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Grief is a universal human experience; however, its expression, meaning, and healing processes are deeply
shaped by cultural contexts. In collectivistic cultures, bereavement is often experienced and managed
communally through shared rituals, spiritual practices, and collective meaning-making, yet many existing grief
interventions remain grounded in Western individualistic models. The objective of this article is to examine how
bereavement grief is expressed within collectivistic communities and to explore the relevance and effectiveness
of group psychotherapy as a culturally responsive intervention. Using a narrative literature review methodology,
recent empirical studies and theoretical frameworks on grief, culture, and group psychotherapy were
systematically examined and synthesized. Findings from the reviewed literature indicate that culturally adapted
group psychotherapy interventions are effective in reducing grief-related distress, enhancing emotional
regulation, and promoting communal healing through shared narratives, rituals, and emotional co-regulation.
Based on these findings, the article proposes a culturally sensitive bereavement group psychotherapy framework
integrating Narrative Therapy, Emotion-Focused Therapy, and Mindfulness-Based Cognitive Therapy. The paper
also highlights key implications for practice in collectivistic cultures and breaks down some limitations,
challenges and critical considerations when using group psychotherapy for bereavement. The article concludes
that group psychotherapy offers a culturally congruent and effective approach to bereavement care in
collectivistic cultures by honoring relational bonds, spiritual traditions, and collective healing processes.
collectivistic culture, bereavement, group psychotherapy
Grief, the emotional and psychological response to the loss of a significant person or entity, is a universal human
experience that goes beyond cultural and individual boundaries (APA Dictionary of Psychology, 2018). In a blog
gathering individuals’ experiences of grief, Jessie shared:
My brother died just under a month ago and it was only when he was gone that I realised I had never had to live
without him. […] Every day throws in a new challenge. Something different to feel from the day before. Some
days, I wake up and I can get on with my work and everything is okay, others it feels like the world is caving in
and I don’t know what to do anymore. Wherever I am he is with me though. His picture is up next to my bed so
I can have the same discussion that we had every morning and every evening. I can wake up and say ‘good
morning, William’. (Hope Again, n.d.)
Jessie’s vulnerability highlights various concepts and understandings of grief. Although often viewed as a linear
process, grief involves various emotional, cognitive, and physical reactions that vary significantly between
cultures, communities, and individuals. Early theories, such as Kubler-Ross’s (Tyrrell et al., 2023) model of the
five stages of grief, have provided a framework for understanding how emotional responses to loss evolve,
particularly regarding terminal illnesses. However, more recent research has shown the multifaceted nature of
grief, not only deviating from a linear progression but also deviating from the idea that grief is experienced the
same way. Attachment theory (Bowlby, 1969), for example, explains that grief is deeply influenced by the nature
of the relationship between the deceased and the bereaved, where mourning is viewed as a process of re-
establishing emotional proximity to the lost attachment. figure.
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Additionally, models like Stroeve and Schuts’s (1999) dual process offer an alternative perspective and suggest
that grief involves a continuing balance between confronting the loss and continuing with everyday life, where
movement between the two phases is crucial for healing. These concepts of grief are extended by Klass et al.’s
(2014) theory of continuing bonds, which suggests that many bereaved finds healing in maintaining a
transformed but ongoing relationship with the deceased, like in Jessie’s narrative, rather than letting go of them.
Beyond individual experiences, cultural contexts also play a significant role in shaping grief responses, with
social and communal practices influencing how individuals make sense of their loss and integrate it into their
lives (Neimeyer, 2019). For example, American Jews have provided specific mourning practices framed in
structured and timely rituals, to maintain continuing bonds with the deceased and provide rest to the bereaved
(Silverman 2020). Illustrating the complexity of grief sheds light on the need for a culturally sensitive model of
bereavement; as current ones tend to be founded on individualistic values that promote autonomy and self-
reliance. This falls short when working with clients from diverse backgrounds. As much as the standard
interventions for grief have been helpful, they miss critical aspects that only treatments tailored to clients’
collectivistic cultures can tackle. In this article, collectivistic cultures are understood as communities that
promote the needs of the group over individual ones; this manifests as interdependence, emphasis on loyalty,
and cooperation but also conflict avoidance or lower differentiation levels.
