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Publications

Journal Article Epublish

PubMed: 42857641 DOI: 10.1016/j.invent.2026.101008

Supporting kids in loss: A randomised controlled trial of a co-produced unguided internet cognitive behaviour therapy intervention for grieving children.

Internet Interv 46:101008

Authors: Sarah J Egan, Tamara Zammit, Amy O'Brien, Danyelle Greene, Sian B Pauley-Gadd, Elizabeth Bills, Bronwyn Myers, Christopher Hall, Hayden Wilson, Michael Duffy, Paul A Boelen, Kirsten V Smith, Jennifer Wild, David Trickey, Lauren J Breen

Affiliations

  • Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
  • Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia.
  • School of Psychology, Murdoch University, Perth, Australia.
  • School of Business, University of Queensland, Brisbane, Australia.
  • Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa.
  • Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
  • Grief Australia, Melbourne, Australia.
  • Child and Adolescent Mental Health Service, Western Australia Country Health Service, Perth, Australia.
  • Queen's University Belfast, Ireland.
  • Department of Clinical Psychology, Utrecht University, the Netherlands.
  • ARQ National Psychotrauma Centre, Amsterdam, the Netherlands.
  • Department of Experimental Psychology, University of Oxford, United Kingdom.
  • Phoenix Australia, Department of Psychiatry, University of Melbourne, Australia.
  • University College London, United Kingdom.

Abstract

Bereavement is a common experience in childhood. Unguided internet cognitive behaviour therapy (CBT) was tested in a sample of 96 grieving children aged 6-12 years (M = 8.51, SD = 3.62). The intervention was intended for use by children who had experienced either bereavement or non-bereavement loss. Children were not required to have an elevated level of prolonged grief to enter the trial. The primary outcome of anxiety and secondary outcomes of well-being, and symptoms of depression, posttraumatic stress disorder (PTSD), and prolonged grief were examined at pre- and post-intervention and one month follow-up compared to waitlist control. There were no significant changes in primary or secondary outcomes; however, treatment completion was low, with 33.33% of children reporting use of the intervention. Clinical significance analysis indicated significantly more intervention participants improved on prolonged grief symptoms compared to control. However, given low uptake, results for clinical significance on prolonged grief symptoms are preliminary and should be viewed with caution. Qualitative findings indicated numerous components children and parents/caregivers liked but also suggested areas to modify and barriers to engagement. Future research should improve intervention uptake and efficacy. Trial Registration: The trial was prospectively registered with ISRCTN on 21 March 2025 (www.isrctn.com/ISRCTN12771259).

MeSH

Internet, Stress Disorders, Post-Traumatic, Signs And Symptoms, Grief, Therapeutics, Cognitive Behavioral Therapy, Child