Author ORCID Identifier

Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Sandra Gramling, PhD

Second Advisor

Bruce Rybarczyk, PhD

Third Advisor

Joseph Dzierzewski, PhD

Fourth Advisor

Pamela Parsons, NP, PhD

Fifth Advisor

Geri Lotze, PhD


Research on expressive art interventions for bereavement has burgeoned in recent years. Studies have supported their effectiveness in facilitating participants’ adjustment to loss (e.g., Rosner, Kruse, & Hagl, 2010; Uttley, 2015) and have revealed the frequency with which they are clinically implemented (Thompson & Neimeyer, 2014). Clinicians and recipients of expressive art interventions advocate for their helpfulness in grief processing (e.g., Gamino, 2015). Publications have highlighted particular visual art modules that facilitate adaptive adjustment to loss by providing avenues for self-expression, meaning making and continuing bonds with the deceased (Neimeyer, 2016), but few studies have quantitatively investigated whether they improve bereavement outcomes. Efficacy of treatment modalities are especially warranted for bereaved subgroups at elevated risk for developing symptoms of complicated grief, such as socioeconomically vulnerable older adults, as they are among those most likely to benefit from intervention but face the most barriers to accessible treatment (Ghesquiere, 2013; Newson et al., 2011). This longitudinal study investigated the feasibility and efficacy of a 4-week grief support group with visual art modalities for bereaved older adults residing in government subsidized independent living facilitates in the community. Measured outcomes included meaning made from the loss, continued bonds with the deceased, perceived social support, personal growth, and negative bereavement experiences such as symptoms of complicated grief and depression. Findings from this study support the feasibility and acceptability of implementing an art-based grief support group for socioeconomically vulnerable older adults. Significant improvement was found in meaning made from the loss, personal growth, and negative grief symptoms. Depressive symptoms significantly decreased immediately following completion of the group, but these levels returned closer to baseline levels at one-month follow up. Participants who screened positively for complicated grief at baseline reported greater improvement in their negative grief symptoms and depression, consistent with the extant literature that the bereft in highest distress receive the most benefit from grief intervention. As complicated grief is more prevalent in the older adult population than other age groups, further investigation on the efficacy and effectiveness of targeted bereavement support is warranted.


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