This article explores how bereavement grief is uniquely experienced and expressed in collectivistic societies;
that emphasize interdependence, group cohesion and communal healing. Traditional models of grief
predominantly shaped by Western individualistic values focus on autonomy, self-reliance and psychological
closure within the individual. However, these frameworks often do not reflect the communal, relational and
ritualistic dimensions of grief observed in collectivistic cultures. As such the absence of culturally tailored
interventions risks pathologizing culturally normative grief responses or offering insufficient support. This gap
in care highlights the urgent need for inclusive, culturally sensitive models of grief therapy. This paper had three
objectives:
1. To examine cultural expressions of bereavement and grief in collectivistic communities
2. To evaluate the effectiveness of group psychotherapy in culturally diverse contexts
3. To propose a culturally sensitive bereavement group psychotherapy framework for collectivistic cultures.
Narrative Therapy, developed by Michael White and David Epston in the late 1980s, is grounded in the
postmodern and social constructionist view that our identities are shaped through the stories we tell about our
lives. It posits that problems do not reside within people but within the narratives constructed around their
experiences (White & Epston, 1990). In the context of bereavement, Narrative Therapy emphasizes the re-
authoring of grief stories, allowing individuals to integrate the loss into a coherent identity and find meaning in
the ongoing relationship with the deceased.
Narrative Therapy aligns particularly well with collectivistic cultures, which value communal storytelling,
intergenerational memory, and shared meaning-making. Within these communities, the grieving process is not
isolated but unfolds within social systems i.e. the family, religious institutions, and larger community. Narrative
Therapy provides space for these relational voices to be acknowledged and honored. Instead of focusing on
detachment or closure, the narrative approach supports continuing bonds with the deceased (Klass et al., 2014),
often through rituals, storytelling, or symbolic practices that resonate deeply within collectivistic traditions.
Therapeutically, the process involves helping clients externalize grief as something separate from their identity;
explore culturally-rooted meanings of loss, and co-create alternative stories that honor their resilience and
relational ties (Neimeyer et al., 2014). This is especially relevant in bereavement contexts where grief may be
shaped by ancestral practices, spiritual beliefs, and community expectations. Therapists using a narrative lens
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often facilitate group therapy that centers around communal storytelling, ritual enactment, and identity
reconstruction through collective support (Denborough, 2014).
Narrative practices such as "re-membering conversations" (White, 2007) where the deceased is brought into the
present through shared stories and therapeutic letter writing are particularly effective in helping individuals
reframe their grief and retain meaningful connections. These practices not only reduce isolation but strengthen
communal ties, reinforcing the collectivistic value of healing through shared experience.
Emotion-Focused Therapy (EFT), developed by Leslie Greenberg and his colleagues, is grounded in humanistic
and experiential psychology, focusing on the primacy of emotions in effecting therapeutic change. EFT posits
that emotional processing especially; accessing, expressing, and transforming primary adaptive emotions is
central to healing (Greenberg & Watson, 2022). In grief work, EFT helps clients process painful emotional
experiences such as sadness, guilt, anger, or abandonment that arise after loss.
EFT provides a strong foundation for group psychotherapy in collectivistic cultures, where emotions may be
regulated communally and expressions of vulnerability are often shaped by cultural expectations. In these
contexts, EFT’s emphasis on empathy, relational safety, and compassionate attunement offers an ideal container
for emotional expression and healing (Johnson, 2002). It helps group members differentiate between primary
emotions (e.g., deep sorrow) and secondary or maladaptive ones (e.g., suppressed anger due to social stigma),
while promoting healthy expression through shared group dynamics.
In EFT-informed bereavement groups, clients are guided to access their core emotions, often through techniques
such as the empty-chair dialogue with the deceased or emotionally evocative storytelling. These interventions
encourage members to “move through” grief rather than avoid it, fostering emotional transformation, mutual
understanding, and inner integration. Research shows that such emotionally attuned environments are essential
for grief resolution, especially in cultures where individual expression is often interwoven with family and
community identity (Sharbanee & Greenberg, 2022).
