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Psychologia. Avances de la Disciplina

On-line version ISSN 1900-2386

Psychol. av. discip. vol.18 no.1 Bogotá Jan./June 2024  Epub Oct 03, 2024

https://doi.org/10.21500/19002386.6577 

Artículo de investigación

Tratamientos terapéuticos para afrontar la ruptura amorosa: Una revisión sistemática

Therapeutic treatments to cope with a love breakup: a systematic review

Libia Yanelli Yanez Peñuñuri1 
http://orcid.org/0000-0003-4682-5123

César Armando Rey-Anacona2 
http://orcid.org/0000-0002-9528-2199

Yolima Bolívar Suárez2 
http://orcid.org/0000-0001-9621-2806

1 Universidad de Sonora; Mexico

2 Universidad Pedagógica y Tecnológica de Colombia; Colombia.


Abstract

The study aimed to conduct a systematic review of therapeutic treatments to cope with a love breakup from 1992 to 2023 in Spanish, English and Portuguese in EBSCO, PsycINFO, PubMed, Scopus, and Web of Science (WOS). Two independent researchers performed the searches and data extraction. Out of 156 records, 13 articles are included addressing treatments to cope with love breakups. Most of the studies found were in the United States and Iran and aimed to women. The studies showed a significant decrease in symptoms of depression and anxiety during the love breakup. Empirical evaluation of the efficacy of future interventions to deal with breakups is recommended, based on experimental designs in adolescents and young people of both sexes.

Key words: Therapeutic treatment; love breakup; couple breakup; review; love relationship

Resumen

El objetivo del estudio fue llevar a cabo una revisión sistemática acerca de los tratamientos terapéuticos para afrontar la ruptura amorosa de 1992 a 2023 en español, inglés y portugués en EBSCO, PsycINFO, PubMed, Scopus y Web of Science (WOS). Dos investigadores independientes realizaron las búsquedas y extracción de datos. De 156 registros, se incluyeron 13 artículos que abordaron tratamientos terapéuticos para afrontar la ruptura amorosa. La mayor parte de los estudios que se encontraron fue en Estados Unidos e Irán y fueron dirigidos a mujeres. Los estudios mostraron una disminución significativa en los síntomas de depresión y ansiedad por la ruptura amorosa. Se recomienda la evaluación empírica de la eficacia de las futuras intervenciones para afrontar la ruptura amorosa a partir de diseños experimentales en población adolescente y joven jóvenes de ambos sexos.

Palabras clave: Tratamiento terapéutico; ruptura amorosa; ruptura de pareja; revisión; relación amorosa

Throughout life, people deal with diverse socialization experiences allowing them to establish relationships or bonds including romances (one of the most satisfying ones helping in the processes of identity, self-esteem, and intimacy) where cognition, behaviors and emotions interact (Blanco, 2011; Bonilla-Algovia & Rivas-Rivero, 2021; Jankowiak & Fischer, 1992; Valdez Medina et al., 2016). Furthermore, romantic relationships occur at a social framework mediated by cultural patterns influencing the way in which the members of the couple perceive themselves and behave (Bonilla-Algovia & Rivas-Rivero, 2021; Maureira-Cid, 2011).

Romantic relationships are set up, then, as an important bond whose ending could represent an event causing emotional distress, confusion, anguish, anxiety, stress, depression, suicidal attempts, sleeping disorders, drug abuse, among other conditions (Barajas-Márquez et al., 2017; Barajas-Márquez & del Castillo Cruz, 2017; Lewandowski, 2009; Martínez-Gómez et al., 2021; Rivera-Aragón et al., 2022). Traumatic events are considered as predictors of mental health issues (Espinosa-Sierra et al., 2017; Schrock et al., 2021). Barajas-Márquez et al. (2017) found that love breakups were the second most common cause of traumatic events in a study with 326 university students between the ages of 17 and 26. This proves the importance people give to these types of relationships.

