Accelerated Resolution Therapy for Early Maladaptive Grief: A Clinical Trial

早期适应不良悲伤的加速解决疗法：临床试验

基本信息

批准号：
10578937
负责人：
Cindy Tofthagen
金额：
$ 67.28万
依托单位：
MAYO CLINIC JACKSONVILLE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-15 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10578937
关键词：
Acceleration Acute Address Aging Assessment tool Attention Bereavement Caregiver Burden Caregivers Cessation of life Characteristics Chronic Disease Chronic stress Clinical Trials Cognitive Data Data Collection Distress Double-Blind Method Early Intervention Early treatment Education Elderly Emotional Enrollment Equipment and supply inventories Event Evidence based treatment Family Family Caregiver Family member Friends Future Geographic Locations Goals Grief reaction Health Hobbies Individual Intervention Interview Life Mental Depression Methods Morbidity - disease rate Outcome Palliative Care Participant Persons Physical Function Pragmatic clinical trial Prevention Process Psychological Factors Psychotherapy Quality of life Randomized Recovery Research Resolution Resources Risk Science Social support Stress Structure Subgroup Symptoms Testing Therapeutic Intervention Time Trauma Veterans Waiting Lists acute stress advanced disease arm attentional control biological adaptation to stress brief intervention cognitive process coping effective intervention efficacy evaluation efficacy testing experience immune function improved instrument loved ones mental function mortality predicting response prevent preventive intervention primary outcome programs psychologic randomized, clinical trials response screening social social factors stress related disorder success time use traumatic event treatment as usual treatment response

项目摘要

PROJECT SUMMARY/ABSTRACT Maladaptive grief negatively impacts 25-40% of older adult family caregivers of persons with a serious chronic illness, with adverse health outcomes including increased morbidity and mortality, reduced independence, and diminished immune function.1-4 Losses associated with aging, such as the death of multiple close family and friends, are highly traumatic and contribute to the devastating impact of maladaptive grief among older adults.8,10 Brief, effective interventions that address maladaptive grief early in the grief trajectory are urgently needed. Accelerated Resolution Therapy (ART) is an evidence-based treatment for post-traumatic distress in civilians and veterans14-17 that may be useful in alleviating maladaptive grief prior to bereavement and could prevent prolonged, complicated grief following bereavement. We are proposing to test the efficacy of ART, a low-risk, brief therapy with a strong theoretical rationale for treatment success in maladaptive grief and supported by the promising results of our recently completed preliminary trial (R21AG056584). Additional aims of the study are to examine changes in cognitive appraisal and integration of loss following ART using a mixed methods approach and to evaluate personal, social, and psychological factors predictors of response. During the proposed double blinded, randomized, controlled two arm clinical trial, 472 older adult family caregivers from two different geographic locations will receive either ART or an educational program that is matched for time and attention. Each participant will receive four sessions of either the ART intervention or the control intervention. Data collection will occur at screening/enrollment (T1), at the end of the 4-session intervention period (T2) and at 6-months (T3) and 12-months post bereavement (T4). A subgroup of 20 participants randomly assigned to ART will participate in semi-structured interviews to enhance understanding of cognitive appraisal and integration of loss. This trial will provide critical information on the efficacy of the ART intervention as a potential first-line treatment option for pre-loss grief and preventative option for complicated grief and contribute new information about characteristics of individuals most likely to benefit from ART.