Table 1.
Study | Therapeutic approach | Intervention components | Exposure | Cognitive reappraisal | Behavioral activation | Therapist feedback |
Brodbeck et al [41] | CBTa | Text-based modules including writing assignments, covering the areas psychoeducation, assessment of current situation, fostering positive thoughts and emotions, finding comfort, self-care, and accepting memories | Yes | Yes | No | Yes |
Dominick et al [38] | Social cognitive theory | 3 intervention modules (“My grieving style”; “Who am I?”; and “How am I doing?”), including interactive exercises supplemented by video testimonials; type-in responses and check lists; additional models: “Grief experience” and “Resources” offering text articles and websites or books covering grief-related topics | No | Yes | No | No |
Eisma et al [35] | CBT | Email-based homework assignments; exposure condition: writing assignments, imaginal or in vivo exposure exercises; behavioral activation condition: 7-day activity diary, identification of pleasurable and meaningful activities, identification of personal core values, development of new meaningful and pleasurable activities based on these values | Yes | No | Yes | Yes |
Van der Houwen et al [39] | CBT | Email-based writing assignments; exposure: describing the most distressing aspects of the loss (2 assignments); cognitive reappraisal: information on and identification of dysfunctional grief cognitions, letter to hypothetical bereaved friend (2 assignments); integration or restoration: letter to the deceased (1 assignment) | Yes | Yes | No | No |
Litz et al [40] | CBT | Internet-based psychoeducation (18 sessions); education about loss and grief, instruction on stress management and other coping skills, behavioral activation: assignments on self-care and social re-engagement, accommodation of loss by establishing and working toward a personalized goal, and relapse prevention | No | No | Yes | Yes |
Kersting et al [34] | CBT | Email-based writing assignments; self-confrontation: describing the circumstances of the loss (4 assignments); cognitive restructuring: supportive letter to hypothetical bereaved friend (4 assignments); social sharing: symbolic farewell letter to oneself, a loved one, or a person connected to the loss (2 assignments) | Yes | Yes | No | Yes |
Kersting et al [33] | CBT | Similar intervention components as Kersting et al [34] | Yes | Yes | No | Yes |
Wagner et al [36] | CBT | Email-based writing assignments; exposure: describing the circumstances of the loss, specifically distressing loss-related thoughts (4 assignments); cognitive reappraisal: letter to hypothetical bereaved friend, identification of new role or identity after the loss and possible rituals to remember the deceased by, activation of social resources and competencies (4 assignments); integration and restoration: outlining important memories about the loss; reflecting on therapeutic process and grieving style; letter to oneself, a significant person, or a person related to the loss | Yes | Yes | No | Yes |
Wagner and Maercker [37] | CBT | Similar intervention components as Wagner et al [36] | Yes | Yes | No | Yes |
aCBT: cognitive behavioral therapy.