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Symposia

Trauma and Stressor Related Disorders and Disasters

Understanding and treating Prolonged Grief Disorder: From individual symptom profiles to system level integration of evidence-based treatment

4 - (SYM 49) Evaluation of the Implementation of a Prolonged Grief Therapy Pathway in a UK National Health Service Talking Therapies Treatment Service

Sunday, November 23, 2025
11:24 AM - 11:45 AM CST
Location: Celestin D&E, Level 3
Keywords: Grief / Bereavement, Transdiagnostic, Treatment
Recommended Readings: Rheingold, A. A., Williams, J. L., & Bottomley, J. S. (2024). Prevalence and co-occurrence of psychiatric conditions among bereaved adults. JAMA Network Open, 7(6), e2415325-e2415325.,   Spencer-Laitt, D., Curreri, A. J., Jaso, B. A., Cardona, N. D., Eustis, E. H., Barlow, D. H., & Farchione, T. J. (2024). Is prolonged grief disorder an emotional disorder?. Journal of Loss and Trauma, 29(2), 117-137.,   Goff S, Carson J, Ladwa A, et al. An evaluation of a pilot high-intensity treatment pathway for prolonged grief reactions in a Devon NHS Talking Therapies service. The Cognitive Behaviour Therapist. 2025;18:e10. doi:10.1017/S1754470X25000030,   ,  
Abstract Body


Background: Grief is a normal reaction to the loss of a loved one that does not routinely require intervention. However, for some grief will become stuck and develop into a prolonged grief reaction. Prolonged grief disorder therapy (PGDT) has been shown to effective at resolving stuck grief in a series of US based randomised controlled trials and is in use internationally.  The current study examines if PGDT can be implemented in a UK National Health Service (NHS) Context.

 



Methods: In the UK, psychological therapies are predominantly delivered in NHS Talking Therapy services (NHS-TT; formerly known as the Improving Access to Psychological Therapies Initiative), but these currently have no provision for grief. A pilot prolonged grief pathway was established in one NHS-TT service in Devon, UK, with experienced CBT therapists being trained to deliver PGDT and clinical outcomes being evaluated using standard NHS-TT anxiety, depression and functioning outcomes (supplemented with a grief outcome). A subset of clients and therapists took part in qualitative interviews regarding their perceptions and experiences of PGDT, analysed using the Framework Method.

 



Results: Between April 2022 and August 2024, 80 clients were treated using PGDT. There were statistically significant, large pre-post treatment effect size improvements across outcomes from intake to last treatment session (ps< .001; Cohen’s ds >1.05). Rates of reliable improvement and recovery were > 63% across outcomes. These findings exceed national NHS-TT targets and outperform the original RCTs of PGDT. Qualitative interviews were conducted with eleven clients and six therapists. PGDT was experienced as being acceptable by both clients and therapists, resulting in meaningful changes in wellbeing and functioning, and with perceived mechanisms of change aligning with the logic model of the intervention.

 



Conclusion: PGT can be implemented in routine NHS-TT settings and is an acceptable and effective treatment, suggesting this may be a promising treatment pathway to support grief in the UK NHS.