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A team of psychology researchers at the University of Lausanne are about to repeat a highly successful Swiss-German experiment, involving online support for people suffering from bereavement or divorce. The first French version of this online therapy will be followed by a second one, aimed at reaching a greater number of users throughout the world. The project especially wants to find out if the method works just as well without guidance.

The death of a spouse or a life partner, together with divorce and separation, are among the most stressful life course events, and some people struggle to recover from them. There are many similarities between the two situations, such as experiencing an unbearable tension between objective reality and how things should be in the eyes of the person left behind.

While most people manage to regain a feeling of purpose in their lives after a few months, 10 to 15% of those affected by the two different types of loss experience complex symptoms of grief, which particularly manifest themselves through intense, persistent suffering for more than six months, permanent preoccupation, an undisputed difficulty in accepting the departure, feelings of identity loss, an inability to imagine the future without the other person, among many others.

A recognised disorder

The American Psychiatric Association entered persistent complex bereavement disorder into the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013, and in 2018 the World Health Organization (WHO) plans to include the diagnosis of prolonged grief disorder in the 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11).

In this regard, computer-supported therapy may be an effective method to help people overcome pathological grief, as was demonstrated by a successful study conducted by a team from the University of Bern from 2016 to 2017, in association with the National Centre of Competence in Research LIVES, also linked to a series of online self-healing programmes popularised by Professor Thomas Berger.

Thanks to the involvement of two members of NCCR LIVES IP212, Professor Valentino Pomini and Dr. Anik Debrot, a lecturer at the University of Lausanne’s Institute of Psychology, the online grief support project, known as LIVIA, has been extended to French-speaking Switzerland and France. A PhD candidate and several masters’ students are also involved in this research.

Results ‘exceed expectations’

The Lausanne team emphasises that the results of the experiment conducted in Bern by Professor Hansjorg Znoj and Dr Jeannette Brodbeck, in collaboration with Professor Berger, ‘exceeded expectations’. Conducted on 110 people suffering from complicated grief, the LIVIA study compared the progress of participants who had undergone the treatment with a control group of people on the waiting list.

After ten weeks, the patients’ levels of psychological distress, depression, embitterment and loneliness had diminished when compared to those of the control group, which still remained extremely high, and their degree of life satisfaction improved significantly.

Advice and exercises

The treatment starts with a range of information about the grieving process. This is followed by advice and exercises aimed at accepting reality of the loss, processing the pain of grief, adjusting to a world without the person who is no longer there, and relocating the connection with the lost person. In the Bern experiment, participants also received encouraging messages, reminders and questions in order to keep patients highly motivated or help them overcome possible difficulties in completing programme tasks.

The researchers emphasise that there are many advantages to online therapy: the process is anonymous, easy to access, inexpensive and does not depend on the quality or availability of a clinician. Patients can go at their own pace, a feature that will be augmented in the future French version where it will also be possible to decide on the order of the sequences.

Without email guidance

There will be two phases to the Lausanne project: the first pilot phase will offer the LIVIA programme in French along the same lines as the German version, but without the supportive messaging. The argument is that results could be equally as good without email guidance.

The second phase will test the new French version of LIVIA, which has shorter, more standardised modules, and includes videos and a discussion forum for participants. The information and tasks provided will be strongly influenced by the latest advances in positive psychology to ensure they meet the four basic psychological needs, namely orientation and control, attachment, pleasure and self-worth.

300 million French speakers

According to Anik Debrot: ‘There is a boom in online therapies, but very few have been scientifically tested in French, and no validated study in this language yet exists on the issue of grief.’

Yet the potential pool of patients is enormous, with 300 million French speakers throughout the world. If a more standardised online therapy without guidance and offering greater flexibility works as well as the guided process, it could reach a far greater number of people.

Little space for grief

In an age when death is no longer accompanied by as many religious and social rites as in the past, and now that divorce is generally widespread, anybody may be affected by complicated grief without necessarily finding a suitable space in which they can try to overcome it.

The LIVIA project could therefore provide a welcome helping hand to those suffering the loss of a loved one in silence, and who haven’t yet found a path to recovery. People who are interested in taking part in the pilot study can get in touch with the team.