Some bereaved people develop severe long term reactions to their loss. This kind of reaction may be associated with adverse health outcomes and has recently been termed “complicated grief.”1 The syndrome is more common after unexpected and violent deaths such as suicide.2 3 People bereaved by suicide are also more likely than those bereaved by other deaths to experience stigmatisation, shame, guilt, and a sense of rejection.4

People going through normal or uncomplicated grief reactions after a death usually do not need or benefit from specific interventions other than support—indeed these may be contraindicated.5 The potentially severe implications for people who develop complicated grief suggest, however, that special treatment may be indicated. But are these interventions effective?

The randomised controlled trial reported by de Groot and colleagues in this week's BMJ is one of few evaluations in this field.6 The findings indicate that provision of a cognitive behaviour …