When a loved one commits suicide, relatives and spouses experience a cascade of emotions including grief, guilt, and depression. Prior studies indicate some family survivors may have particularly difficult grief reactions and that cognitive behavioral therapy could be useful for the treatment of complicated grief.

Dutch investigators discovered a grief counseling program for families bereaved by suicide did not necessarily reduce grief or depression, but may help to prevent perceptions of blame among close relatives and spouses.

The study is published in the British Medical Journal.

According to background information in the article, up to 15 per cent of bereaved people develop complicated grief, characterized by symptoms such as purposelessness, subjective sense of detachment, yearning, disbelief, and bitterness related to the death. It is also associated with long term psychiatric illness and suicidal ideation.

The study involved 122 first degree relatives and spouses of 70 people who had committed suicide between 1 September 1999 and 1 January 2002. Thirty-nine families (68 participants) were allocated to four sessions with a trained psychiatric nurse counselor, while 31 families (54 participants) received usual care. The counseling sessions took place three to six months after the suicide.

Thirteen months after the event, self-reported grief was measured and the presence of depression, suicidal ideation, and perceptions of being to blame for the suicide were recorded.

Counseling had no beneficial effect on complicated grief, suicidal ideation or depression. However, after adjusting for several factors, the researchers did see a trend towards reduced perceptions of being to blame and fewer maladaptive grief reactions in the counseling group compared to the usual care group.

The authors suggest that having a chance in counseling to inform relatives of the psychiatric context in which suicide usually occurs, and reflect on and acknowledge their loved one’s difficulties before the suicide, may have helped relatives to realize that they did nothing wrong.

Source: British Medical Journal