This study aimed to examine the feasibility and preliminary effectiveness of a behavioral activation (BA) program for the bereaved of cancer patients toward reducing depressive symptoms.

The BA program for the bereaved was a partially modified version for cancer patients. This program encompassed a preinterview and seven 50-minute sessions every 1–2 weeks, using worksheets, with homework assignments each day. To examine feasibility, the completion rates of intervention and 3 months of follow-up were examined. To examine the preliminary effectiveness, psychological symptoms were assessed with the Patient Health Questionnaire (PHQ-9; primary outcome) and Beck Depression Inventory-II (BDI-II) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. These were evaluated 3 times: before, immediately after, and 3-month post-intervention. Non-parametric tests were used for comparison of scores at 3 time points and calculation of effect size.

Of the 42 bereaved who were contacted, 21 were eligible and 20 were participated, while 19 and 18 were in the completed intervention and completed 3-month post-intervention categories (intervention completion rate was 95% and follow-up completion rate was 90%). PHQ-9, BDI-II, and GAD-7 showed significant reductions immediately and 3 months after the intervention compared to pre-intervention, and the effect sizes were all large after 3 months, although they were less than immediately after (PHQ-9: 0.89, 0.71; BDI-II: 0.88, 0.67; GAD-7: 0.57, 0.53).

This study indicated that the BA program for the bereaved of cancer patients was feasible and effective vis-à-vis reducing depressive symptoms.

The natural disaster in South-East Asia had a great impact in Sweden affecting many individuals and families. In this paper, a series of strategies from Ersta Association for Diaconal Work (Ersta) are described to reach survivors by the tsunami of 26 December 2004, from January 2005 to August 2007.

To find out what needs the survivors had and how professionals may work and take care of their needs during similar events in the future.

An immediate empathic effort took place at Ersta; thanks to good funding and many qualified professionals. This is a retrospective, mainly descriptive study of those strategies.

The work included training of group leaders, support groups, memorials and rituals, weekly Open House meetings, individual contacts, weekend gatherings, day seminars most marketed through Erstas’ website, advertisements and word of mouth. A total of 180 trainers/group leaders countrywide were trained and 25 became engaged at Ersta. Through the website and an unknown number of phone calls, an estimated 1362 adults, teenagers and children, grieving, injured and traumatised were reached.

The Ersta project was in many ways successful, but could not be sustained, due to lack of enough collaboration with other voluntary organisations and change of leadership. Meeting other survivors and the structure of the activities were appreciated. There was much benefit from support groups. Questions arose about how to act efficiently and when to intervene, early or/and later. Particularly to consider, early signs of resilience among survivors, their own initiatives and networks such as ‘naturally emerging groups’.

Extended collaboration between the authorities is necessary as well as continuous evaluation. A new law aimed at a more divided individual and societal responsibility. A new body (2009) under the Ministry of Defense will coordinate future resources, starting at the parish.