Côté, Roxanne (2026) Fostering Embodied Reconstruction with Bereaved Caregivers: An Integrative Group Art Therapy Intervention Research Project. [Graduate Projects (Non-thesis)] (Unpublished)
Preview |
Text (application/pdf)
636kBCôté_MA_S2026.pdf - Accepted Version Available under License Spectrum Terms of Access. |
Abstract
An increasing number of people are affected by the realities surrounding terminal illness, end-of-life, and bereavement. Findings indicate that end-of-life caregiving and bereavement can disrupt the autonomic nervous system, triggering changes in emotional states as well as physiological symptoms. Furthermore, overwhelming experiences, such as the death of a loved one, can lead to the emergence of trauma responses in the body. This paper investigates the impacts of end-of-life caregiving and of bereavement on adults and develops an integrative group intervention that combines constructivist grief therapy, trauma-informed approaches, polyvagal theory, and art therapy. The aim of this project is to create an intervention framework that would adequately meet the needs of bereaved caregivers. Guided by the first two steps of Fraser & Galinsky’s (2010) intervention research model, this paper establishes a rationale for the inclusion of trauma-informed art therapy approaches within interdisciplinary bereavement services in palliative care.
| Divisions: | Concordia University > Faculty of Fine Arts > Creative Arts Therapies |
|---|---|
| Item Type: | Graduate Projects (Non-thesis) |
| Authors: | Côté, Roxanne |
| Institution: | Concordia University |
| Degree Name: | M.A. |
| Program: | Creative Arts Therapies (Art Therapy Option) |
| Date: | June 2026 |
| Keywords: | palliative care; bereavement; polyvagal theory; art therapy; trauma-informed approaches |
| ID Code: | 997407 |
| Deposited By: | Roxanne Côté |
| Deposited On: | 16 Jun 2026 18:52 |
| Last Modified: | 18 Jun 2026 15:17 |
References:
Alvarez, M. C. I., Clemente, W., Rillo, R. J. A., & Narvaez, R. A. (2025). Creative pathways to comfort: The transformative role of art therapy in palliative and hospice care. International Journal of Palliative Nursing, 31(1), 18–28. https://doi.org/10.12968/ijpn.2025.31.1.18American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
Anngela-Cole, L., & Busch, M. (2011). Stress and grief among family caregivers of older adults with cancer: A multicultural comparison from Hawai‘i. Journal of Social Work in End-Of-Life & Palliative Care, 7(4), 318–337. https://doi.org/10.1080/15524256.2011.623460
Applebaum, A. J., & Breitbart, W. (2013). Care for the cancer caregiver: A systematic review. Palliative and Supportive Care, 11(3), 231–252. https://doi.org/10.1017/S1478951512000594
Austin, P. D., Siddall, P. J., & Lovell, M. R. (2024). Posttraumatic growth in palliative care settings: A scoping review of prevalence, characteristics and interventions. Palliative Medicine, 38(2), 200–212. https://doi.org/10.1177/02692163231222773
Beaumont, S. L. (2013). Art therapy for complicated grief: A focus on meaning-making approaches. Canadian Art Therapy Association Journal, 26(2), 1–7. https://doi.org/10.1080/08322473.2013.11415582
Benson, J. J., Washington, K. T., Landon, O. J., Chakurian, D. E., Demiris, G., & Parker Oliver, D. (2023). When family life contributes to cancer caregiver burden in palliative care. Journal of Family Nursing, 29(3), 275–287. https://doi.org/10.1177/10748407231167545
Blomstrom, M., Burns, A., Larriviere, D., & Penberthy, J. K. (2022). Addressing fear of death and dying: Traditional and innovative interventions. Mortality, 27(1), 18–37. https://doi.org/10.1080/13576275.2020.1810649
Borgstrom, E., & Visser, R. (2024). Critical approaches to death, dying and bereavement. Routledge.
