Do community-based support services benefit bereaved children? A review ofempirical evidence

Aims To consider the evidence of effect from English language, empirically based quantitative evaluations of community-based interventions for bereave d children; community-based interventions being understood as those taking place outside a clinical setting. Methods MedLine, PsychInfo, Applied Social Sciences Index and Sociological Abstracts were searched for documents containing the words 'child', 'bereav ement' and 'program', 'group', 'intervention', 'support' or 'evaluation'. T he criterion for inclusion was that studies use a control group or pre- and post-test measurements using a standardized instrument. Results Nine relevant studies were identified. However, empirical evidence of positive outcomes for children was limited and compromised by methodolog ical weaknesses in the design of the studies. Small sample sizes, irregular attendance, high levels of attrition, short time scales between pre- and p ost-testing and difficulty in developing appropriate instrumentation, inclu ding assessment of adherence to the agreed intervention programme, all crea ted problems. Conclusions The case for universal inclusion of this group of children in s uch support programmes remains unproven, and further exploration of the out comes of a range of different community interventions is required, with a s pecific focus on long-term and/or unwanted effects and evaluation of the ba sis for referral.