title: Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss.
abstract: BACKGROUND
  Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief.
  
  
  OBJECTIVE
  To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief.
  
  
  METHODS
  To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette.
  
  
  RESULTS
  Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual.
  
  
  CONCLUSIONS
  Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components.
authors.affiliation: Foundation Centrum '45/Arq Psychotrauma Expert Group, Diemen, The Netherlands; g.smid@centrum45.nl.
authors.forename: Geert E
authors.initials: GE
authors.lastname: Smid
authors.affiliation: Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.|Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Rolf J
authors.initials: RJ
authors.lastname: Kleber
authors.affiliation: Foundation Centrum '45/Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Simone M
authors.initials: SM
authors.lastname: de la Rie
authors.affiliation: Foundation Centrum '45/Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Jannetta B A
authors.initials: JB
authors.lastname: Bos
authors.affiliation: Arq Psychotrauma Expert Group, Diemen, The Netherlands.|Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Berthold P R
authors.initials: BP
authors.lastname: Gersons
authors.affiliation: Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Boelen
keywords: Grief; PTSD; attachment; bereavement; brief eclectic psychotherapy; cognitive; depression; refugee; trauma