Aims: Grief or bereavement counselling is a feature of many cancer services, both in Australia and internationally. Despite guidelines endorsing its provision to bereaved families and friends, this form of counselling has been the subject of much debate in the literature, with some arguing a lack of efficacy and even suggesting it could be harmful. The aim of this study was to examine the literature to determine a) the relative proportion of descriptive, measurement and intervention research in the field of grief counselling and b) the quality of intervention studies in this field.
Methods: A systematic review of studies published between 2000 and 2013 in the area of grief counselling was conducted. Titles were screened for eligibility for inclusion in the review. Eligible papers were categorised into descriptive, measurement, review, commentaries and intervention studies. Intervention studies were assessed against the EPOC methodological criteria, and papers meeting EPOC design criteria were assessed for quality.
Results: After removal of duplicates, 1092 papers were screened for eligibility, with 160 papers deemed eligible for inclusion in the review. Of these, 47 presented the results of descriptive studies, 3 reported measurement research, and 76 papers reported grief counselling interventions. However only 59% (n=45) of the intervention studies met the EPOC design criteria. These papers included 19 papers reporting the primary results of an intervention, and the remainder reported secondary analyses of the primary studies. Overall, study quality was poor, with the majority of interventions showing a risk of bias in several key areas. Evidence for the effectiveness of grief counselling on grief symptoms was mixed.
Conclusions: There is a lack of well-designed, methodologically rigorous intervention studies in the area of grief counselling. While there is limited evidence that counselling can be effective, especially for those with complicated grief, further work is necessary to ensure practice is based on good quality evidence.