Community-based counseling reaches and helps bereaved people living in low-income households

Catherine Newsom, Margaret S. Stroebe, Henk Schut, Stewart Wilson, John Birrell, Mirjam Moerbeek, Maarten C. Eisma

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OBJECTIVE: Poverty is related to increased grief-related mental health problems, leading some to suggest bereavement counseling should be tailored to income. However, information about accessibility and effectiveness of such counseling programs serving low-income households is scarce. This longitudinal study therefore investigated the association between poverty and complicated grief (CG), and the effectiveness of a community-based bereavement counseling program in serving low-income households.

METHODS: Two hundred eighty-eight participants (75% female) were enrolled. Loss-related and demographic variables were assessed at baseline. Regression analyses were used to investigate household income as a predictor of CG, and examine bereavement counseling effectiveness by comparing CG symptom change across three household income categories across three time-points: baseline (T1), T1 + 12 months (T2), and T1 + 18 months (T3).

RESULTS: Of all participants, 35.8% reported below poverty-threshold income, twice the general population's rate. Multiple regression analysis indicated poverty-threshold income was a predictor of CG symptoms over and above demographic and loss-related characteristics. Three-way interaction analysis detected a significant treatment effect for study condition across time, but no differences in treatment effects across income.

CONCLUSION: Lower household income was associated with higher CG symptoms. Since income did not predict differential treatment response, community-based bereavement counseling appeared no less efficacious for members of low-income households.

Original languageEnglish
Pages (from-to)479-491
Number of pages13
JournalPsychotherapy research
Issue number4
Early online date25-Sept-2017
Publication statusPublished - 4-Jul-2019


  • bereavement
  • grief
  • poverty
  • counseling
  • effectiveness
  • CARE

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