Exploring the Potential Psychological Benefits of a Death Reflection Manipulation-Based Intervention

Background: Mortality awareness research has emphasised fearful aspects of death. Contrastingly, death reflection has been associated with a number of psychological benefits and may offer a more holistic, growth-orientated approach to mortality awareness. As a novel psychological intervention, the lack of research on the effectiveness of death reflection, both within clinical psychology research and outside of a one-off event in laboratory conditions, needs to be addressed. Aims: This study reviewed the literature on interventions for death anxiety in working age adults before investigating the potential psychological benefits of an extended version of the Death Reflection Manipulation (Cozzolino et al., 2004) and evaluated this intervention using a mixed methods design. This was hoped to inform future studies investigating the effectiveness of death reflection as a psychological intervention. Methods: The systematic review asked What Psychological Interventions Have Been Used to Treat Death Anxiety in Working Age Adults? Subsequently, death reflection was evaluated quantitatively through psychometric outcome measures (wellbeing, death attitudes, authenticity, depression, anxiety, and stress) and qualitative interviews to explore individuals’ experiences of death reflection. Results: The systematic review, apart from identifying methodological issues, found that a variety of psychological interventions efficaciously addressed death anxiety with therapy type substantially impacting treatment effectiveness. Quantitative findings indicated that, while death reflection was associated with, at best, modest effects in the outcomes investigated, there were notable trends towards significance. There was descriptive evidence to suggest this intervention’s effectiveness in bringing about positive changes in wellbeing and death attitudes. Discussion: Findings from quantitative and qualitative analysis, alongside existing literature, provided preliminary evidence that death reflection has the potential to improve different psychological outcomes, pending confirmation in a larger scale intervention study. These findings form part of a rationale for death reflection to be developed into a form of psychological therapy in the future.