The sting of grief is familiar to anyone who has ever lost a loved one. But some bereaved people have a hard time working through their grief. Many months, or even years, after their loss, they are still preoccupied with thoughts of the deceased and have feelings of anger, bitterness, and disbelief about the death. Mental health professionals often have a difficult time treating these people, who are said to be suffering from a newly described condition called complicated grief. Now, researchers at the University of Pittsburgh School of Medicine have developed a therapy that is specially designed to treat these people.

What the researchers wanted to know: Does the new therapy help people deal with complicated grief more than traditional psychotherapy does?

What they did: The researchers recruited bereaved people and enrolled those who tested positive for complicated grief. About half of the 95 people enrolled were given about five months of interpersonal therapy, which involved talking through feelings and developing strategies to move on. The other half were given about five months of the newly developed complicated-grief treatment, which borrowed elements from interpersonal therapy and treatment for post-traumatic stress disorder. It included exercises such as having the patients close their eyes and revisit the death or have conversations with the deceased as if they were in the room.

What they found: More than half (51 percent) of the patients given complicated-grief therapy improved within five months, while less than a third (28 percent) given interpersonal therapy showed similar improvement. There was an especially positive response to complicated-grief treatment among those who had lost someone in a violent death. Parents who had lost a child did not seem to respond as well. The researchers say both these findings are preliminary and need further testing. People taking antidepressants showed more improvement than those not taking medication in both groups.

What it means to you: While complicated-grief treatment is still fairly new (this is the first large study of it), it shows promise. If you or someone you know is having a hard time getting over a loss, it might be worth talking to someone about this type of treatment.

Caveats: The techniques involved in complicated-grief therapy might not be for everyone. Six of the people who had complicated-grief therapy (and who were included in the results) dropped out early because they said the therapy was too hard and they didn't want to tell the story of their loved one's death. An additional five people, who did complete the therapy, refused to do an exercise imagining a conversation with their loved one because they said it was too hard.

Find out more: The Yale University School of Medicine has a webpage that gives the definitions of both normal and complicated grief.

The University of Michigan also has a page that could be helpful in determining what is normal in dealing with grief and when to seek professional help.

The National Cancer Institute has many pages about grief and grieving including a page on complicated grief.

Read the article: Shear, K. et al. "Treatment of Complicated Grief: A Randomized Controlled Trial." Journal of the American Medical Association. Vol. 293, No. 21, pp. 2601-2608

Abstract online: http://jama.ama-assn.org