Brinkmann, S. (2023). Why does the pathologization of grief cause such a stir? A comment on Bergsmark and Ramsing. Theory & Psychology, 33(6), 873–878. https://doi.org/10.1177/09593543231184889
Chesnot, O., & Schauder, S. (2026). « C’est comme si j’étais sortie de l’humanité ». Deuil, argile et art-thérapie. Annales Médico-psychologiques, revue psychiatrique, 184(2), 112–120. https://doi.org/10.1016/j.amp.2025.12.004
Dana, D. (2023). Polyvagal practices: Anchoring the self in safety. Norton Professional Books.
Elbrecht, C. (with Malchiodi, C. A.). (2019). Healing trauma with guided drawing: A sensorimotor art therapy approach to bilateral body mapping. North Atlantic Books.
Elbrecht, C., & Deuser, H. (2013). Trauma healing at the clay field: A sensorimotor art therapy approach. Jessica Kingsley Publishers.
Éthier, S. (2022). Proche aidant jusqu’au bout. Les enjeux de la proche aidance en soins palliatifs, en fin de vie et en contexte de deuil. Frontières, 33(1), 1089337ar. https://doi.org/10.7202/1089337ar
Fisher, J. (2014). Putting the pieces together: 25 years of learning trauma treatment. Psychotherapy Networker, 38(3), 33–39.
Fortin, G., Leblanc-Huard, G., Gauthier, M., & Ruest-Bélanger, A. (2025). Les centres de jour en soins palliatifs au Québec. Cahiers Francophones de Soins Palliatifs, 24(2), 10–27. https://doi.org/10.7202/1118002ar
Fraser, M. W., & Galinsky, M. J. (2010). Steps in intervention research: Designing and developing social programs. Research on Social Work Practice, 20(5), 459–466. https://doi.org/10.1177/1049731509358424
Gouvernement du Québec. (2025). Le rapport sur la situation des soins de fin de vie au Québec du 1er avril 2018 au 31 mars 2023. Commission sur les soins de fin de vie.
Government of Canada. (2026). Palliative Care. https://www.canada.ca/en/health-canada/services/health-services-benefits/palliative-care.html
Grunfeld, E., Coyle, D., Whelan, T., Clinch, J., Reyno, L., Earle, C. C., Willan, A., Viola, R., Coristine, M., Janz, T., & Glossop, R. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 170(12), 1795–1801. https://doi.org/10.1503/cmaj.1031205
Gündel, H., O’Connor, M.-F., Littrell, L., Fort, C., & Lane, R. D. (2003). Functional neuroanatomy of grief: An fMRI study. American Journal of Psychiatry, 160(11), 1946–1953. https://doi.org/10.1176/appi.ajp.160.11.1946
Haeyen, S. (2024). A theoretical exploration of polyvagal theory in creative arts and psychomotor therapies for emotion regulation in stress and trauma. Frontiers in Psychology, 15, 1382007. https://doi.org/10.3389/fpsyg.2024.1382007
Hamel, J. (2014). L’art-thérapie somatique: Pour aider à guérir la douleur chronique (3e éd). les Éditions Québec-livres.
Hamel, J., & Labrèche, J. (2019). Art-thérapie: Mettre des mots sur les maux et des couleurs sur les douleurs le livre de référence pour comprendre et pratiquer. Larousse.
Harnden, B. (2025). Our embodied presence and the climate crisis: Clinical commentary on the interplay between trauma, the nervous system, the climate crisis and drama therapy. Drama Therapy Review, 11(1), 107–116. https://doi.org/10.1386/dtr_00165_7
Hendricks, B. A., Vo, J. B., Dionne-Odom, J. N., & Bakitas, M. A. (2021). Parentification among young carers: A concept analysis. Child and Adolescent Social Work Journal, 38(5), 519–531. https://doi.org/10.1007/s10560-021-00784-7
Herman, J. L. (2022). Trauma and recovery: The aftermath of violence - From domestic abuse to political terror (4th ed.). Basic Books.