The statistical landscape points out that a great deal of the population is immersed in love relationships and, in consequence, facing eventual breakup processes. For instance, in the United States in 2019, the marriage rate was 16.3 per 1000 inhabitants in people older than 15 years of age, but the divorce rate was 7.6 per 1000 inhabitants (Manning & Payne, 2021).

Among married adults older than 20 years of age, 34% of women and 33% of men had divorced at least once, while this rate was 43% for adults between the ages of 55 and 64 (U.S. Census Bureau, 2021). In Mexico, the National Institute of Statistics and Geography (INEGI 2018) in the National Survey of Demographic Dynamic found that for people between the age of 15 and 29, corresponding to 30.7 million people, 20.1% lived in cohabitation, 11.9% were married and 3.8% had separated, divorced, or widowed.

In Chile, love breakups represent the second cause of suicide among youngsters between 15 and 29 years of age (García et al., 2020). Puente (2017) found that 48.2 % of a group of Ecuadorian adults experiencing a love breakup suffered from moderate to acute depression, while Brassard et al., (2018) found that anxiety due to abandonment in Canadian adults experiencing a breakup was related to depression symptoms and the severity and intensity of suicidal ideation.

Therefore, negative consequences triggering before a breakup or love distress and love grief and their affectation in a broad population group lead to consider this situation as a public health issue. From clinical psychology and psychiatry perspectives, various treatments and therapeutic models have been implemented to address love breakups individually, in groups, in-person, or online, such as Integrative Therapy for Emotional Regulation, a third-generation behavioral-contextual therapy focused on treating emotional and affective problems. It promotes accepting psychological discomfort, improves problem-solving, and develops skills for establishing healthy and lasting social relationships. The treatment involves validating the patient's emotions, replacing ineffective strategies with effective ones, clarifying life values, reevaluating emotional and personal assumptions, and preparing the patient to prevent relapses (Alcázar-Zapata & Hernández-Brussolo, 2018). Another therapy is Behavioral Activation Therapy: This involves setting short and long-term goals to gradually increase the frequency and duration of activities, which generate a positive mood through a sense of achievement and self-recording of commitment (Kavanagh et al., 2016).

The Worden's Tasks of Mourning Model also proposes four essential tasks for processing grief and adapting to life after a loss, such as that experienced in a love breakup. These tasks range from accepting the reality of the loss, living and connecting with the pain it causes, adapting to everyday life without the loved one by developing new skills, assuming roles previously performed by the lost person and rebuilding self-concept, to emotionally relocating the lost person so that one can continue to invest emotional energy in other relationships and life in general (Worden, 2018; Navarro-Vásquez, 2020). In addition, Spiritual-Religious Psychotherapy: A love breakup can be a traumatic event, leading individuals to rely on their spirituality and religion. Interventions from this approach can improve or mitigate symptoms of emotional distress (Behdost et al., 2019).

Regarding reviews and meta-analyses on romantic breakups, Field et al. (2011) conducted a non-systematic review of the literature on research on distress due to the breakup of a relationship that has used the scale for the breakup of a relationship (Field et al., 2009) in university students. The authors found that distress due to breakup is related to symptoms of depression, anxiety, sleep disorders, poor academic performance, and disorganized behavior. On the other hand, Mirsu-Paun et al. (2017) conducted a meta-analysis to analyze the magnitude of the association between the quality of romantic relationships, romantic breakups, and mental health symptoms. The authors found an association between adolescent romantic breakups with symptoms of depression and self-harm in women. Machia et al. (2023) reviewed the literature on research into relationship breakups in the last 20 years. The review was aimed at analyzing the methodological, theoretical, and conceptual approaches regarding the definitions and measurement instruments of romantic breakups. However, there is no literature record of systematic reviews that address treatments to deal with romantic breakups.

Nevertheless, scientific evidence about treatments specially designed to cope with love breakups, as well as reviews summarizing the ways of approach allowing to characterize the reach and impact of such interventions are scarce. In this sense, it is important to mention that mental health difficulties associated with couple difficulties are one of the main reasons of clinical attention (Peel et al., 2018) and that the current standards point out the need of having treatments with empirical support allowing to take care of this type of needs with the best empirical evidence possible indicating that these treatments are clinically effective and useful (APA Presidential Task Force on Evidence-Based Practice, 2006).

