Bereavement after the death of someone close is universal, and clinicians may be uncertain if or what interventions may be beneficial. To synthesize effects of health care interventions for bereaved children and adults. Eight databases were searched from inception in September 2025, supplemented with screening reviews, guidelines, federal register entries, and expert input. Dual independent reviewers selected randomized controlled trials (RCTs) comparing interventions for bereaved or soon-to-be bereaved persons with usual care, no intervention, or an alternative intervention. Outcomes were evaluated using the abstractor-checker model. Risk of bias was assessed; random-effects meta-analysis was used for effect estimates; multiple effect modifiers were explored; and applicability, generalizability, and strength of evidence (SoE) were determined. A total of 169 RCTs reported in 303 publications evaluated psychotherapy; expert-facilitated support groups; pharmacotherapy; peer support; self-help interventions; writing, music, and art therapy; enhanced provider contact; and integrative medicine for bereaved persons. Risk of bias was substantial, and only 15 RCTs included children. There was moderate SoE that individual psychotherapy improves grief disorder, grief, and depression symptoms and low SoE that expert-facilitated support groups and enhanced contact with health care providers may improve depression symptoms. Other interventions showed conflicting results, indicated no benefit, or had insufficient SoE. Research focused on grief in adults, study populations were complex, and the review may have missed culturally specific interventions. Psychotherapy can improve key outcomes in bereaved adults, and expert-facilitated support groups and enhanced provider contact may also provide benefits. Evidence for other bereavement interventions, approaches for children, and outcomes beyond general grief or grieving, grief disorder, and depression symptoms is limited. Agency for Healthcare Research and Quality. (PROSPERO: CRD42023466057).
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