Supporting People having Lost a Close Person by Bereavement or Separation: Study Protocol of a Randomized Controlled Trial Comparing Two French-Language Internet Interventions

Background: Internet interventions are as efficient as face-to-face psychotherapy for a variety of mental health disorders, including for complicated grief. Most evidence stems from guided Internet interventions. However, recent evidence indicates that the benefit of guidance is lower in internet interventions that are more interactive in nature. As such, providing guidance only to people requiring it (guidance on demand) appears as a cost-effective solution. This is particularly important to develop given the recent rise in grief symptoms in the context of the COVID-19 pandemic. This protocol presents a randomized control trial comparing the efficacy and drop-out rate of two internet interventions for grief related symptoms after the loss a close person following death or separation, using a guidance on demand framework. LIVIA 2.0 was developed based on theoretical and empirical findings on grief processes and internet intervention, and will be compared to LIVIA 1, that already demonstrated its efficacy. Objective: Our main hypotheses are that LIVIA 1 (control condition) and LIVIA 2.0 (experimental condition) increase participants’ well-being and decrease their distress, at post-test and at follow-up, that LIVIA 2.0 is more efficient than LIVIA 1 on all outcomes, and that LIVIA 2.0 has less dropouts than LIVIA 1. Methods: Outcomes will be assessed at pre-test, post-test (12 weeks later) and follow-up (24 weeks later). 234 participants will be recruited through a variety of means, including social media and mass e-mails. Primary outcomes are grief symptoms, depressive symptoms, and eudemonic well-being. Secondary outcomes are anxiety symptoms, grief coping strategies, aspects related to self-identity reorganisation, and programme satisfaction. LIVIA 2.0 participants will additionally complete a weekly mood and grief symptom monitoring, allowing to explore the short-term efficacy of the sessions. Conclusions: This study will inform about the relevance of the innovations included in LIVIA 2.0 for the efficacy and dropout rate of internet interventions for grief symptoms and will allow to investigate how these changes impact the demand for guidance. In the current (post)-pandemic times, developing and assessing internet interventions targeting grief symptoms appears as particularly critical given the raise in grief-related symptoms. Trial Registration: clinicaltrials.gov, Record NCT05219760