It should be noted that no reviews summarize the approaches to characterize treatments' reach and impact to cope with a love breakup, therefore, this review aimed to review therapeutic treatments to cope with love breakups to determine the most effective ways for interventions allowing to design and/or adapt, implement, and assess these programs or treatment strategies underpinning clinical actions for the attention of people with difficulties associated with breakups.

Method

Search strategy

For the elaboration of this systematic review, the guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) (Liberati et al., 2009) methodology were considered. The searches were carried out by two independent authors from May 20 to May 30, 2023, in the following data bases: EBSCO, PsycINFO, PubMed, Scopus and Web of Science (WOS) in English, Spanish, and Portuguese. The search period included a period of 30 years (January 1 1992 to May 30 2023), considered enough to identify and get to know the therapeutic treatment effective to cope with love breakups (Muela Aparicio & Sansinenea Méndez, 2020).

The following combinations of key words by title and abstract were used for the realization of the searches: (a) Spanish: ruptura amorosa OR ruptura de pareja OR afrontamiento de ruptura amorosa OR duelo amoroso OR duelo por ruptura de pareja AND Intervención OR tratamiento OR terapia; (b) English: romantic breakup OR romantic relationship breakup OR love grief OR love duel AND intervention OR therapy OR treatment; (c) Portuguese: separação romântica OR rompimento de um relacionamento amoroso OR luto amoroso AND intervenção OR terapia OR tratamento. In table 1, different searches in the databases are fully shown. The protocol of this systematic review was registered in the data base of systematic reviews called PROSPERO with registration number CRD42022335652.

Table 1 Search strategy and terms used in the different sources of information in English, Spanish and Portuguese. 

EBSCO and APA PsycInfo
Spanish: AB (ruptura amorosa OR ruptura de pareja OR afrontamiento de ruptura amorosa OR duelo amoroso OR duelo por ruptura de pareja) AND (Intervención OR tratamiento OR terapia) English: AB (romantic breakup OR romantic relationship breakup OR love grief OR love duel) AND AB (intervention OR therapy OR treatment) Portuguese: AB (separação romântica OR rompimento de um relacionamento amoroso OR luto amoroso) AND AB (intervenção OR terapia OR tratamento)
Pubmed
Spanish: (ruptura amorosa[Title/Abstract] OR ruptura de pareja[Title/Abstract] OR afrontamiento de ruptura amorosa[Title/Abstract] OR duelo amoroso[Title/Abstract] OR duelo por ruptura de pareja[Title/Abstract]) AND (Intervención[Title/Abstract] OR tratamiento[Title/Abstract] OR terapia[Title/Abstract]) English: (romantic breakup[Title/Abstract] OR romantic relationship breakup[Title/Abstract] OR love grief[Title/Abstract] OR love duel[Title/Abstract] AND (Intervention[Title/Abstract] OR treatment[Title/Abstract] OR therapy[Title/Abstract]) Portuguese: (separação romântica[Title/Abstract] OR rompimento de um relacionamento amoroso [Title/Abstract] OR luto amoroso[Title/Abstract] AND (intervenção [Title/Abstract] OR terapia[Title/Abstract] OR tratamento[Title/Abstract])
Scopus
Spanish: TITLE-ABS-KEY (ruptura amorosa OR ruptura de pareja OR afrontamiento de ruptura amorosa OR duelo amoroso OR duelo por ruptura de pareja AND Intervención OR tratamiento OR terapia) English: TITLE-ABS-KEY (romantic breakup OR romantic relationship breakup OR love grief OR love duel AND intervention OR therapy OR treatment) Portuguese: TITLE-ABS-KEY (separação romântica OR rompimento de um relacionamento amoroso OR luto amoroso AND intervenção OR terapia OR tratamento)
Web of Science (WOS)
Spanish: ruptura amorosa OR ruptura de pareja OR afrontamiento de ruptura amorosa OR duelo amoroso OR duelo por ruptura de pareja AND Intervención OR tratamiento OR terapia (Title) English: romantic breakup OR romantic relationship breakup OR love grief OR love duel AND intervention OR therapy OR treatment (Title) Portuguese: separação romântica OR rompimento de um relacionamento amoroso OR luto amoroso AND intervenção OR terapia OR tratamento (Title)

