When a parent dies – a systematic review of the effects of support programs for parentally bereaved children and their caregivers

Bergman, Ann-Sofie; Axberg, Ulf; Hanson, Elizabeth

doi:10.1186/s12904-017-0223-y

Table 4 Study effects within and between treatment groups

From: When a parent dies – a systematic review of the effects of support programs for parentally bereaved children and their caregivers

Interventions directed to the bereaved children
Intervention	Reference and grade of evidence	Study population	Evaluation design	Measure	Outcome variable	Effect size TG			Effect size CG			Effect size between groups
Intervention	Reference and grade of evidence	Study population	Evaluation design	Measure	Outcome variable	sig	d_z	CL %	sig	d_z	CL %	sig	d_m (ϕ)
“Bereavement groups for inner-city children”	Schilling et al. 1992 [36]	38 children (age 6–12)	Pre-test/post-test-design	BID	Depr. (Parent) Depr. (Child)	.26 .29	−.22 .21	−59 58	na na	na na	na na	na na	na na
“Bereavement groups for inner-city children”	IIIC		Evaluation: post treatment	ATCD	Attitudes and Concepts of Death	.01	.52	70	na	na	na	na	na
Grief camp “Camp MAGIC” (CG) delayed treatment	McClatchey et al. 2009 [31]	100 children (age 6–16)	Quasi experimental design	UCLA PTSD	PTSD-symptoms	.08	.33	63	.73	−.05	52	.08	.27
Grief camp “Camp MAGIC” (CG) delayed treatment	IIB	TG = 46 CG = 54	Evaluation: post treatment	EGI	Childhood Traumatic Grief	.00	.73	77	.90	−.02	51	.01	.50
“Writing for recovery” (CG) no treatment	Kalantari et al. 2012 [28] IB	61 children (age 12–18) TG = 29 CG = 32	RCT Evaluation: 1 week post treatment	TGIC	Traumatic grief	.00	1.26	90	.03	−.39	65	.00	1.21
Family-intervention (CG) no treatment	Black & Urbanowicz 1985 [40]; 1987 [25] IIB	83 children (age 0–16) TG = 38 CG = 45 45 families TG = 21 CG = 24	RCT Evaluation: 1 year post treatment	Clinical Interview	Behavior Sleep Depressed parent	na na na	na na na	na na na	na na na	na na na	na na na	.05 .09 .01	(.21) (.21) (.33)
				Clinical Interview	Talk about dead parent	na	na	na	na	na	na	.04	(.26)
				Rutter A Rutter A	Restless Nail-biting	na na	na na	na na	na na	na na	na na	.01 .03	(.34) (.28)
				Rutter A Rutter A	School problems	na	na	na	na	na	na	.10	(.19)
Family-intervention (CG) no treatment	Black & Urbanowicz 1987 [25] IIB	73 children (age 0–16) TG = 38 CG = 35 39 families TG = 21 CG = 18	RCT Evaluation: 2 years post treatment	Clinical Interview	Behavior Talk dead parent	na na	na na	na na	na na	na na	na na	.09 .04	(.28) (.24)
Family-intervention (CG) no treatment	Black & Urbanowicz 1987 [25] IIB		RCT Evaluation: 2 years post treatment	Clinical Interview	School Health	na na	na na	na na	na na	na na	na na	.03 .04	(.28) (.39)
“Parent Guidance Program” (CG) telephone monitoring intervention	Christ et al. 2005 [26] IA	104 families with children (age 7–17) TG = 79 CG = 25	RCT Evaluation: 8 and 14 months after parent’s death	CDI SEI STAI-S STAI-T CBCL-soc	Depression Self-Esteem State anxiety Trait anxiety Social competence	.00 .00 .00 .00 .29	.56 .64 .89 .61 .17	71 74 81 73 57	.03 .21 .12 .87 .27	.48 .29 .35 .04 −.31	69 61 64 51 62	.53 .36 .12 .31 .32	.14 .28 .44 .43 .36
				CBCL-bprob	Behavior problem	.17	.16	59	.80	−.07	53	.69	.26
				POPM-tot	Perceived Parenting	.06	.25	60	.31	−.22	59	.11	.37
“The Family Bereavement Program” (first version) (CG) delayed treatment	Sandler et al. 1992 [32] IB	72 families with 72 children (age 7–17) TG = 35 CG = 37	RCT Evaluation: post treatment	CRPBI PRS PRS	Par. warmth Grief discussion Par. Support	.00 .78 .00	.97 .07 .88	83 53 81	.25 .00 .11	.22 −.70 −.31	59 76 62	.03 .03 .01	.50 .62 .83
“The Family Bereavement Program” (revised version) (CG) self-study program	Sandler et al. 2003 [33] IA	156 families TG = 90 CG = 66 244 children (age 8–16) TG = 135 CG = 109	RCT Evaluation: Posttest and 11 months post treatment	Posttest