Mindfulness-Based Cognitive Therapy (MBCT), developed by Segal, Williams, and Teasdale (2013), combines
principles of cognitive-behavioral therapy (CBT) with mindfulness practices rooted in Buddhist psychology.
MBCT helps clients cultivate nonjudgmental awareness of their thoughts, emotions, and bodily sensations,
reducing emotional reactivity and promoting acceptance (Segal et al., 2013).
In the context of bereavement, MBCT supports clients in observing grief-related thoughts (e.g., “I should be
over this by now”) without over-identifying with them. These decentering fosters emotional regulation and
reduces ruminative thinking, which is often heightened after loss (Huang et al., 2021). For collectivistic cultures,
where grief may be deeply spiritual and ritualized, MBCT offers techniques (e.g., breath awareness, body scans,
loving-kindness meditations) that can be easily harmonized with communal healing practices such as prayer,
silence, and ancestral honoring.
MBCT in bereavement groups enhances participants’ ability to stay present with their emotions while engaging
in rituals of remembrance and community reflection. It aligns with the collectivistic values of inner harmony,
interdependence, and resilience through communal support. As shown in Huang et al.'s (2021) neuroimaging
study in Taiwan, MBCT improved grief symptoms by enhancing emotional regulation and brain connectivity,
suggesting its cultural flexibility and neurological grounding.
Bereavement in collectivistic cultures is not solely a private experience but a shared communal journey. The
mourning process is governed by social rituals, spiritual beliefs, and culturally embedded expectations that define
how grief is expressed, processed, and healed. These expressions differ significantly from Western models that
emphasize individual coping, psychological closure, and emotional independence.
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In African contexts, Nwoye and Nwoye (2012) offer a compelling case study of a woman grieving her mother’s
suicide. The authors highlight that conventional Western interventions did not resonate with the client's cultural
experience. Instead, healing emerged through culturally grounded interventions such as narrative healing, ritual
theory, and communal storytelling. The study emphasized the importance of re-anchoring grief in cultural and
relational contexts, underscoring the failure of standard models to acknowledge indigenous African grief
practices.
Similarly, Adinkrah (2016) examined grief rituals in the Akan society of Ghana, focusing particularly on the
stigma and communal sanctions surrounding suicide. The study found that suicide victims are denied full burial
rites, subjected to ritual punishment, and erased from communal memory. Mourning is communal but
conditional, where grief is allowed only when it upholds societal values. These practices illustrate how
communal grief is intertwined with moral codes and social harmony, reinforcing the collectivistic emphasis on
shared identity and legacy.
In Togo, Kokou-Kpolou et al. (2017) conducted a cross-sectional study with 162 widowed spouses from mutual
support groups. They found that religious coping mechanisms such as collective prayer, scripture readings, and
funeral gatherings played a protective role in expected deaths but could exacerbate grief when death was sudden.
This reinforces the centrality of spirituality and community in shaping bereavement experiences and emotional
responses.
The ethnographic work of Haram (2020) in Northern Tanzania presents the grief practices of Meru women who
mourned vocally and physically for lost loved ones. These expressive rituals clashed with Christian religious
expectations of silent mourning. This tension revealed a deeper cultural conflict: while the Meru tradition views
outward grief as honoring the dead and expressing collective loss, the imposed religious norms pathologized
such displays. The study illustrated how collectivistic cultures often use grief as a language of resistance and
identity affirmation.
A powerful example from East Asia is found in Zhao et al. (2021)’s study of Shidu parents in rural China who
had lost their only child. Among 228 participants, 87% exhibited symptoms of depression, largely driven by
stigma, social exclusion, and cultural beliefs about failure in lineage continuity. However, the strong perceived
social support helped buffer depressive symptoms. In these communities, grief is communal not only in
expression but also in consequence; bereavement affects the family’s social role, ancestral duty, and future
legacy.
