A qualitative study of perceptions and acceptability of unguided internet cognitive behavior therapy for grieving adolescents

Grief is a common experience in adolescence. Evidence-based therapies are not readily accessible for grieving young people. Unguided internet-based cognitive behavior therapy for grief in adolescents has recently been investigated in a pilot randomized controlled trial. Research is required to determine acceptability as this unguided internet intervention incorporates exposure and imagery transformation techniques that are typically delivered by therapists. The aim of this study was to understand, through qualitative content analysis, adolescents’ views about the acceptability of unguided internet-based cognitive behavior therapy for grief. Nine adolescents (M age = 16.44 years, SD = 1.13, age range 14–18 years, 55.6% female, 44.4% male) engaged in a post-intervention interview, or provided written responses to the interview questions, after trial participation. Most participants reported exposure and imagery transformation as acceptable. The findings provide initial support in a small sample of adolescents of the acceptability of unguided internet cognitive behavior therapy for grief. Grief and loss are commonly experienced by youth; 90% of adolescents have experienced bereavement of a family member or friend (Ens & Bond, 2005). Grief is a broad term that covers a wide range of responses to losses including bereavement, parental divorce, relationship break-up, and death of a pet (Breen et al., 2023). Grief in adolescence is associated with an elevated risk of developing psychological disorders including anxiety, depression, post-traumatic stress disorder (PTSD), and prolonged grief disorder (Guzzo & Gobbi, 2023). Parental loss in adolescence through death or divorce is a risk factor for depression (Guzzo & Gobbi, 2023). Data showing that both death and non-death losses are associated with a range of psychological symptoms in youth indicate the need for an accessible intervention for grief.