Clinical utility of the Bereavement and Grief Cultural Formulation Interview (BG-CFI) in psychotherapy for traumatic grief in refugees

Background: Refugees seeking mental healthcare often present with comorbid prolonged grief disorder (PGD) and (symptoms of) PTSD and/ or depression. Brief Eclectic Psychotherapy for Prolonged and Traumatic Grief (BEPPTG) integrates evidence-based cognitive behavioural interventions for PGD, PTSD, and depression with culturally sensitive, meaning-focused interventions. The Bereavement and Grief Cultural Formulation Interview (BG-CFI) has been developed to promote culturally sensitive treatment, but its clinical utility has not yet been evaluated.

Objective: To evaluate the clinical utility of the BG-CFI in culturally sensitive application of BEPPTG in refugees.

Method: Interviews were conducted with psychotherapists practicing BEPPTG (N = 8). Topics included the contribution of the BG-CFI to the therapy, how therapists handle discrepancies between cultural preferences and the BEPPTG protocol, variations in treatment, and alignment of grief psychotherapy with non-Western perspectives on grief. Thematic analysis was applied.

Results: Six themes emerged that illustrated the clinical utility of the BG-CFI: understanding grief in context, thinking in terms of possibilities, adapting therapy, the patient’s personal relationship to cultural traditions, avoidance versus culture, and shared decision-making.

Conclusions: Results support the utility of the BG-CFI in culturally sensitive psychotherapy for refugees with traumatic grief. The use of the BG-CFI enhances the understanding of grief in context, and adjusting BEPPTG interventions based on BG-CFI outcomes leads to a tailored treatment. The BG-CFI supports aligning with patients’ worldviews by exploring their personal relationship with cultural traditions.