These studies together emphasize that in collectivistic cultures, bereavement is rarely an individual journey. It is
an experience regulated by cultural scripts, communal rituals, and spiritual practices that serve to both express
and contain the intensity of grief. These systems create culturally sanctioned avenues for mourning, facilitating
a sense of belonging, meaning-making, and intergenerational continuity elements often absent in Western grief
paradigms.
Group psychotherapy has emerged as a powerful modality for addressing bereavement, especially in
collectivistic and culturally diverse contexts. Unlike individual therapy, group settings naturally mirror the
communal structures found in many non-Western cultures, offering spaces where shared experiences, empathy,
and collective meaning-making, enhance therapeutic outcomes. The shared nature of grief in collectivistic
societies aligns seamlessly with the interpersonal and communal dynamics of group therapy.
A meta-analysis by Maass et al. (2022) reviewed 14 randomized controlled trials (RCTs) involving 1,519
bereaved participants. Most interventions used structured group therapy formats such as cognitive-behavioral
therapy (CBT) and supportive-expressive groups. The findings indicated that group interventions were more
effective than control conditions in reducing grief and depressive symptoms in the short term. Tertiary
interventions particularly targeting those with complicated grief showed stronger outcomes. While the long-term
effectiveness remained uncertain, the review concluded that group psychotherapy holds promise, especially
when contextualized to meet the cultural and relational needs of participants.
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In an RCT conducted in Hong Kong, Chow et al. (2019) explored two culturally adapted bereavement group
interventions for older adults: the Dual-Process Bereavement Group Intervention-Chinese (DPBGI-C) and the
Loss-Oriented Bereavement Group Intervention–Chinese (LOBGI-C). The DPBGI-C incorporated both
emotion-oriented and restoration-oriented coping strategies, consistent with Chinese cultural values of balance
and harmony. Participants in this group experienced greater reductions in anxiety, depression, and loneliness
than those in the loss-oriented group. The communal and ritual elements embedded in the DPBGI-C appeared
to resonate more deeply with collectivistic values, reinforcing the significance of cultural fit in group therapy
design.
Moss (2002) examined bereavement groups for Israeli parents who lost children in terror attacks, using dream
analysis and narrative techniques within a Foulkesian group-analyticmodel. The study highlighted how shared
group dreams and symbolic processing of grief facilitated not only emotional release but also community
bonding. Since participants were from a collectivistic background, the group format allowed them to express
grief in ways that were culturally sanctioned; emphasizing mutual support, communal strength, and the ongoing
presence of the deceased within the group consciousness.
What unites these studies is the recognition that group psychotherapy, when culturally adapted, can mirror and
enhance the communal grieving processes already embedded within collectivistic cultures. The group setting
serves not just as a therapeutic intervention but as a modern replication of traditional healing circles, mourning
ceremonies, or spiritual gatherings. This allows for emotional expression, shared ritual, and co-regulation of
grief all of which are foundational to healing in non-Western societies. These findings suggest that effective
bereavement group therapy in diverse cultural settings must: (a) Reflect communal values, (b) Honor spiritual
and ritual practices (c) Create shared narratives, and (d) Offer emotionally safe, culturally responsive group
environments. When these conditions are met, group psychotherapy transforms from just a treatment to a
culturally congruent experience of collective healing.
Grief in collectivistic cultures unfolds within social and spiritual systems, where healing is not an isolated
psychological process but a communal journey rooted in rituals, storytelling, and collective memory. In light of
this, the design of bereavement group therapy must go beyond Western clinical paradigms and intentionally
integrate cultural values, communal structures, and spiritual practices. This section presents a proposed culturally
sensitive framework for bereavement group therapy, grounded in Narrative Therapy, Emotion Focused Therapy
(EFT), and Mindfulness-Based Cognitive Therapy (MBCT).
This model recognizes that healing in collectivistic communities often takes place through storytelling,
communal rituals, emotional resonance, and spiritual anchoring elements that align naturally with the three
therapeutic approaches used. Narrative Therapy (White & Epston, 1990) supports participants in re-authoring
their grief stories by engaging in culturally familiar practices of storytelling, communal remembrance, and legacy
building. Practices such as “re-membering conversations” and therapeutic letter writing empower participants to
maintain continuing bonds with the deceased (Klass et al., 2014) and frame their grief in collective terms rather
than personal failure.
