A Randomized Controlled Pilot Trial of a Mindfulness Intervention for Grief in Widows and Widowers

Abstract

Background: Following bereavement, prolonged and intense yearning and grief rumination are repetitive cognitive processes that can promote a complicated course of grief. Mindfulness training (MT) has been shown to reduce maladaptive repetitive thought in healthy and clinical populations. However, empirical investigation of MT in bereaved populations is limited. The current randomized controlled pilot trial implemented a MT intervention for widow(er)s to examine the feasibility, acceptability, and preliminary efficacy of MT for improving grief outcomes and to test the mediating effects of yearning and grief rumination on grief severity. Method: Ninety five people who experienced the death of a spouse or romantic partner between six months to four years prior were randomly assigned to a 6 week MT intervention or a Progressive Muscle Relaxation (PMR) intervention, or were quasi randomized to a wait list condition. Self reported psychosocial outcomes were assessed at baseline, post intervention, and 1 month post intervention. In addition, yearning, grief rumination, decentering, and grief severity were assessed at two additional time points at weeks two and four of the intervention/wait list period to preserve a temporal connection between mediators and outcomes. Results: Controlling for relevant covariates, the MT and PMR groups showed significant declines in grief severity and yearning from baseline to the 1 month follow up, though only the PMR group showed a significant difference in rates of change compared to the wait list control group. Multi level mediation analyses revealed that reductions in yearning mediated the declines in grief severity. The MT, PMR, and wait list groups showed significant decreases in grief rumination across intervention time points for all but one grief rumination subscale, which was rumination about injustice of the death. Last, the PMR and wait list groups showed significant increases in decentering across study time points whereas the MT group did not experience significant change. Conclusion: The results of this first pilot RCT of a MT intervention in widows and widowers support the feasibility, acceptability, and preliminary efficacy of MT and PMR for improving grief outcomes in widows and widowers, and they suggest that PMR is most effective compared to the wait list control. With replication, PMR and MT could be standalone interventions for normative grief or components added to treatments for disordered grief.