Hinz, L. D. (2020). Expressive Therapies Continuum: A framework for using art in therapy (2nd ed.). Routledge. https://doi.org/10.4324/9780429299339
Hinz, L. D. (2023). Filling the form: Expressive Therapies Continuum-guided treatment of narcissistic personality disorder. Journal of Clinical Psychology, 80(5), 1192–1206. https://doi.org/10.1002/jclp.23635
Hinz, L. D., & Lusebrink, V. B. (2024). Using the Expressive Therapies Continuum as a framework in the treatment of trauma. In J. L. King & C. E. Strang, Art Therapy and the Neuroscience of Trauma (pp. 51–75). Routledge. https://doi.org/10.4324/9781003348207-3
Hurst, R., & Kannangara, C. (2024). Post-traumatic growth from grief – a narrative literature review. Mental Health and Social Inclusion, 28(3), 261–273. https://doi.org/10.1108/MHSI-09-2022-0059
Jones, P. (2020). The arts therapies: A revolution in healthcare (2nd ed.). Routledge. https://doi.org/10.4324/9781315536989
Kaimal, G., Carroll-Haskins, K., Mensinger, J. L., Dieterich-Hartwell, R. M., Manders, E., & Levin, W. P. (2019). Outcomes of art therapy and coloring for professional and informal caregivers of patients in a radiation oncology unit: A mixed methods pilot study. European Journal of Oncology Nursing, 42, 153–161. https://doi.org/10.1016/j.ejon.2019.08.006
Kes, D., Özcan, A., & Adahan, D. (2025). Factors affecting the caregiver burden of family members to palliative care patients: A descriptive and cross-sectional study. Chronic Illness, 21(3), 401–409. https://doi.org/10.1177/17423953251322261
Koenig, S. B. (2025). Engaging Polyvagal Theory to inform a relational approach in clinical work with adolescent-parent dyads. Clinical Social Work Journal. https://doi.org/10.1007/s10615-025-00989-8
Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing – effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023
Landgarten, H. B. (1991). Termination: Theory and practice. In H. B. Landgarten (Ed.), Adult art psychotherapy. Routledge. https://www-taylorfrancis-com.lib-ezproxy.concordia.ca/reader/read-online/5f235fe7-bc26-4472-90d5-f5b8473be1a2/chapter/pdf?context=ubx
Lang, D., & Lim, L. C. (2014). Effects of art therapy for family caregivers of cancer patients: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 12(4), 374–394. https://doi.org/10.11124/jbisrir-2014-1096
Levine, P. A. (1997). Waking the tiger: The innate capacity to transform overwhelming experiences. North Atlantic Books.
Liebmann, M. (2004). Art therapy for groups: A handbook of themes and exercises. Routledge. https://doi.org/10.4324/9780203420720
Lusebrink, V. B., Mārtinsone, K., & Dzilna-Šilova, I. (2013). The Expressive Therapies Continuum (ETC): Interdisciplinary bases of the ETC. International Journal of Art Therapy, 18(2), 75–85. https://doi.org/10.1080/17454832.2012.713370
Malchiodi, C. A. (Ed.). (1999). Medical art therapy with adults. Jessica Kingsley.
Malchiodi, C. A. (2020). Trauma and expressive arts therapy: Brain, body, and imagination in the healing process. Guilford Publications. http://ebookcentral.proquest.com/lib/concordia-ebooks/detail.action?docID=6039410
Maltais, D., & Cherblanc, J. (Eds.). (2020). Quand le deuil se complique: Variété des manifestations et modes de gestion des complications du deuil. Presses de l’Université du Québec.
Marsman, M., Van Der Meer, M., Bakker, A., & Schweizer, C. (2024). The expressive therapies continuum and mentalization-based art therapy for individuals diagnosed with a cluster B/C personality disorder: A successful marriage! The Arts in Psychotherapy, 91, 102221. https://doi.org/10.1016/j.aip.2024.102221
Melin-Johansson, C., Henoch, I., Strang, S., & Browall, M. (2012). Living in the presence of death: An integrative literature review of relatives’ important existential concerns when caring for a severely ill family member. The Open Nursing Journal, 6(1), 1–12. https://doi.org/10.2174/1874434601206010001
Menakem, R. (2021). My grandmother’s hands: Racialized trauma and the pathway to mending our hearts and bodies. Penguin Books.