Selection strategy

The selected studies included treatments of therapeutic interventions to cope with love breakups selected independently by the two authors of this review. The inclusion criteria were established based on the criteria from the PICOS format (Perestelo-Perez, 2013): (a) Description of the participants: adolescents or young adults, men and women, of 12 to 29 years of age, single or married having a love breakup and participating in a treatment to cope with affective loss; (b) type of study: empirical and case studies; (c) comparators: studies including or not the comparison of intervention groups (e.g. experimental group or control group); (d) description of results: effectiveness and feasibility of interventions or treatments to cope with love breakups; (e) type of design: experimental design, quasi-experimental, pre-experimental, and case studies on the implementation of a psychological treatment to cope with love grief. Plus, papers mentioning other types of losses or griefs apart from love breakups were excluded. Moreover, the implementation of quality criteria was implemented in the case of many papers (50 or more).

Data collection process

To summarize the scope and impact of the research, the following elements were included: authors, country of origin, sample, percentage of participating women, range, average and standard deviation of ages, object of the intervention, number of sessions, topics or intervention components, type of study, theoretical basis or techniques, results, contribution or scope and limitations.

Results

156 papers were reviewed after having eliminated duplicates and 13 articles satisfying the inclusion criteria were included in the systematic review (see Figure 1). Three of them were from the United Stated, three from Iran, two from Indonesia, one from Bolivia, one from Colombia, one from Spain, one from Mexico, and one from Pakistan.

Figure 1 Flowchart of the selection of therapeutic treatment studies to deal with love breakups. 

Regarding the methodological characteristics of the studies included, the number of participants ranged from 1 to 152 adults between the age of 18 and 59 having recently ended a love relationship. It is worth mentioning that in 9 out of 13 studies, the percentage of participants was greater for women (see Table 2).

Table 2 Description of the interventions to deal with love breakups 

Authors and year Country of orign Sample % of women Range and mean age Objective of the study
Dehghani, et al., 2011 Ir 5 adult women 100 24-26, 24.8 To investigate the efficacy of a short-term dynamic therapeutic intervention for love trauma syndrome.
Carmona, 2012 Co 4 adults 50 31-49, 39.2 To identify the main grieving responses to loss that the breakup of a couple implies, and the intervention techniques based on the review of four medical records.
Falb, 2015 US 87 Adults 78 21.5 To compare the effects of a mindfulness meditation training condition with those of a relaxation training condition and with a no-treatment condition among people facing a recent nonmarital romantic breakup.
Harris, 2015 US 58 adults 56 18-24, 19.7 To test the hypothesis that Hatha yoga and mindful meditation reduce distress and rumination associated with breakups in college students.
Negash et al., 2016 US 152 adults 73 19.5 To evaluate the impact of a relationship education program on those having experienced psychological aggression in their ex-partner relationship.
Rajabi et al., 2018 Ir 44 adults 75 20-23, 22.7 To compare the effectiveness of two intervention protocols: one focused on transactional analysis training and the second on emotional regulation therapy to reduce love trauma syndrome.
Valadez et al., 2018 Mx An adult man 0 N/A, 29 To evaluate the efficacy of an intervention in models of brief cognitive-behavioral therapy and solution-focused therapy in a case of grief due to a love breakup.
Novo et al., 2019 Sp 116 adults 52 22-59, 39.4 To evaluate the effects of an educational program on mental health problems in separated parents. .
Soltani et al., 2019 Ir Three adult women 100 20-24, 21.6 To investigate the efficacy of compassion-focused therapy on depression and rumination after a breakup.
Menaldi, et al., 2020 Id An adult man 0 N/A, 26 To assess the efficacy of intervention in cognitive behavioral therapy to reduce symptoms of depression, such as sadness and the idea of being unworthy, as well as to increase self-confidence to face the difficulties derived from a love breakup.
Ponce Valdivia et al., 2020 Bo An adult 0 N/A, 19 To describe from a qualitative methodology the therapeutic process from a structural approach and problem-focuses therapy applied to the breakup of a young man.
Qasmani et al., 2021 Pk 18 adults 72 18-30, 24.2 To examine the efficacy of play therapy interventions on breakup distress and depression symptoms among people with nonmarital breakup.
Krisnamurthi et al., 2021 Id 8 adult women 100 20-25, - To develop an online intervention program to help young adults improve their self-esteem and their ability to forgive after a relationship breakup.

