Journal of Traumatic Stress, Vol. 20, No. 4, August 2007, pp. 625–629 ( C  2007) A 1.5-Year Follow-Up of an Internet-Based Intervention for Complicated Grief Birgit Wagner and Andreas Maercker Department of Psychopathology & Clinical Intervention, University of Zurich, Switzerland Only recently have psychotherapeutic interventions for complicated grief been developed and evaluated in randomized controlled trials. These trials have reported significant reductions in complicated grief and related symptoms in response to treatment relative to control groups. However, little is known about the long-term outcomes of these treatments. The authors present an evaluation of a 1.5-year follow-up of an Internet-based cognitive–behavioral intervention for complicated grief. Treatment group patients (n = 22) were administered various assessments of complicated grief indicators, including the Impact of Event Scale, the anxiety and depression subscales of the Brief Symptom Inventory, and the SF-12. Results indicate that the reduction in symptoms of complicated grief observed at posttreatment was maintained at 1.5-year follow-up. Only recently have two treatment approaches tailored specifically for patients experiencing complicated grief been developed and evaluated in randomized controlled tri- als (Shear, Frank, Houck, & Reynolds, 2005; Wagner, Knaevelsrud, & Maercker, 2005, 2006). The findings of these trials suggest that bereaved individuals experiencing complicated grief may benefit from these new disorder- or problem-specific treatments. Parallel to this development in the field of bereave- ment interventions, the Internet has emerged as a new de- livery channel for psychotherapeutic treatments. Wagner et al. (2006) developed and evaluated an Internet-based cognitive–behavioral intervention for complicated grief. The 5-week intervention comprised two components: structured writing disclosure and cognitive–behavioral therapy. Results of a randomized controlled trial indicated that, relative to the waiting group, the treatment group experienced significant statistical and clinical reductions in various symptoms at posttreatment and at 3-month Correspondence concerning this article should be addressed to: Birgit Wagner, University of Zurich, Department of Psychopathology, Binzm¨ uhlestr. 14/17, 8050 Zurich, Switzerland. E-mail: b.wagner@psychologie.unizh.ch. C  2007 International Society for Traumatic Stress Studies. Published online in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/jts.20230 follow-up. Specifically, significant reductions were found in the severity of the main symptoms of complicated grief (e.g., intrusion, avoidance, failure to adapt) as well as in depression and anxiety at posttreatment and at 3-month follow-up. Additionally, posttraumatic growth increased significantly during the treatment. Complicated grief as a subset of clinically significant grief reactions has been found to have a specific phe- nomenology and to be distinct from bereavement-related depressive, anxiety, and posttraumatic stress disorder symp- toms (Boelen & van den Bout, 2005; Prigerson et al., 1995). Two existing diagnostic approaches have been in- vestigated in recent years (Forstmeier & Maercker, 2006). The present study is based on the clinical conceptualiza- tion of Horowitz’s stress response theory (Horowitz, 2001; Horowitz, Bonanno, & Holen, 1993; Horowitz et al., 1997), which considers complicated grief as an interactive phenomenon of intrusive, avoidance, and maladjustment symptoms. 625