The Effectiveness of Cognitive Behavioral Therapy for Prolonged Grief Symptoms in Children and Adolescents: A Systematic Review

Children and adolescents who experience the loss of a beloved one in traumatic circumstances can experience prolonged grief symptoms, characterized by symptomatology that may alter the grieving process, impair global functioning, and interact with cognitive development. Cognitive behavioral therapy (CBT) has been showing significant results in treating grief-related issues. The present systematic review assessed the effectiveness of CBT for prolonged grief symptoms in the pediatric population. This study was carried out by two independent reviewers who searched electronic databases through a combination of keywords and a set of inclusion and exclusion criteria. A total of 20 studies were selected and data were synthesized in these categories: characteristics of the participants; specificities of the instruments; effectiveness of CBT. The results of this systematic review highlighted significant improvements in prolonged grief symptoms and global functioning following CBT. No significant age, gender, or ethnicity differences were found in most studies. The Inventory of Prolonged Grief for Children/Adolescents and the Inventory of Complicated Grief– Revised for Children appear to be the pediatric population’s most sensitive prolonged grief measures. The treatments were adapted based on various contextual and structural factors without losing clinical significance. Significant effect sizes were found for primary and most secondary outcomes. This systematic review underlines the effectiveness of CBT for prolonged symptoms in the pediatric population. Nonetheless, the included studies had a certain degree of heterogeneity, and their quality varied due to some biases. A validation procedure of standard methodologies for prolonged grief symptoms in children and adolescents is required to establish shared directions both in research and clinical settings.