Moon, B. L. (2016). Art-based group therapy: Theory and practice (2nd ed). Charles C Thomas Publisher, Ltd. https://lib-ezproxy.concordia.ca/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=1237216&site=ehost-live&scope=site
Morgan, S. P., Lengacher, C. A., & Rodriguez, C. S. (2022). Caregiver burden in caregivers of patients with advanced stage cancer: A concept analysis. European Journal of Oncology Nursing, 60, 102152. https://doi.org/10.1016/j.ejon.2022.102152
Morrell, M. (2011). Signs and symbols: Art and language in art therapy. Journal of Clinical Art Therapy, 1, 25–38.
Motlagh, E. G., Bakhshi, M., Davoudi, N., Ghasemi, A., & Moonaghi, H. K. (2023). The physical and psychological outcomes of art therapy in pediatric palliative care: A systematic review. Journal of Research in Medical Sciences, 28(1). https://doi.org/10.4103/jrms.jrms_268_22
Neimeyer, R. A., Burke, L. A., Mackay, M. M., & Van Dyke Stringer, J. G. (2010). Grief therapy and the reconstruction of meaning: From principles to practice. Journal of Contemporary Psychotherapy, 40(2), 73–83. https://doi.org/10.1007/s10879-009-9135-3
Nowels, M. A., Kalra, S., Duberstein, P. R., Coakley, E., Saraiya, B., George, L., & Kozlov, E. (2023). Palliative care interventions effects on psychological distress: A systematic review & meta-analysis. Journal of Pain and Symptom Management, 65(6), e691–e713. https://doi.org/10.1016/j.jpainsymman.2023.02.001
O’Connor, M.-F. (2019). Grief: A brief history of research on how body, mind, and brain adapt. Psychosomatic Medicine, 81(8), 731–738. https://doi.org/10.1097/PSY.0000000000000717
Ogden, P. (2015). Sensorimotor psychotherapy: Interventions for trauma and attachment. W.W. Norton & Company.
Ossefort-Russel, C. (2018). Grieving through the lens of polyvagal theory: Humanizing our clinical responses to loss. In S. Porges (Ed.), Clinical applications of the polyvagal theory: The emergence of polyvagal-informed therapies. W. W. Norton & Company, Incorporated.
Park, S., & Song, H. (2020). The art therapy experiences of patients and their family members in hospice palliative care. The Korean Journal of Hospice and Palliative Care, 23(4), 183–197. https://doi.org/10.14475/kjhpc.2020.23.4.183
Paulsen, B. T., Kærgaard Johansen, M. L., Lund, S. K., Enggaard, H., & Jørgensen, L. (2025). Anticipatory grief - A neglected phenomenon among relatives of patients with incurable cancer: A qualitative study. European Journal of Oncology Nursing, 74, 102730. https://doi.org/10.1016/j.ejon.2024.102730
Pinheiro, P., Gonçalves, M. M., Nogueira, D., Pereira, R., Basto, I., Alves, D., & Salgado, J. (2022). Emotional processing during the therapy for complicated grief. Psychotherapy Research, 32(5), 678–693. https://doi.org/10.1080/10503307.2021.1985183
Porges, S. (2022). Polyvagal Theory: A science of safety. Frontiers in Integrative Neuroscience, 16, 871227. https://doi.org/10.3389/fnint.2022.871227
Porges, S. (2025). Polyvagal Theory: Current status, clinical applications, and future directions. Clinical Neuropsychiatry, 22(3), 169–184. https://doi.org/10.36131/cnfioritieditore20250301
Porges, S. (with Dana, D. A.). (2018). Clinical applications of the polyvagal theory: The emergence of polyvagal-informed therapies. W. W. Norton & Company, Incorporated.
Rothschild, B. (2000). The body remembers. Norton.
