The Effectiveness of Mindfulness-Based Cognitive Therapy to Reduce Depression and Prolonged Grief Among Suicide-Loss Survivors: A Longitudinal Randomized Controlled Trial

Suicide loss is one of the devastating life experiences one can encounter. Thus, it is not surprising that suicide-loss survivors (SLSs), i.e., family members whose loved one died by suicide, often deal with adverse consequences such as depression and prolonged grief (PG) in the aftermath of suicide loss. Given that upwards of 60 million people are added to the SLS population each year, it has become critical to seek effective interventions to help SLSs decrease their depression or PG and even facilitate post-traumatic growth (PTG). While mindfulness-based cognitive therapy (MBCT) has been recognized as a highly effective intervention for depression and grief reactions, no study has examined the effectiveness of MBCT for SLSs' mental health or its mechanisms of change.

To address these gaps, we will adopt a 10-month longitudinal study to examine MBCT's effect on depression, PG, and PTG among 180 SLSs at four measurement points: pre-and post-intervention and two follow-ups (3 and 6 months after the end of intervention). The MBCT intervention, a manualized group skills-training program of eight weeks, will be examined in a randomized controlled trial (RCT) design, comparing the effect of MBCT intervention to a treatment-as-usual group. In addition to examining the trajectories of distress and growth, we will also examine three psychological mechanisms: intrapersonal (e.g., shame), interpersonal (e.g., social support), and mindfulness (e.g., self-compassion), that may serve as mediators of changes among SLSs following MBCT.

This proposed project represents an innovative effort to extend our ability to help individuals dealing with the adverse consequences of suicide loss by examining an empirically based intervention (i.e., MBCT) that can reduce depression and PG and facilitate growth in the aftermath of a loved one's suicide. Employing an RCT design will allow us to validate the effectiveness of MBCT as a key intervention for suicide bereavements, thus making it accessible to many individuals who struggle with suicide in the family. Together, the study's findings can facilitate the prospect of implementing a sound, short, and accessible treatment for SLSs.

The focus on mechanisms of change related to MBCT will increase our understanding of whether MBCT is effective as well as why it is effective. Thus, the project's findings can enhance our understanding of the roles of the psychological dimensions crucial for improving SLSs' emotional condition. Ultimately, these understandings will enable us to draw an integrative model of critical facilitating factors that can offer refinements and modifications for MBCT and promote the development and implementation of specific mindfulness-based interventions targeting SLSs, beyond traditional treatments. Moreover, the longitudinal nature of this project offers a unique opportunity for a comprehensive understanding of theoretically and clinically driven mediators and moderators (e.g., guilt, self-compassion) suggested as having critical roles in mental health and growth in the aftermath of suicide loss. Together, we hope that the study’s novel approach will yield findings to help reduce depression and PG, enhance PTG, and comprise a significant step toward helping SLSs in their journey to cope and heal from their suicide loss.