# Empower-Grief for Relatives of Cancer Patients: Implementation and Findings from an Exploratory Randomized Controlled Trial

## TL;DR

A new grief intervention for relatives of cancer patients was tested and found as effective as standard care, with benefits for psychological outcomes.

## Contribution

Empower-Grief is a novel selective intervention targeting early grief reactions in palliative care relatives.

## Key findings

- Empower-Grief showed comparable effectiveness to Treatment as Usual in reducing PGD symptoms.
- Initial symptoms and therapeutic alliance predicted outcomes in both groups.
- Empower-Grief is a promising low-intensity alternative for grief prevention in palliative care.

## Abstract

Grief reactions among relatives of palliative care patients are often overlooked, with most interventions targeting Prolonged Grief Disorder (PGD) rather than its prevention. Few interventions have been developed for individuals at risk. This study aimed to evaluate the efficacy of Empower-Grief, a selective intervention designed to address early problematic grief reactions and to explore predictors of its effectiveness. This exploratory randomized controlled trial (RCT) compared Empower-Grief with Treatment as Usual (TAU) among relatives or caregivers of palliative and oncological patients at risk of developing PGD. A total of 46 participants were assessed at baseline, post-intervention, and six months later. The primary outcome was PGD symptoms, with additional measures including anxiety, depression, coping strategies, attachment style, psychological flexibility, post-traumatic growth, social support, and therapeutic alliance. The final analyses indicate equivalence between Empower-Grief and TAU, suggesting that both interventions yielded comparable outcomes in reducing PGD symptoms and associated psychological distress. The initial symptoms and therapeutic alliance were predictors of the results in both post- and follow-up moments. This study contributes to the evidence on grief interventions in palliative care, highlighting the importance of structured support for bereaved caregivers. While Empower-Grief demonstrated comparable effectiveness to TAU, its lower intensity, ease of training, and application make it a promising treatment option.