Islamically Integrated Chair-Work for Bereaved Muslims

Condition(s) studied

Investigational drug(s) / intervention(s)

Psychotherapy-Empathic Attunement Phase: The initial focus of our therapeutic intervention is on establishing empathic attunement to aid individuals in processing the inherent pain of grief in a constructive manner. For this phase, therapists will focus solely on adhering to the relationship formation and introspective exploration. Practitioners aimed at empathetically tuning into the patient's emotional experience, validating and reassuring the patient's emotional state, and adhering to the fundamental principles of empathy, sincerity, and positive regard for establishing and upholding a strong therapeutic alliance. Also, accompanying the patients to uncover and process the natural pain to gain self-awareness about their emotions.

Psychotherapy - Chair-work intervention phase: During this phase, bereavement person will conduct imaginal conversation with a deceased. Practitioners utilized the resolution model including 5 components: (1) emotional reaction of the bereavement (blame, hurt, regret etc.) and enactment of the deceased; (2) differentiation of the bereavement's feelings and deceased's specific negative aspects accessed; (3) intense expression of the bereavement's specific emotions; (4) expression of the bereavement's previously unmet interpersonal needs from the deceased and the deceased validates bereavement's feelings; (5) understanding and forgiveness of the deceased or shift in view of the deceased.

Psychotherapy - Cognitive consolidation and spiritually behavioral activation phase: Cognitive consolidation and spiritually behavioral activation complement the emotional interventions implemented in earlier stages. This cognitive process aids in the transformation and integration of adaptive growth, enabling patients to assimilate the knowledge and insights acquired during therapy. Therapists take a directive and co-constructivist approach, guiding patients to discover emotionally adaptive reconciliations and meanings that challenge and reshape their emotional and cognitive frameworks in the cognitive consolidation and spiritually behavioral activation phase. Aligned with this cognitive shift, spiritual behavioral activations involve creating plans to address unmet needs.

Study summary

This study aims to develop and to evaluate the efficacy of an Islamically integrated chair-work intervention designed to assist Muslims experiencing prolonged grief in resolving unfinished business tension. Employing a randomized, non-concurrent, multiple baseline design, the study comprises five phases: (1) baseline assessment, (2) empathic attunement, (3) Traditional Islamically Integrated Psychotherapy (TIIP) chair-work intervention, (4) cognitive consolidation \& spiritually behavioral activation, and (5) follow-up. By integrating insights from early Islamic scholars like Al-Kindi, Abu Bekir er-Razi, and Ibn Sina, alongside psychological counseling and cultural elements, this intervention aims to fill a crucial gap in existing literature. Grief, a normal emotional reaction after the loss of a loved one, is typically resolved over time without professional intervention. However, a small yet significant number of individuals experience prolonged grief disorder (PGD), a persistent and impairing form of grief lasting over 6 months. Unfinished business, indicating unresolved relational issues with the deceased, is a key risk factor for severe PGD. Higher levels of unfinished business are associated with increased psychological problems and unhealthy expressions of grief. Within the framework of Traditional Islamically Integrated Psychotherapy (TIIP), unfinished business is viewed as an emotionally charged problem. Processing this emotional burden during TIIP sessions aims to facilitate resolution, replacing maladaptive emotions with adaptive ones, fulfilling emotional needs, and establishing new meanings for unresolved conflicts. Sense-making of one's loss is crucial for a healthier grieving process, making meaning-oriented techniques more effective in grief therapy. Moreover, research indicates that the expression of grief is influenced by spirituality, religious beliefs, and practices. Yet, there is a lack of faith-based intervention programs tailored for grieving Muslims. This study seeks to address this gap by providing closure and therapeutic methods that cater to the nuanced emotional struggles of bereaved Muslims, offering a faith-based approach previously unavailable in the literature.

Eligibility

Primary outcome measure(s)

• The Unfinished Business in Bereavement Scale - Brief — Baseline, weekly through Week 7 (end of treatment), and at 1-month follow-up (up to 11 weeks total)
  The Unfinished Business in Bereavement Scale - Brief (UBBS - Brief) is a self-report measurement tool developed by Holland et al. (2020). Utilizing a 5-point Likert scale (ranging from 1 = Not at all distressed to 5 = Extremely distressed), the UBBS - Brief comprises 8 items and includes two subscales: 'unfulfilled wishes' and 'unresolved conflict.'
• Prolonged Grief Disorder-13 Scale — Baseline (Week 0), end of treatment (Week 7), and 1-month follow-up (Week 11; up to 11 weeks total).
  The Prolonged Grief Disorder-13 (PG-13) Scale, developed by Prigerson et al. (2009) serves as a diagnostic tool for prolonged grief disorder (PGD) and aims to assess the severity of symptoms experienced after a loss. PG-13 comprises a total 13 item, with 11 of them utilizing 5-Likert point scale (1 = Not at all, 3= At least once a week, 5= Several times a day) to gauge severity of the struggles associated with the loss. And the remaining two items are yes/no question to designed to determine the duration time post-loss (a minimum of 6 months) and to assess dysfunction criterion. An increase in the cumulative scores obtained from the 11 items on the scale indicates a rise in the severity of prolonged grief symptoms. The PG-13 outlines five criteria (A-E) to diagnose PGD: (A) event criterion; (B) separation distress; (C) Duration Criterion; (D) cognitive, emotional, and behavioral symptoms; and (E) impairment criterion (Prigerson et al., 2009).
• The Grief Cognitions Questionnaire — Baseline (Week 0), end of treatment (Week 7), and 1-month follow-up (Week 11; up to 11 weeks total).
  The Grief Cognitions Questionnaire (GCQ) was developed by Boelen et al. (2003) comprises a 38-item self-report assessment tool utilizing a 6-point Likert scale (ranging from 0 = strongly disagree to 5 = strongly agree) encompassing nine distinct subscales. Its primary function is to evaluate the negative cognitions experienced by bereaved individuals following a loss, which may contribute to the complexity of the grieving process. The Turkish version includes 30 items, consolidating into six subscales (Cesur and Durak-Batıgün, 2018): (1) negative cognitions about future after loss, (2) negative/threatening interpretation of emotions and reactions to loss, (3) negative cognitions about self after loss, (4) negative cognitions about world after loss, (5) cherish grief and, (6) negative cognitions about others after loss. Scores on the questionnaire range from 0 to 150, with higher scores indicating a greater intensity of negative cognitions.

Trial sites (1)

More Ibn Haldun University trials in Turkey

Other trials for the same condition