Cognitive behavioural therapy for relatives of missing persons: study protocol for a pilot randomized controlled trial.

The preliminary effectiveness and feasibility of cognitive behavioral therapy (CBT) as an intervention for relatives of long-term missing persons will be evaluated in a pilot randomized controlled trial. An intervention group will be compared to a wait-list control group. It is hypothesized that participants of the intervention group will show lower levels of psychological complaints by reducing repetitive negative thinking and intrusive memories and enhancing self-compassion in comparison to the participants of the wait-list control group at post-treatment measurement. Follow-up measurements at three and six months post-treatment will show the short- and long-term effects of the intervention.

The main aim of this project is to conduct a pilot randomized controlled trail (RCT) to evaluate the preliminary effectiveness and feasibility of cognitive behavioral therapy (CBT) as an intervention for relatives of long-term missing persons. The effectiveness of CBT will be compared to a wait-list control group. Relatives of missing persons with clinically elevated levels of depression, PTSD and/or complicated grief are eligible for the individual CBT that aims to learn the individuals to deal with the unresolved loss of a loved one.

It is hypothesized that participants of the intervention group will show lower levels of psychological complaints by reducing repetitive negative thinking and intrusive memories and enhancing self-compassion in comparison to the participants of the wait-list control group at post-treatment measurement. Follow-up measurements at three and six months post-treatment will show the short- and long-term effects of the intervention.

Pretreatment, posttreatment, follow-up measure after 12 weeks and follow-up measure after 24 weeks.

Participants are randomized into:
1. Experimental condition
2. Wait-list control condition.

Experimental condition
Participants in the experimental condition are referred to a trained psychologist in their region. Approximately 15 psychologists are trained to conduct the CBT according to the treatment-protocol. The CBT consists of eight sessions divided over 12 weeks. The rationale for the treatment is based on previous studies that showed the effectiveness of CBT for reducing depression, PTSD and complicated grief. Due to the ongoing uncertainty and lack of closure for the relatives of missing persons, the therapy is not only focused on reducing psychological complaints, but also focused on enhancing coping strategies to deal with the painful situation by integrating mindfulness exercises. The treatment protocol is as follows: Session 1 - identification of psychological complaints, diagnosis, psycho-education. Session 2- invite a friend of family member, social support Session 3 - introduction of mindfulness Session 4 - 7 Recognition and changing maladaptive thoughts. Session 8 - evaluation of the therapy and relapse prevention During the therapy the participant is recommended to read chapters from the workbook (psycho-education) and to do home exercises (e.g. mindfulness exercises and recognition of changing maladaptive thoughts exercises). The exercises are based on previous literature from CBT and mindfulness. Before each session the participant is asked to answer a short questionnaire, in order to evaluate the progress during the therapy.

Wait-list control condition
Participants who are randomized to the wait-list control will start the intervention after 12 weeks. The intervention is the same as the intervention for the experimental condition.