Rebecca Rhodin: Bereavement support for adolescents in grief: Development and evaluation of a psychosocial self-management mobile app

Abstract

Adolescents who experience the death of a family member have an increased risk of developing mental health difficulties. Although most bereaved adolescents gradually adapt to life after loss, challenges related to understanding grief, limited coping resources, barriers to social support, and a diminished sense of agency may increase their vulnerability to mental health difficulties. Despite these risks, bereavement support for adolescents remains limited, and rigorously evaluated interventions tailored to their needs are currently scarce.

The overall aim of this thesis was, therefore, to develop and evaluate a self-management mobile application designed to support adolescents bereaved of a parent or sibling. Guided by a mixed methods approach, quantitative and qualitative methods were integrated to generate a comprehensive understanding of the intervention’s development, feasibility, acceptability, perceived impact, and effectiveness. 

The findings indicate that the bereaved adolescents who collaborated as research partners in the intervention development contributed influential perspectives that shaped key aspects of the intervention design. They experienced their involvement as meaningful, highlighting the potential of collaborative research to promote agency among young mourners while enhancing intervention relevance. Across the studies, although engaging with the app was often emotionally challenging for the adolescents, the intervention was generally appreciated and perceived as relevant. They particularly valued the flexibility of the mHealth format, which enabled engagement according to individual needs and emotional capacity. Consequently, the findings suggest that the app supported processes central to adaptive grieving, including an increased understanding of grief, stronger coping resources, improved communication about grief, and meaning-making related to the loss and its implications for the self and the future. These experiences may represent pathways through which the intervention contributed to improved mental health, as adolescents receiving the intervention demonstrated greater long-term reductions in grief reactions and symptoms of prolonged grief, posttraumatic stress, and depression compared with adolescents receiving an active control condition.

This thesis provides the first evaluation of a self-management mobile application specifically designed for bereaved adolescents. The findings suggest that mHealth interventions, and the app in particular, may represent a promising approach for increasing access to bereavement support and promoting mental health among young mourners.