Psychotherapeutic Interventions and Psychosocial Outcomes Following Perinatal Loss: An Umbrella Review with a Patient-Centered Care Perspective.

BACKGROUND/

objectivesPerinatal loss is a profoundly distressing life event associated with grief, depression, anxiety, post-traumatic stress symptoms, and long-term psychosocial challenges among bereaved parents who experience miscarriage, stillbirth, or neonatal death. Although psychotherapeutic interventions are increasingly used to address these adverse outcomes, there is limited synthesis on how characteristics consistent with a patient-centered care perspective are reflected in such interventions and how they may relate to psychosocial well-being. This umbrella review aimed to synthesize evidence on psychotherapeutic interventions following perinatal loss and to examine patient-centered care-related dimensions reported across the included reviews, including therapeutic communication, patient engagement, therapeutic relationships, emotional validation, and meaning-making processes.

methodsAn umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance. Systematic reviews and meta-analyses published between 2019 and 2025 were identified through searches of PubMed, CINAHL, PsycINFO, and the Cochrane Library from database inception to 31 May 2026. Eligible reviews examined psychotherapeutic, psychosocial, and psychological support interventions designed to improve grief, depression, anxiety, post-traumatic stress symptoms, psychological distress, coping, and psychosocial well-being among bereaved parents following perinatal loss. In accordance with the predefined secondary exploratory objective, a secondary interpretive synthesis examined patient-centered care-related dimensions described within the included reviews.

resultsFive systematic reviews and meta-analyses met the inclusion criteria. Interventions included cognitive behavioral therapy, mindfulness-based approaches, bereavement counseling, psychosocial support programs, narrative interventions, supportive counseling, and digitally delivered psychological therapies. Across reviews, psychotherapeutic interventions were generally associated with beneficial effects on grief, depression, anxiety, post-traumatic stress symptoms, and broader indicators of psychosocial well-being. Communication-, support-, and engagement-related characteristics consistent with a patient-centered care perspective, including empathy, therapeutic alliance, individualized support, emotional validation, and continuity of communication, were identified through secondary interpretive synthesis as recurring features of beneficial interventions. Digital modalities, such as internet-based cognitive behavioral therapy and telephone-delivered counseling, were consistently described as supporting accessibility, engagement, and continuity of care.

conclusionsPsychotherapeutic interventions following perinatal loss appear to improve a range of psychosocial outcomes. A patient-centered care perspective may help interpret how communication, emotional validation, patient engagement, and supportive therapeutic relationships are described in relation to psychological adaptation after loss. These dimensions should be understood as interpretive characteristics identified across the included reviews rather than as directly measured mechanisms of intervention effectiveness. Future research should examine communication processes, therapeutic alliance, and patient engagement using validated measures, assess how these factors relate to intervention effectiveness, and support the development of integrated, patient-centered models of perinatal bereavement care.