title: Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial.
abstract: BACKGROUND
  Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement.
  
  
  METHODS
  The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme.
  
  
  CONCLUSIONS
  This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice.
  
  
  METHODS
  Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.)
  
  
  BACKGROUND
  ACTRN12613001270707.
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors.forename: Jenine
authors.initials: J
authors.lastname: Wenn
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors.forename: Moira
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Breen
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Kane
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors.forename: Clare S
authors.initials: CS
authors.lastname: Rees
mesh_terms: D001007:Anxiety / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D000067489:Metacognition; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Grief therapy; MENTAL HEALTH; Metacognition; Persistent Complex Bereavement Disorder; Prolonged Grief Disorder