Abstract
Background: Traumatic bereavement frequently combines grief-specific separation distress with trauma-related intrusions, avoidance, and dysregulation. A subgroup of patients develops persistent impairment consistent with prolonged grief disorder (PGD).
Objective: This commentary outlines the clinical rationale and conceptual foundations of a manualized group program for bereavement after traumatic loss, integrating psychotherapeutic structure with art-based containment strategies.
Approach: Drawing on evidence-based grief psychotherapy, group intervention research, and expressive therapies frameworks, the program was developed as a ten-session closed-group protocol integrating manualized art-based containment within a trauma-informed safety architecture. The model emphasizes structured oscillation between stabilization and symbolic exposure, graded affect regulation, and meaning reconstruction.
Program outline: Sessions follow a consistent rhythm of grounding, psychoeducation, graded symbolic engagement, cognitive-emotional integration, and closure rituals. Core modules address guilt reappraisal, continuing bonds, trigger mapping, restoration-oriented re-engagement, and future orientation. Art-based elements function as bounded externalization and containment tools for experiences that are difficult to verbalize.
Evaluation: A pilot implementation (2026) is planned as a mixed-methods feasibility study including pre-, post-, and 3-month follow-up assessments. Outcomes will include measures of prolonged grief symptoms, depression/anxiety, trauma-related distress, and qualitative indicators of containment and group cohesion.
Conclusion: Manualized trauma-informed bereavement groups may provide an intermediate intervention between non-specific support and specialized individual therapy, particularly for patients experiencing isolation and persistent traumatic grief reactions.
Keywords
Traumatic bereavement, Prolonged grief disorder, Group psychotherapy, Art therapy, Manualized intervention