Emotion-Focused Therapy, developed by Leslie Greenberg, offers an emotionally attuned, process-oriented
framework for accessing, differentiating, and transforming grief emotions. In collectivistic cultures, where public
emotional expression may be discouraged or regulated, EFT provides safe spaces such as group therapy; for
validating and transforming suppressed or culturally bound emotions (Greenberg & Watson, 2022). Through
techniques such as evocative dialogue, empty-chair work, and empathic reflection, EFT fosters connection and
emotional healing while resonating with communal values of emotional co-regulation and shared mourning
(Greenberg, 2011).
Mindfulness-Based Cognitive Therapy (Segal et al., 2013) incorporates structured meditative practices such as
breath awareness, body scans, and loving-kindness meditations. These practices help regulate emotional distress
and echo traditional spiritual rituals in collectivistic cultures, such as candle lighting, group prayer, and ancestor
veneration (Huang et al., 2021).
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The group model is designed as a closed group of 6-8 bereaved adults, meeting weekly for 8 sessions (120
minutes each), facilitated by licensed therapists. Participants will be grouped by type of loss i.e. parent, spouse,
child, sibling, and sessions incorporate cultural practices such as communal altars, grief rituals, prayer circles,
and storytelling ceremonies. Groups will emphasize shared experiences, empathy, collective meaning making
and will apply Yalom & Leszcz’s, (2020) principles of composing therapeutic groups.
The group will not only encourage individual emotional processing but also facilitate collective resilience, a
critical need in collectivistic societies where grief is seen as a disruption to community harmony. By
incorporating spiritual traditions, communal storytelling, and culturally resonant rituals, this framework offers
an affirming, safe space for grief processing that aligns with local worldviews. This approach aligns with findings
from Mathew (2021), who observed that blending Eastern and Western mourning practices enabled more
meaningful grief resolution. It is further supported by Chow et al. (2019), whose culturally tailored group
intervention (DPBGI-C) yielded better mental health outcomes among Chinese elders than standard bereavement
models.
Ultimately, this culturally sensitive framework restores grief work to its rightful place: not only as an individual
task of letting go, but as a community process of remembrance, transformation, and reintegration
MBCT
• Informed consent
• Introductions
• Joining
• Safety creation
• Discuss grief within collectivistic
cultures
• Acknowledge spiritual beliefs and
communal rituals
• Highlight importance of community
healing and shared mourning
• Psychoeducation
• Use mindfulness and grounding
techniques
• Write about significant
memory of the loved one
• Guided meditation for 15
minutes daily
Narrative
Therapy
• Members explore and narrate their grief
story; therapist identifies how it is
perceived in that culture
• Reframe grief story while identifying
and separating accompanying feelings
• Discuss group as a new community of
support
• Participants retell their grief experience
in an empowering way
• Include spiritual traditions such as
rituals and memorial practices that
accompany storytelling
• Write grief story with a
focus on positive
memories and role of
community in their grief
journey. This will be
shared in group in the next
session.
• Guided meditation for 15
minutes a day
MBCT
• Focus on emotional awareness and
acceptance techniques
• Mindfulness to create distance from
intrusive thoughts and emotional
reactivity
• Mindfulness practice for
15 minutes daily and
whenever grief symptoms
arise
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• Use guided meditations, identify and
label emotions, thoughts and resulting
behavior
• Introduce self-compassion exercises
• Discuss communal activities like
prayers that encourage mindfulness
• Psychoeducation
• Introduce rituals like candle lighting in
the group to symbolize mindfulness and
connection.
