Thank you for you comment Ahmed, I would say that the main difference between expressive art therapy and traditional art therapy lies in who is doing the analysis and discovery. In traditional art therapy, a therapist may tell the client to draw a face. Afterwards, based on the the drawing the art therapist may give a diagnosis or analysis that because the eyes were drawn a certain way this is what is going on with the individual. Art therapy may also be used by non-art therapists such as in sand tray therapy or photovoice where clients create art to help communicate ideas to the therapist that they are either having difficulty expressing or are too young to express. In Expressive Art Therapy, the therapist would direct the art or ritual to a degree, but revelations come to the client themselves. It is not about the therapist providing analysis on the art. The benefit comes from creation. In addition, in ritual (a form of expressive art therapy) the client has the ability to create a legacy for the individual that has passed away that they either carry with themselves or share with others. My personal belief on the mechanism for benefit of expressive art therapy is that it is similar to how individuals that process their thoughts through conversation work. Some individuals clarify their thoughts and come up with ideas by speaking about them with other people. I believe that a similar mechanism is at work with expressive art therapy. As people create art or prepare and conduct rituals they process their thoughts and emotions in order to create the art. What is created may be just as much a discovery to the client as to the therapist. The therapist acts as a guide and navigator but the discovery is made through the process by the client. Thank you for bringing up orientation. In the pdf paper their is more background theory to greater elucidate this concept in regards to the Dual Model Process of Bereavement. It is referring to the loss orientation or restoration orientation that clients oscillate between in this model. I think it would be helpful to think about what orientation (loss or restoration) the therapist is working on while with a client so that they may better understand how to support a client and recognize if there is an imbalance in focus by the client (concentration on loss may indicate risk for complicated grief, etc.) When it comes to case management, the actual assessment is done individually, not in the group. From my experience, people may not openly share all of their struggles in a group setting. Research has shown that how an individual is able to manage life stressors is a better indicator of outcomes than personality traits in grief. However, this does not mean that it is not tied to the groupwork. If the case management assessment is done before the group starts than this gives the facilitator an opportunity to develop a rapport with each individual of the group, making the groupwork more favorable. In addition, it has been my experience in doing groupwork that as individuals get to know each other and bond as the group progresses, they become more open and are likely to tell the facilitator how they are struggling. Therefore, although the case management referral section is delegated to a pre-group task, that does not mean that referrals can not be made as the group continues and issues arise. Although it may not be explicit group work, in certain instances (such as a loss of a spouse in a low income family resulting in a severe reduction of income or an older adult that loses a spouse that was their main support and companion) I find that doing therapy without including this type of instrumental support would be (as I like to say) putting a band-aid on a gun shot wound. Would you be able to clarify what you mean by constructs and variables? As I created the group I focused on desired outcomes. Desired outcomes included decreasing isolation, increased self-care strategies and practices, increase in resources, self-awareness of grief symptoms, cathartic self-expression, increased reflection and healthy grieving practices. While these are a lot of variables, grief is a complex process. My group is not perfect, yet I attempted to create a well-rounded and multi-faceted group that, though not extensive, would be of benefit to a large population while still having a safety net for people that need more intensive services (Through case management and individual therapy referral). At the time that this group was submitted for IASWG it was in the pre-implementation phase. Since than, it is in the process of being implemented in an older adult collaborative in Arizona but no data has been collected yet. For intended outcomes it would be possible to measure the group both quantitatively and qualitatively. For a simple quantitative measurement, I would suggest a pre-post test touching on items such as increased use of coping skills, increased social support, increased knowledge of grief symptoms, increased resources (in case management referrals). However, I would caution against creating a recommendation of intended outcomes for quantitative measurement until a researcher’s population has been defined. For example, if this group were run with family members of hospice clients, people that acted as caretakers may actually feel relief upon a death. And it was not unexpected. In addition, the hospice would probably provide a case manager. Therefore, a goal of increasing coping mechanisms and resources may not be as relevant. Yet the poetry group on defining new roles in life or creating a legacy of the deceased through ritual may be of benefit. Yet a young family where a spouse died in a car accident may benefit from case management referrals and coping mechanisms. In the context of an older adult passing away, a large struggle from a surviving spouse may be social isolation while the surviving children may struggle with self-care while dealing with grief, yet they have social support. Therefore, I leave it up to the person that is implementing the group to define their population and intended outcomes in terms of quantitative research. However, if I were to have a preference of quantitative studies I would perform a pre-test post-test study with a control group, with the post-test being measured a few months after the group has ended using the Multicultural Quality of Life Index. Though not made for grief, it is my first choice. The reason for this is two-fold. This measure is strengths based, does not pathologize grief (which is a normal emotion) and measures how well someone is doing in their life over a variety of realms which are included in Group to Healing. Taking the measurement a few months after members have left the group does not put unreasonable expectations that an individual will have their life turned around in 8 weeks (grief is a natural process that takes time) but will measure whether people show an improvement in their lives after going through the group compared to a control. The group would also work very well with a qualitative study, as themes that come up as a result of reflection, connection with peers, creation and expression with the benefits of being heard, etc. may come up. Indeed, my introduction to the group in the pdf paper might as well be raw qualitative data! I have specifically kept the group general so that the basic form of it can be applied to a wide audience and still be of benefit, yet individual social workers are able to use their judgement to tailor it to specific needs. I greatly appreciate your feedback on how I should go forward in researching and refining this group and shall work with my collaborators in the future to validate the group.

This is a strong and thoughtful proposal—your integration of the Dual Process Model and expressive arts is both creative and clinically relevant, and the attention to case management adds a valuable layer of practical support. That said, I have a few questions and suggestions to help strengthen the project further: Could you define “expressive art” more clearly? How is it distinct from art therapy in this context, and how do you conceptualize its therapeutic mechanism? What does "orientation" refer to here? If you're referring to the Dual Process Model's "loss" and "restoration" orientations, it would be helpful to clearly state that upfront, especially for readers less familiar with the model. Can you elaborate more directly on how case management connects with the group work? It’s mentioned in multiple sections, but a clearer conceptual or logistical link would make this stronger. What are the primary variables or constructs you're addressing in this proposal? If this is a pre-implementation or proposal stage, you might still name intended outcomes or targets (e.g., emotional regulation, coping skills, social support). Is this a qualitative, quantitative, or mixed methods project? If it’s a proposal only, specifying your intended research design or evaluation plan would clarify your methodology. Is this a proposal or have you already collected data? The wording is sometimes ambiguous. If this is a qualitative or mixed methods proposal, I recommend including a brief note on your positionality. Since this project arises from personal experience, naming your relationship to the topic adds transparency and depth, especially in qualitative work. Consider clarifying how this group model could be replicated by others. Right now, the intervention is rich in detail, but relies heavily on personal experience and implicit knowledge. Including more structured implementation guidance—such as a logic model, session fidelity checklist, or facilitator competencies—would support replication and increase its utility for future practitioners or researchers. What is the plan for evaluating the effectiveness of the group intervention? Even in a proposal stage, it would strengthen your approach to outline how you plan to assess outcomes—e.g., through pre/post assessments, participant feedback, or observational measures. This would not only support future program refinement but also help establish its evidence base for broader adoption.