Boelen, P. A., Hout, M. A. van den, & Bout, J. van den (2006). A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice, 13, 109-128.


A cognitive-behavioral conceptualization of complicated grief (CG) is introduced that offers a framework for the generation of hypotheses about mechanisms that underlie CG and that can be targeted in treatment. Three processes are seen as crucial in the development and maintenance of CG: (a) insufficient integration of the loss into the autobiographical knowledge base, (b) negative global beliefs and misinterpretations of grief reactions, and (c) anxious and depressive avoidance strategies. These processes are offered to account for the occurrence of CG symptoms, whereas the interaction among these processes is postulated to be critical to symptoms becoming marked and persistent. The model recognizes that background variables influence CG, but postulates that this influence is mediated by the model's three core processes.