Help Texts Grief Intervention for Bereaved College Students

Overview

The proposed study aims to evaluate the effectiveness of Help Texts, a weekly text-based program, among bereaved students at UCLA. Specifically, the study will evaluate whether Help Texts reduces grief severity and symptoms of depression, and whether it improves academic functioning (e.g., graduation, grades, student enrollment retention). The investigators hypothesize that bereaved UCLA students who receive a 12-month Help Texts weekly digital text intervention will have reduced grief severity and depressive symptoms and increased academic functioning compared to bereaved UCLA students in a waitlist control condition receiving treatment as usual (i.e., list of resources for grief). Participants will complete surveys at four timepoints: baseline and 3 months, 6 months, and 12 months following enrollment. They will be randomly assigned to either the treatment condition (receive 12-month Help Texts subscription at enrollment) or the waitlist control condition (receive list of resources for grief at enrollment, and receive 12-month Help Texts subscription at 6 months following enrollment). The Help Texts program involves texts offering psychoeducation related to grief and coping strategies, delivered twice weekly.

Detailed description

Grief and loss are common occurrences among students on college campuses but are inadequately addressed and associated with a number of negative outcomes. A mixed methods study of grieving students on a large campus found that 60% of those surveyed within a 3-year period at UCLA reported experiencing the loss of a loved one, but only 8% reported using campus resources to aid them during their grief, and only 38% sought resources off-campus (e.g., therapy, support groups, psychiatry). Numerous barriers to accessing grief support resources have been identified, including not knowing about them or perceiving them to be inadequate. Moreover, over one-third of participants interviewed in the study noted stigma associated with help-seeking. Despite a high prevalence of experiences of grief among students, resource utilization for supporting bereavement remains low.

Help Texts offers text message-based grief support, overcoming the barriers of access and stigma by providing up to a year of private, evidence-based grief support developed by clinical psychologists. Help Texts is an established company (specifically, a Public Benefit Corporation) and is currently in use. It was founded in 2018 and comprises a fully remote, 7-person team with over 100+ additional Expert Contributors providing expertise on different types of loss (e.g., the loss of a sibling, child, parent, partner; loss to cancer, dementia, suicide, COVID-19, etc); and the unique risks associated with being a caregiver, veteran, or member of the LGBTQIA2S+ or Black, Indigenous, and People of Color (BIPOC) communities. Help Texts is delivering support in 57 countries, in all 50 states in the U.S., and in 27 languages.

Help Texts provides twice-weekly, one-way texts offering basic grief education by normalizing and validating the grief experience and then offering tips for coping within various themes around grief. Preliminary evidence suggests that bereaved users of HelpTexts have found it supportive; 95% of all users rated their satisfaction with HelpTexts as a 4 or 5 out of 5 and found the text messages helpful. The proposed study is a randomized control trial that aims to evaluate the effectiveness of Help Texts to grieving students at UCLA in reducing grief severity and symptoms of depression, preventing prolonged grief and major depressive disorder, and in improving quality of life and occupational functioning (e.g., graduation, grades, student enrollment retention).

Interventions

• Behavioral list of resources for grief
  Participants will receive treatment as usual, consisting of a list of resources for coping with grief both on-campus and off-campus
• Behavioral text-based intervention for grief
  Help Texts delivers texts twice a week over a period of 12-months to provide psychoeducation, validation, and coping strategies relevant to bereavement. The The texts offer some customization in specifying the name of the participant and their deceased loved one, as well as providing texts relevant to the participants' cause of bereavement and relationship to their deceased loved one.

Primary outcome measures

• Prolonged Grief Disorder-Revised (PG-13-R) [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]
• Patient Health Questionnaire (PHQ-3) [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]

Secondary outcome measures (4)

• Academic Functioning - GPA [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]
• Academic Functioning - Negative Impacts to Academic Performance [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]
• Academic Functioning - Class Enrollment Status [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]
• Academic Functioning - Dropped Course [Time frame: 0 months, 3 months, 6 months, 12 months following enrollment]

Eligibility criteria

Inclusion criteria

• Enrolled UCLA student
• At least 18 years old
• Experienced death of a close person in the past 12 months
• Able to read English

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

United States · 1 center

• Franz Hall — Los Angeles

Publications

• Levesque DA, Lunardini MM, Adams SN, Payne EL, Neumann BG. Grief Coach: Feasibility and acceptability of a text message program for bereavement support among grievers in the United Kingdom. Death Stud. 2025;49(4):391-402. doi: 10.1080/07481187.2024.2334080. Epub 2024 Apr 4. PMID 38573792
• Chang M, Panda S, Tajrian M, Kim WI, Dunkel Schetter C, Robles TF. Bereavement, resource utilization, and collective grieving since the COVID pandemic: Mixed-methods study of university students and staff. 2024.
• Varga MA, Lanier B, Biber D, Stewart B. Holistic Grief Effects, Mental Health, and Counseling Support in Bereaved College Students. College Student Affairs Journal. 2021;39(1):1-13. doi: 10.1353/csj.2021.0000.
• Sirrine EH, Kliner O, Gollery TJ. College Student Experiences of Grief and Loss Amid the COVID-19 Global Pandemic. Omega (Westport). 2023 Aug;87(3):745-764. doi: 10.1177/00302228211027461. Epub 2021 Jun 23. PMID 34162233
• Jones S, Martini M. Sense of self, depression and adaption to grief, in emerging adults who suffered parental loss. Current Psychology. 2023;42(7):5212-25. doi: 10.1007/s12144-021-01843-z.

Identifiers

NCT: NCT07228260 · IRB-25-0709

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