Abstract
ObjectivesRelatives of long-term missing persons need to deal with uncertainties related to the disappearance. These uncertainties may give rise to ruminative thinking about the causes and consequences of the loss. Focusing on tolerating uncertainties in treatment of relatives of missing persons might foster recovery. Adding mindfulness to cognitive behavioural therapy might serve this aim. The feasibility and potential effectiveness of cognitive behavioural therapy with mindfulness were evaluated in a pilot study. We aimed to detect changes in symptom levels and mindfulness from pre-treatment to 1 week, 12 weeks, and 24 weeks post-treatment.MethodDutch adults who experienced the disappearance of a significant other more than 3 months earlier and scored above clinical thresholds for psychological distress were eligible to participate. Participants were recruited from January 2015 to July 2016. Participants in the immediate treatment group started treatment after 1 week after randomization, whereas waiting list controls started the treatment after 12 weeks of waiting. Data from self-report measures as well as clinical diagnostic interviews (tapping persistent complex bereavement disorder, major depressive disorder, and posttraumatic stress disorder) were gathered among 17 relatives of missing persons with elevated symptom levels.ResultsThe response rate (31.7%) was low, and dropout rate (47.1%) high. Cognitive behavioural therapy with mindfulness coincided with changes in psychopathology levels (Hedges’ g 0.35–1.09) and mindfulness (Hedges’ g − 0.10–0.41). Participants completing the treatment were satisfied with treatment quality and reported high treatment compliance.ConclusionsBecause of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research. However, in order to increase the feasibility of future trials among relatives of missing persons, we recommend collaborating internationally and/or extending duration of recruitment phase, to maximize the sample size.Trial registrationThe Netherlands National Trial Register, NTR4732.
Highlights
Background characteristics of the participants Table2 shows background information about the participants at individual level who were randomized
Because of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research
We aimed to evaluate the feasibility and potential effectiveness of cognitive behavioural therapy (CBT)+M for reducing persistent complex bereavement disorder (PCBD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) symptoms and enhancing mindfulness among relatives of missing persons with clinically significant psychopathology, using a pilot randomized controlled trial (RCT), comparing Cognitive behavioural therapy with elements of mindfulness (CBT+M) with a waiting list control condition
Summary
2 shows background information about the participants at individual level who were randomized. To safeguard participants’ privacy, some characteristics are not reported, but only reported on group level in this paragraph. Of all 17 participants included in the pilot RCT, twelve participants were female (70.6%) and 8 participants (47.1%) had a high educational level. The mean age of the participants was 54.65 (SD = 12.50, range 22 to 71) years. The disappearance took place 11.71 (SD = 16.39) years earlier (range 3 months to 47 years). Four (23.5%) participants had a missing child, four (23.5%) a missing spouse, two (11.8%) a missing parent, six (35.3%) a missing sibling, and one (5.9%) a missing foster child. The presumed reason of the disappearance was in four cases (23.5%) a criminal act (e.g. presumed homicide), four cases (23.5%) a voluntarily disappearance (e.g. run away), three cases (17.6%) an accidental disappearance (e.g. skiing accident), and six persons (35.3%) had no (specific) presumption about the reasons of disappearance
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