GREAT-SF (Grief-focused REsilience Activities and Training for Surviving Families): An Online Selective Intervention for Bereaved Military Families

Military Service members often die young and all too often in violent ways. From 2001 through 2011, over 80% of Service member deaths were violent. Such deaths included combat-related deaths, accidents, suicides, and homicides. Illnesses accounted for 16% of deaths. The National Military Family Bereavement Study (NMFBS), research conducted at the Uniformed Services University, has shown surviving military family members to be suffering high levels of grief and distress, putting them at risk for harmful long-term changes in physical and mental health. This risk has been shown present even many years after the death and has been reported elsewhere. In fact, Israeli parents who lost a child in combat were shown to experience higher grief 9 years after the loss than parents who had lost a child to illness within the prior year. Most people experience the death of a loved one during their lifetime. So grief is a normal process that usually improves over time. But sometimes this is not the case, and when complications arise, the process of grief may slow or even stop, leaving people with continued strong feelings of loss that don't resolve. Some circumstances of death make it harder for survivors to cope and can prolong the grief, for example, when a young person dies from a sudden or violent death as occurs in the military. Recognizing the need to help these families, the NMFBS formed a partnership with the Center for Complicated Grief at Columbia University to create a program for bereaved military families to better manage grief, guilt, and anger so that grief can find its rightful place in their lives rather than causing unending cycles of emotional pain and long-term problems in health and functioning. The study we propose will develop and test an Internet program, Grief-focused REsilience Activities and Training for Surviving Families (GREAT-SF) that is designed to lower grief and decrease risk for long-term problems in surviving military family survivors. GREAT-SF is being adapted from Complicated Grief Therapy (CGT), which has been studied and shown to be helpful in the civilian population. CGT is based on the premise that grief is a form of love that emerges naturally and intensely after a loss and usually lessens as people adapt to a new normal life where grief is given a permanent place. CGT helps to resolve grief complications and promote wellness. Our proposed GREAT-SF study is a 'randomized controlled trial,' which means that it will ask military survivors to participate and then assign them to one of two group, either the GREAT-SF group or a 'control' group (WELLNESS-SF) that will focus on building resilience. The study will compare how the people in the GREAT-SF group do compared to the WELLNESS-SF group in overall improvement in grief severity and adaptation to loss. All study participants will be able to complete their programs on the Internet. In addition, both will have coaches who can help or answer questions about the intervention. If we learn how to best assist military family survivors with their grief and reduce the long-term problems that can result after a loss, we could have a program that is an extremely helpful resource for current and future survivors who suffer the death of a military loved one. Military Service members may also be consoled by knowing that such services are available to families if they or a close unit member or friend should die while on active duty.