Complicated Grief: Risk Factors, Protective Factors, and Interventions

Tina M. Mason, Cindy S. Tofthagen, Harleah G. Buck

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Complicated grief (CG) poses significant physical, psychological, and economic risks to bereaved family caregivers. An integrative review of the literature published 2009−2018 on CG associated with caregiving was performed using PubMed, PsychINFO, and Web of Science. The search returned 1428 articles, of which 32 were included in the review. Sixteen studies described risk and protective factors and 16 described interventions for CG. Caregiver-related risk factors included fewer years of education, depression, anxiety, poor physical health, and maladaptive dependency and attachment traits. Additional risk factors included lower perceived social support, family conflict at end-of-life, and family having difficulty accepting death. Care recipient-related risk factors are younger age, fear of death, and place of death. Protective factors included hospice utilization in reducing fear of death, high pre-bereavement spiritualty, and satisfaction with palliative care. Complicated grief treatment was the most widely-studied intervention. Social Workers and other clinicians can use this information to identify family caregivers at increased risk for CG and refer or implement an early intervention to lessen its impact.

Original languageEnglish (US)
Pages (from-to)151-174
Number of pages24
JournalJournal of Social Work in End-of-Life and Palliative Care
Issue number2
StatePublished - Apr 2 2020


  • Bereavement
  • caregiver
  • prolonged grief
  • systematic review

ASJC Scopus subject areas

  • Health(social science)
  • Life-span and Life-course Studies


Dive into the research topics of 'Complicated Grief: Risk Factors, Protective Factors, and Interventions'. Together they form a unique fingerprint.

Cite this