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Internet-Based Interventions for Prolonged Grief Symptoms: A Systematic Review and Meta-Analysis
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Description: Background: Internet-based interventions have been introduced as novel and effective treat-ments for affective and anxiety disorders and, in recent years, specifically for the bereaved. However, research on the effectiveness of online interventions for prolonged (or complicated) grief is still missing. Objective: We review and meta-analytically summarize the evidence for internet-based interven-tions for prolonged grief symptoms. Methods: Systematic searches resulted in 7 randomized controlled studies (N = 1,257) compar-ing internet-based grief interventions with control groups, all of which were included in the me-ta-analysis. We used random effects models to summarize treatment effects for between-group comparisons (treatment vs. control at post), and stability over time (post-follow-up). Results: In comparison with control groups, internet-based interventions showed moderate (g = .53) to large effects (g = .86) for symptoms of prolonged grief and PTSD, respectively. The effect for depression was small (g = .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for prolonged grief and more individual feedback increased effects for depression. Other moderators (i.e, dropout rate, time since loss, exposure) did not significantly reduce heterogeneity. Conclusions: Overall, the results of internet-based interventions for prolonged grief symptoms are promising, and its low-threshold approach might reduce barriers to bereavement care. None-theless, future research should further examine potential moderators and specific treatment com-ponents (e.g., exposure, feedback) and compare interventions with active controls.