				Comp. GLESC Comp. Comp. AIS TAS SPPC MCPCS CBCL CBCL	Pos. parenting Negative events Ment. health Positive coping Inhibition Neg. thoughts Self-esteem Control belieifs Internalizing Externalizing	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	.00 .03 .01 .02 .01 .78 .37 .72 .03 .11	.58^a .43^a .50^a .30^a .48^a .05^a .19^a .06^a .41^a .28^a
				11-mth
				Comp. GLESC Comp. Comp. AIS TAS SPPC MCPCS CBCL CBCL	Pos. parenting Negative events Ment.health Positive coping Inhibition Neg. thoughts Self-esteem Control belieifs Internalizing Externalizing	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	na na na na na na na na na na	.03 .11 .10 .20 .06 .18 .16 .00 .61 .19	.39^a .32^a .32^a .18^a .39^a .29^a .27^a .40^a .10^a .24^a
“The Family Bereavement Program” (CG) self-study program	Schmiege et al. 2006 [37] IA	156 families TG = 90 CG = 66 244 children (age 8–16) TG = 135 CG = 109	RCT Evaluation: 3 and 11 months post treatment		3-months
				CMAS-R	Anxiety Girls Anxiety Boys	.08^a .17^a	.32^a .23^a	59 57	.32^a .04^a	.20^a .38^a	56 61	.41^c .25^c	.11 −.13
				CDI	Depression Girls Depression Boys	.10^a .19^a	.30^a .22^a	58 56	.28^a .37^a	.21^a .17^a	56 55	.58^c .98^c	.11 .06
				YSR	Externaliz. Girls Externaliz. Boys	.03^a .08^a	.39^a .30^a	61 58	.09^a .05^a	.34^a .38^a	59 61	.36^c .50^c	.08 −.03
				CBCL	Intrenaliz. Girls Internaliz. Boys	.00^a .00^a	.74^a .48^a	70 63	.01^a .00^a	.53^a .69^a	65 69	.88^c .39^c	.19 −.16
				CBCL	Externaliz. Girls Externaliz. Boys	.00^a .01^a	.56^a .43^a	65 62	.07^a .00^a	.37^a .57^a	60 66	.43^c .44^c	.23 −.12
					11-months
				CMAS-R	Anxiety Girls Anxiety Boys	.02^a .01^a	.43^a .44^a	62 62	.80^a .01^a	.05^a .48^a	51 63	.06^c .73^c	.36 .02
				CDI	Depression Girls Depression Boys	.02^a .07^a	.41^a .32^a	62 59	.55^a .05^a	.12^a .37	53 60	.16^c .65^c	.28 −.01
				YSR	Externaliz. Girls Externaliz. Boys	.08^a .27^a	.33^a .19^a	59 55	.89^a .13^a	-.03^a .30^a	51 58	.03^c .45^c	.36 −.08
				CBCL	Intrenaliz. Girls Internaliz. Boys	.00^a .01^a	.80^a .47^a	72 63	.01^a .00^a	.57^a .63^a	66 67	.93^c .58^c	.20 −.10
				CBCL	Externaliz. Girls Externaliz. Boys	.00^a .02^a	.55^a .42^a	65 62	.32^a .00^a	.20^a .69^a	56 69	.11^c .86^c	.40 −.22
“The Family Bereavement Program” (CG) self-study program	Luecken et al. 2010 [29] IA	139 children TG = 78 CG = 61 (age 8–16)	RCT Evaluation: 6 years post treatment	Cortisol	Cortisol level before and after a conflict discussion task	na	na	na	na	na	na	.03^b	.39^b
“The Family Bereavement Program” (CG) self-study program	Sandler et al. 2010 [34] IA	156 families TG = 90 CG = 66	RCT Evaluation: Post-test, 11 months and 6 years post treatment		Post (3-months)
		156 families TG = 90 CG = 66		TRIG IGTS	Present grief Intrusive grief	.19^a .16^a	-.16^a .17^a	54 55	.09^a .50^a	-.23^a .09^a	57 53	.72^c .43^c	.05 .09
		244 children (age 8–16) TG = 135 CG = 109			11-months
				TRIG IGTS	Present grief Intrusive grief	.69^a .00^a	.05^a .47^a	51 63	.87^a .12^a	-.02^a .21^a	51 56	.88^c .06^c	.08 .27
					6-years
				TRIG IGTS	Present grief Intrusive grief	.00^a .00^a	.73^a 1.30^a	70 82	.00^a .00^a	.63^a 1.08^a	67 78	.75^c .03^c	.14 .21
“The Family Bereavement Program” (CG) self-study program	Sandler et al. 2010 [35] IA	140 families TG = 78 CG = 62	RCT Evaluation: 6 years post treatment	DISC Compsite	Mental Disorder Externalizing Internalizing	na na na	na na na	na na na	na na na	na na na	na na na	.28^b .02^b .57^b	na^b .31^b na^b
“The Family Bereavement Program” (CG) self-study program	Sandler et al. 2010 [35] IA	218 children TG = 116 CG = 102	RCT Evaluation: 6 years post treatment	RSE PERI BDI	Self-esteem Demoralization Depression	na na na	na na na	na na na	na na na	na na na	na na na	.01^b .03^b .04^b	.40^b .42^b .40^b

