A recently developed program for extensive inpatient grief therapy in groups, administered on a time-limited basis, is outlined, an illustrative case study is described, and empirical assessment of the program's efficacy is provided. During a 3-month stay in a Dutch Health Care Centre, a combined treatment program was offered that integrated behavior and art therapy [so-called Cross-Modality Grief Therapy, (CMGT)]. Assessment (levels of symptomatology on the General Health Questionnaire) was made at pretest, post-test, and follow-up and was compared with levels at comparable time points among participants in a more traditional program. Systematic advantages were found for CMGT. Discussion focuses on the identification of elements within CMGT that were responsible for its effectiveness. 0 1996 John Wiley & Sons, Inc.
How effective are intervention programs in alleviating the symptomatology of grief? In the last two decades a great variety of grief counselling and grief therapy programs have been developed (for a review, see Raphael, Middleton, Martinek & Misso, 1993). Yet very few methodologically rigorous assessment programs have been conducted to evaluate the efficacy of such interventions. None, to our knowledge, has focused on the effectiveness of therapy for bereaved persons in inpatient institutions. While inpatient care is indicated only for a relatively small portion of bereaved persons (most bereaved who need help are being treated on an outpatient basis), these patients are likely to be the most severely affected. Furthermore, it has been acknowledged for some considerable time that complicated bereavement occurs in large proportions of inpatients to psychiatric care (cf. Parkes, 1964). Thus, it seems timely to try to derive procedures to increase the efficacy of inpatient therapy, and it also seems essential to evaluate the effectiveness of new programs of intervention for such high-risk bereaved subgroups.
The opportunity to develop and assess an intervention program for the treatment of bereaved inpatients was offered to the authors by a Health Care Centre in The Netherlands a few years ago. Such Centres combine extensive inpatient treatment, frequently on a timelimited basis, with a non-stigmatizing environment, an advantage that they have over psychiatric hospitals. They are particularly suited to-and often attended by-people who are