Note: Bo= Bolivia, Co= Colombia, Sp=Spain, US=United Stated, Id= Indonesia, Ir= Iran, Mx= Mexico, Pk= Pakistan. The hyphen (-) means no information was provided, N/A= not applicable.

In general, the objectives of the studies comprised to design and to assess the efficacy of therapeutic interventions involving from 1 to 16 sessions to deal with issues such as anguish, depression symptoms, rumination, anxiety, love grief, and love trauma syndrome defined by Rosse (1999) as a series of severe symptoms among people suffering a love breakup affecting their functionality and generating maladaptive responses (see Table 2 and Table 3).

Table 3 Methodological characteristics and results of the interventions to cope with love breakups 

Authors and year Number of sessions Topics or elements Study design Theoretical approach or technique Results
Dehghani, et al., 2011 20 Restructuring of defense, restructuring of affect and self-restructuring. CSF STARP All subjects completing treatment showed significant improvement in their symptoms, including depression and general functioning.
Carmona, 2012 from 1 to 12 Empathy, clarification of the role played by the former partner, restructuring of dysfunctional attributions of the loss, review of the current role towards the partner and strengthening of self-esteem. CS CBT Recommendations about the techniques that can be used in future studies based on the presentation of the clinical cases are presented.
Falb, 2015 4 Psychoeducation on the effects of stress in romantic breakup, mindfulness meditation, and relaxation training. E MM Mindfulness meditation was not significantly more effective than relaxation.
Harris, 2015 6 Mindfulness meditation, mini body scan (reported by MBSR), Hatha yoga, pranayama (breathing), mantra, and savasana (relaxation). E HY and MM There were statistically significant differences in the use of Hatha yoga and mindfulness meditation in reducing rumination in the experimental and control groups.
Negash et al., 2016 13 Healthy relationships, warning signs related to unhealthy relationships, communication skills, stress management, and identification of personal needs. E CBT Compared to participants in the control group, participants in the experimental group were significantly more likely to end their relationship.
Rajabi et al., 2018 8 Intervention in emotional regulation: Regulation of emotions, increase of positive emotions, management of emotions, problem solving technique. Transactional analysis: Personality states, form of interaction, life script, and helping individuals to know themselves (self-knowledge). E ERT and TA Statistically significant differences were found between the two experimental groups and the control group. Both the emotional regulation intervention and the one based on transactional analysis reduced love trauma syndrome.
Valadez et al., 2018 11 Self-esteem, working on your relationship pattern, reducing symptoms of depression and anxiety. CS CBT and SFT The therapeutic objectives were achieved, there was a great decrease in symptoms of depression and anxiety.
Novo et al., 2019 16 Awareness of the negative effects of separation on mental health, relationship and benefits of parental collaboration, child development, parenting styles. Q CBT The intervention had a significant effect in reducing mental health problems between 19% phobic anxiety to 36% depression and generalized anxiety in separated parents, compared to the control group.
Soltani et al., 2019 8 Familiarity with compassion-focused therapy, understanding of emotions, three streams of compassion, self-critical coping styles. QC CBT Significant effects were obtained in reducing depression and mental rumination.
Menaldi, et al., 2020 5 Acknowledgement of patterns of thought patterns, relationships, problem solving and assertive communication skills. CS CBT Symptoms of depression, such as sadness and the idea of being unworthy, were decreased. In addition, self-confidence to face difficulties was increased.
Ponce Valdivia et al., 2020 8 Acknowledgement of mistakes made within the couple relationship, reformulation of the concept of love and work based on the functioning of the family system. CS EE and PFT The mistakes and benefits of the relationship were identified, and the concept of love was reformulated.
Qasmani et al., 2021 7 Acknowledgement of loss, coping and problem- solving skills, guided meditation, self-care. Q Six Rs Therapy, PT Statistically significant differences in relation to the control group in the reduction of breakup anguish were obtained, but not in depressive symptomatology.
Krisnamurthi et al., 2021 8 Self-esteem, forgiveness, healthy vs. unhealthy relationship, management of cognitive distortions, advance plan to cope with problems. Q CBT Differences were found between participants' scores before and after participating in increased self-esteem and their ability to forgive.

