A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people

Grief in young people is common and associated with symptoms of anxiety and depression, yet grief interventions for this age group are under-researched. We conducted a systematic review and meta-analysis to examine the efficacy of grief interventions in young people. The process was co-designed with young people and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PsycINFO, Medline, and Web of Science databases were searched in July 2021 (updated December 2022). We extracted results from 28 studies of grief interventions with young people (14–24 years) that measured anxiety and/or depression (N = 2803 participants, 60 % girls/women). Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression. A meta-regression indicated that CBT for grief that included a higher degree of CBT strategies, was not trauma focused, had >10 sessions, offered on an individual basis, and did not involve parents, was associated with larger effect sizes for anxiety. Supportive therapy had a moderate effect for anxiety and a small-moderate effect for depression. Writing interventions were not effective for anxiety or depression. Studies are limited in number and there were few randomized controlled studies. Findings indicate that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. CBT for grief should be offered as the first line treatment for grieving young people experiencing anxiety and depression. PROSPERO (registration number CRD42021264856). •Grief in young people is more common than people realize.•Young people can provide views that can improve grief interventions.•CBT for grief reduces symptoms of anxiety and depression in grieving young people.•CBT for grief is the most effective intervention for grieving young people.