Note: TG = Treatment Group; CG = Control Group. Effect size is presented in Cohen’s d and Common Language effect size (CL). The CL effect size indicates that after controlling for individual differences, the likelihood in percent that a person scores a different observed measurement for Mean 1 than for Mean 2. For categorical data ϕ is presented. Numerical data in the publications have been used or recalculated when possible, na = not available, e.g. numbers are missing or calculating not possible based on information in the publication
Abbreviations: AIS active inhibition scale, BID bellevue index of depression, CAS child assessment schedule, CBCL child behavior checklist, CDI children’s depression inventory, CMAS-R children’s manifest anxiety scale-revised, Comp composite scale, CRPBI children’s reports of parental behavior inventory, DISC the diagnostic interview schedule for children, EGI the extended grief inventory, GLESC general life events schedule for children, IGTS intrusive grief thoughts scale, MCPCS multidimensional measure of children’s perceptions of control scale, PERI psychiatric epidemiology research interview, POPM perception of parenting measure, PRS parent report scale, RSE Rosenberg self-esteem scale, SEI self-esteem inventory – short form, SPPC self perception profile for children, STAIC state-trait anxiety inventory for children, STAIY state-trait anxiety inventory for youth, TAS threat appraisal scale, TGIC traumatic grief inventory for children, TRIG Texas Revised Inventory of Grief (Present), UCLA PTSD University of California–Los Angeles Post-Traumatic Stress Disorder Reaction Index for the DSM-IV for Children
^aDue to data presented in article calculated as independent t-test, effect size d_s
^bCohen’s d and p-value as reported by the authors of the study in reference. Only findings with p ≤ .05 were reported
^cDue to data presented in article calculated as independent t-test at each time-point (post, follow-up respectively), when controlled for no statistical significant difference in pre-rating

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