Source: Self-made. Note: The hyphen (-) means no information was given, CBT= Cognitive Behavioral Therapy, MM=Mindfulness Meditation, HY= Hatha Yoga, SFT= Solution-Focused Therapy, STARP= McCullough’s Short-Term Anxiety Regulating Psychotherapy CFT=Compassion-Focused Therapy, ERT= Emotional Regulation Therapy, TA= Transactional Analysis, SA=Structural Approach, PFT=Problem-Focused Therapy, PT=Play Therapy, CS=Case-study, CSF= Case-study with baseline and follow-up, E= Experimental with pre- and post-test, Q= Quasi-experimental with pre- and post-test, QC= Quasi-experimental single case and simple baseline.

Treatments varied depending on their design: five were case studies (Carmona, 2012, Dehghani, et al., 2011, Menaldi et al, 2020; Ponce Valdivia et al 2020; Valadez et al., 2018), four used quasi-experimental designs (Krisnamurthi et al., 2021; Novo et al., 2019; Qasmani et al., 2021; Soltani et al., 2019), and four were experimental (Falb, 2015; Harris, 2015; Negash et al., 2016; Rajabi et al., 2018). Of the 13 studies selected, one of them was applied online (Krisnamurthi et al., 2021) and more than half of them (7) informed on the realization of a follow-up measure starting from the second week up to six months (Dehghani, et al., 2011; Falb, 2015; Harris, 2015; Menaldi et al., 2020; Rajabi et al., 2018; Soltani et al., 2019; Valadez, et al., 2018).

Regarding the theoretical approaches considered in treatments dealing with love breakups, six consisted in Cognitive Behavioral Therapies (CBT Carmona, 2012; Krisnamurthi et al., 2021; Menaldi, et al., 2020; Negash et al., 2016; Novo et al., 2019; Soltani et al., 2019), incorporating some of the following elements: psychoeducation, empathy, healthy relationships, stress management, and identification of personal needs, restructuring on dysfunctional attributions of loss, strengthening of self-love, management of cognitive distortions and an anticipated plan to cope with issues (see Table 2 and Table 3). Plus, two studies considered CBT and other approaches. In one of them, Valadez et al. (2018) considered CBT and Solution-Focused Therapy from Systems Theory (ST) centering its elements in the improvement of self-esteem and the reduction of depression symptoms and anxiety. Rajabi et al. (2018) carried out an assessment of the efficacy of two protocols: one supporting Emotional Regulation Therapy (ERT) and another one Transactional Analysis.

