and also whether it improved the outcome of PGT. Here’s what we found:
- PGT was twice as effective as IPT in reducing grief intensity and the degree to which the loss disrupts a person’s life
- Antidepressant medication had no effect on grief symptoms; however, the addition of medication did help reduce co-occurring depressive symptoms when present
- Rates of suicidal ideation diminished to a substantially greater extent among participants receiving PGT than among those who did not
You helped me to crawl through my memories good and bad. You helped me to give voice to my fears and to face them. Weeks and weeks of self-examination showed me that I was still strong, still valuable and still loved. My pain began to de-escalate. I saw a pattern— he was gone, but I am not. You taught me to value myself for who I am and not who I was. I was standing. When I fell hard you never let go of my hand pulling me to my feet once again. Your concern, your support and your guidance made me stronger. Made me truly believe I have value. I see myself now quite differently. I am a mother, a grandmother, a daughter and a friend. And I’m good at it. I can bring happiness, joy and help to others. And I can now accept it in return. I’m learning to make new memories. I am learning to laugh again. And now I’m walking…
- A Letter from a Client to their PGT Therapist
How it's different from other therapy
People with PG often know they are stuck in their grief and seek help from a therapist. Grief therapy is often helpful but usually insufficient to get their lives back on track. Good supportive therapy with an empathic mental health therapist is similarly helpful but insufficient. Efficacious treatments for depression or PTSD can be helpful if these conditions are present with Prolonged Grief, but again, are not very effective in addressing grief.
What this means is that when a person with PG reaches out to a trained professional, they are often disappointed with the results. Over time, they begin to feel discouraged, helpless, and confused. Their experience reinforces the idea that the only thing that can help is for their loved one to be alive. They become resigned to their situation and to the idea they can never feel better. PGT is different and it can make a big difference in the lives of people with PG. Some of the things that make it unique include that it’s,
Short-term
(~ 16 sessions) with a clear focus and goals
Twice as effective
as gold standard treatment for depression
Integrative
utilizing strategies and techniques from a range of different therapeutic practices to meet grievers where they are and offer an impactful learning experience
Informed by research on efficacious treatments
for related conditions of mood, anxiety, trauma, substance use and personality disorders; strategies derived from Interpersonal Therapy, Cognitive Behavioral Therapy, Psychodynamic Psychotherapy, Motivational Interviewing and DBT
Well-specified
with principles and corresponding procedures introduced sequentially to invigorate the dual processes of adapting to the loss and addressing derailers (stuck points)
Evidence-based
it’s the most extensively and rigorously tested treatment currently available to help people with PGD
Informed by foundational theories and research
on the science of loss and grief as well as a lot of other science – for example, the give and take of close relationships, reactions to experiencing an unwanted event, what people need in order to thrive in their lives, and how implicit and explicit mental processes are used in feelings and thoughts and in coping and adapting