Ryland, S., Johnson, L. N., & Bernards, J. C. (2022). Honoring protective responses: Reframing resistance in therapy using polyvagal theory. Contemporary Family Therapy, 44(3), 267–275. https://doi.org/10.1007/s10591-021-09584-8
Sas, C., & Coman, A. (2016). Designing personal grief rituals: An analysis of symbolic objects and actions. Death Studies, 40(9), 558–569. https://doi.org/10.1080/07481187.2016.1188868
Sonke, J., Sams, K., Morgan-Daniel, J., Schaefer, N., Pesata, V., Golden, T., & Stuckey, H. (2021). Health communication and the arts in the United States: A scoping review. American Journal of Health Promotion, 35(1), 106–115. https://doi.org/10.1177/0890117120931710
Sunderland, N., Stevens, F., Knudsen, K., Cooper, R., & Wobcke, M. (2023). Trauma aware and anti-oppressive arts-health and community arts practice: Guiding principles for facilitating healing, health and wellbeing. Trauma, Violence, & Abuse, 24(4), 2429–2447. https://doi.org/10.1177/15248380221097442
Thomas, E. J., & Rothman, J. (2013). Intervention research: Design and development for human service. Taylor and Francis.
Thrower, C., Barrie, C., Baxter, S., Bloom, M., Borja, M. C., Butters, A., Dudgeon, D., Haque, A., Lee, S., Mahmood, I., Mirhosseini, M., Mirza, R. M., Murzin, K., Ankita, A., Skantharajah, N., Vadeboncoeur, C., Wan, A., & Klinger, C. A. (2023). Interventions for grieving and bereaved informal caregivers: A scoping review of the Canadian literature. Journal of Palliative Care, 38(2), 215–224. https://doi.org/10.1177/08258597221101826
Tonkin, L. (1996). Growing around grief—Another way of looking at grief and recovery. Bereavement Care, 15(1), 10–10. https://doi.org/10.1080/02682629608657376
Uysal, N., Doğan, N., Topbaş, E., Çayır Yılmaz, M., Eskiyurt, R., & Nalinci, G. Z. (2025). Art therapy and caregiver anxiety, distress and well-being. BMJ Supportive & Palliative Care, spcare-2024-005288. https://doi.org/10.1136/spcare-2024-005288
Van Der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253–265. https://doi.org/10.3109/10673229409017088
Waldrop, D. P. (2007). Caregiver grief in terminal illness and bereavement: A mixed-methods study. Health & Social Work, 32(3), 197–206. https://doi.org/10.1093/hsw/32.3.197
Wang, T., Molassiotis, A., Chung, B. P. M., & Tan, J.-Y. (2018). Unmet care needs of advanced cancer patients and their informal caregivers: A systematic review. BMC Palliative Care, 17(1), 96. https://doi.org/10.1186/s12904-018-0346-9
Willemsen, M., Abbing, A., Haeyen, S., Witte, M. D., & Van Hooren, S. (2024). The creative arts therapists on the continuum of practice within arts in health in the Netherlands. Dramatherapy, 45(1), 117–124. https://doi.org/10.1386/dj_00008_1
Williams, H., Skalisky, J., Erickson, T. M., & Thoburn, J. (2021). Posttraumatic growth in the context of grief: Testing the mindfulness-to-meaning theory. Journal of Loss and Trauma, 26(7), 611–623. https://doi.org/10.1080/15325024.2020.1855048
Wood, M. J. M., Jacobson, B., & Cridford, H. (Eds.). (2019). The international handbook of art therapy in palliative and bereavement care. Routledge. https://doi.org/10.4324/9781315110530
Word Health Organization. (2020). Palliative Care Fact Sheets. https://www.who.int/news-room/fact-sheets/detail/palliative-care#:~:text=Palliative%20care%20is%20an%20approach,actively%20as%20possible%20until%20death.
Xiu, D., He, L., Killikelly, C., & Maercker, A. (2020). Prolonged grief disorder and positive affect improved by Chinese brush painting group in bereaved parents: A pilot study. Journal of bSocial Work in End-of-Life & Palliative Care, 16(2), 116–132. https://doi.org/10.1080/15524256.2020.1749923
Zech, E., Westrelin, N., & Boever, C. (2023). Et après le décès d’un proche aidé…: Processus de croissance et de deuil chez les aidants proches. Jusqu’à La Mort Accompagner La Vie, N° 152(1), 41–50. https://doi.org/10.3917/jalmalv.152.0041
Repository Staff Only: item control page


Download Statistics
Download Statistics