On the other hand, Qasmani et al. (2021) used Rando's Six R's Mourning Therapy (1993) with techniques from Play Therapy and the following topics: acknowledgement of the loss, coping skills and problem solving, confrontation, guided meditation, strategic technique of belonging and self-care. Plus, Ponce Valdivia et al. (2020) included topics such as the reformulation of the concepts of love and work based in the functioning of the family system of the young person allowing to get over the love relationship, based on Solution-Focused Therapy and Structural Approach. In the same way, the intervention performed by Degahni et al. (2011) incorporated McCullough et al.’s (2003) Short-Term Anxiety-Regulating Psychotherapy, a model of integrative dynamic psychotherapy using an empathic and collaborative relation for the feelings of the individual and their peers divided in three parts: restructuring of defense, restructuring of affect, and participants’ self-restructuring.

In reference to the use of other techniques, an intervention considered mindfulness meditation and Hatha yoga using the following elements: full attention meditation, body mini-scan, Hatha yoga, pranayama, mantra and savasana (Harris, 2015). In the same line, Falb (2015) based his intervention in mindfulness meditation and relaxation training (see Table 2).

In reference to the effectiveness and the feasibility of the interventions included in this review, six studies informed a decrease in depressive and anxious symptomatology, and an improvement in general functioning (Dehghani, et al., 2011; Menaldi et al., 2020; Novo et al., 2019; Valadez, et al., 2018). Plus, Soltani et al. (2019) reported significant effects in depression and sadness symptoms and an increment in self-confidence. Nevertheless, in Qasmani et al.’s intervention (2021), the decrease in anguish with respect to a control group was reported, not being the case for depressive symptomatology. Additionally, Rajabi et al. (2018) found that both emotional-regulatory intervention and the one based in transactional analysis reduced love trauma syndrome finding statistically significant differences with respect to the control group. Besides, Krisnamurthi et al. (2021) obtained differences among scores of participants before and after treatment indicating an increase in self-esteem and the ability to forgive. Likewise, in the research by Negash et al. (2016), the participants having experienced psychological aggression from their ex-couples and receiving treatment on education in abusive relationships showed more probabilities in breaking up their relationship compared to the control group.

Carmona’s study (2012) identified the main responses to grief after a breakup and intervention techniques from four case studies in adults. The author recommends techniques for future treatments such as: clarifying the role played by the ex-couple, emotional venting, love, dignity, restructuration of loss dysfunctionality, role towards the couple, and strengthening of self-love. In the same line, Ponce Valdvia et al. (2020) described a qualitative approach to the therapeutic process of a case study from a structural approach and problem-focused therapy of a young person suffering from a love breakup. The intervention was oriented to the acknowledgement of the mistakes made during the couple’s relationship, the reformulation of the concepts of love as the main therapeutic problem, and the coping of their parents’ separation.

In the interventions including mindfulness and Hatha yoga techniques, Falb (2015) identified the first one as not more statistically effective than relaxation. Harris (2015) reported statistically significant differences in the use of Hatha yoga and conscious meditation directed to the decrease in rumination associated with love breakups between the experimental group and the control group.

Discussion

This work aimed to review the current trend in therapeutic treatments to cope with love breakups. For this purpose, 156 records in a span of 31 years were reviewed and 13 were selected based in the criteria of inclusion, developed in countries from different regions, suggesting the love grief is a circumstance affecting humans all around the world. This number of studies can be considered low when such a long period of time for this review is taken into account as well as the negative impact on mental health provoked by love grief, an issue affecting a wide sector of the population (Barajas-Márquez et al., 2017; Barajas-Márquez & del Castillo Cruz, 2017; Lewandowski, 2009; Martínez-Gómez et al., 2021; Rivera-Aragón et al., 2022; U.S. Census Bureau, 2021). Plus, there is a lack of studies aimed to empirically assess these programs in several continents and regions such as Europe, Eastern Asia, Africa, and Oceania. In this sense, Peel et al. (2018) highlighted the lack of interventions based on evidence for individuals and couples experiencing difficulties in their relationship, according to information from 15 psychologists in Australia performing a semi-structured interview. They also pointed out that these difficulties are usually diagnosed and treated like depression or anxiety and that many psychologists use non-evidence-based treatments to deal with these difficulties.

On the other hand, it is interesting to note that in 9 out of the 13 studies selected, most of the participants were women, suggesting that they possess a greater awareness of the need for help for these types of issues than men, due to socio-cultural factors validating this request among women, but not in men, because it goes against gender expectations towards the latter, such as projecting themselves as not being weak, strong and self-contained (Soria, 2018). However, the scope of this study cannot support these claims; therefore, it is recommended to consider in future studies the differences by sex, cultural factors, and marriage perception when dealing with love grief since it represents a topic without a lot of studies available in the literature. On the other hand, it is worth mentioning that none of these programs aimed to teenagers but to young adults and adults although it is well-known that teenagers represent a population usually exposed to factors of psycho-social risk such as sexual abuse, bullying, and violence during dating affecting their physical and sexual health (Kim et al., 2019; World Health Organization, 2022). Plus, adolescence is the period of life cycle in which people commonly experience their first romantic relationships, being that love grief at this stage of life has been related to suicidal behavior (Londoño & Cañón, 2020; Moulinec, 2022). Therefore, it would be convenient to access to programs with empirical support aimed to deal with love grief in this population.

Moreover, it is noted that 8 out of 13 studies stated that cognitive behavioral treatment was exclusively used or along with techniques coming from other approaches. This suggests a greater interest in empirical validation of psychological treatments for love grief by researchers working from this approach compared to other psychotherapeutic approaches as generally observed in psychotherapy (David et al., 2018).

Although treatments are also part of other approaches, the convergence of some topics and techniques such as psychoeducation on health effects provoked by affective loss, loss acknowledgement, and relationship patterns, knowledge on the characteristics of healthy relationships, self-esteem or self-love, meditation and relaxation techniques, problem solving abilities, and coping strategies become evident. Considering that the studies selected inform, in general, on favorable effects of interventions on emotional symptomatology and aspects such as self-esteem, it would be convenient to consider these topics and techniques for the formulation of new treatment programs.

Nonetheless, methodologically speaking, and despite these positive results, most of these studies did not implement experimental designs but quasi-experimental ones and case studies. Plus, out of the 13 studies, only 4 included more than 50 participants. The independent effect of their elements was not examined either. Although more than half of them carried out follow-up measurements, these did not exceed six months after the implementation of the program. Thus, these interventions require more research to verify their effectiveness to reach criteria of therapeutic efficacy according to the parameters from the American Psychological Association (2002; APA Presidential Task Force on Evidence-Based Practice, 2006).

In conclusion, this review points out a relatively low number of interventions to deal with difficulties associated with affective loss around the world, so it is recommended to create new treatments for love grief and to continue the assessment of treatments with favorable evidence including teenagers and considering socio-cultural factors influencing the management of grief in men opposed to women and evaluated against experimental designs, large enough samples, incorporating yearly, biannual, and 5-year follow-up measurements after the implementation of the program to move towards the administration of these treatments and in other populations and regions. It is also recommended to examine the effect of each individual element, in this way, it will be possible to have empirical evidence available to support the use of these programs in clinical practice avoiding the use of non-specifically designed treatments for these issues improving in this way clinical attention (APA Presidential Task Force on Evidence-Based Practice, 2006; Peel et al., 2018).

This systematic review is strengthened by the extensive search period, the implementation of information systems including an important number of publications such as Web of Science and EBSCO, and the performance of two independent searches including experimental, quasi-experimental and case studies. However, some limitations include the lack of inclusion of other regional information systems of free access that could have provided studies about treatments for love grief such as Redalyc or Scielo as well as the non-implementation of quality indexes for the paper selection, although this was disregarded due to the low number of papers selected.

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Para citar este artículo: Yanez-Peñuñuri L. Y., Rey-Anacona C.A. & Bolívar-Suárez Y. (2024). Therapeutic treatments to cope with a love breakup: a systematic review. Psychologia. Avances de la Disciplina 18(1) pp. 23-37. https://doi.org/10.21500/19002386.6577

Received: March 23, 2023; Accepted: April 12, 2023

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