• Journal about impact of
mindfulness on their
emotional state
EFT
• Access primary emotions and
differentiate from secondary emotions
• Process emotional blocks and allow full
expression of grief
• Share how emotions are handled in their
families/cultures
• Psychoeducation
• Suggest communal rituals/symbols like
shared altars
• Empty chair technique to explore
unexpressed emotions
• Use mindfulness exercises
• Engage in emotional
expression activity like
letter writing
• Guided meditation 15
minutes a day and
whenever grief symptoms
arise
Narrative
Therapy
• Reframe grief as part of life’s journey,
incorporate continued bonds with the
deceased and personal growth
• Meaning making exercises aimed at
rewriting a significant part of the story
of loss to foster healing and purpose.
• Connect participants’ grief to
community rituals such as
remembrance rituals to symbolize
continuity or transformation.
• Write about the meaning
attributed to their grief and
its impacts on their identity
and relationships
• Mindfulness exercise for
15 minutes a day and
whenever grief symptoms
arise
MBCT AND
EFT
• Foster a compassionate healing
environment
• Create safe space for vulnerability
• Cultivate mindfulness and compassion
towards self and others
• Psychoeducation
• Use compassion meditation, sharing in
group and empathetic listening.
• Group prayer, collective reflections on
shared healings, spiritual practices from
their culture
• Introduce upcoming termination
• Practice giving
compassionate responses
to their own grief through
writing as if they were
responding to a close
friend.
• Mindfulness exercises
daily
EFT and
MBCT
• Help participants begin integrating
grief so they can move ahead with
acceptance and healing
• Engage in an activity that
symbolizes letting go
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• Process unresolved grief and promote
self-compassion in the context of
moving on.
• Psychoeducation
• Use guided visualization for a future
without the deceased, reframing and
closure techniques
• Acknowledge rituals that honor the
deceased while moving on.
• Mindfulness of a daily
activity
MBCT and
EFT
• Reflect on the progress made, action
plans and relapse prevention
• Solidify integration and resilience
• Use gratitude exercises, share on
personal growth, mindfulness practices
to reinforce skill
• Group ceremony or closing ritual,
incorporating cultural and spiritual
traditions
• Finish with a mindfulness activity
• Writing a letter of gratitude
to the group for their
support in healing
• Guided meditations at least
15 minutes a day
Note: Information compiled from Neimeyer (2014), Yalom & Leszcz (2020), MacLaren et al (2022), Greenberg
and Watson (2022), Segal et al. (2013), MacKinnon et al., (2015); Nelson et al. (2022) and Johnson (2002).
In collectivistic cultures, grief rituals should not be understood as merely symbolic acts but as active forms of
relational and spiritual communication. Practitioners are encouraged to conceptualize culturally embedded
rituals as ongoing “spirit dialogues” that sustain the bond between the living and the deceased. Therapeutic
incorporation of practices such as lighting incense, maintaining family altars, storytelling ceremonies, or the use
of memorial objects within group sessions can help validate culturally normative expressions of continuing
bonds. These practices reinforce the understanding that grief is not about detachment but about the
transformation of relational presence (Klass et al., 2014; Adinkrah, 2016).
Aligning grief work with indigenous philosophical frameworks further enhances cultural resonance. Concepts
such as filial piety, which emphasizes respect and obligation toward ancestors, or saṃsāra, which frames death
as part of an ongoing cycle of rebirth and transformation, can be used to reframe grief as a transitional process
rather than a final rupture. Integrating these worldviews allows clients to situate their loss within familiar moral
and spiritual narratives, thereby supporting meaning-making and emotional regulation within culturally
sanctioned frameworks (Adinkrah, 2016; Haram, 2020).
Where appropriate, therapists should also consider collaborative partnerships with community elders, religious
leaders, or traditional healers. Such partnerships help bridge the divide between Western clinical models and
community-based healing practices, strengthening cultural legitimacy, fostering trust, and reducing resistance to
formal mental health interventions (Haram, 2020).
To enhance accessibility and sustainability in collectivistic and resource-limited contexts, bereavement group
psychotherapy models must be structurally adaptable. One effective approach is the implementation of task-
sharing strategies, in which trained community workers, semiprofessionals or paraprofessionals deliver low-
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intensity, manualized grief interventions under the supervision of licensed therapists. This approach has been
shown to increase service reach, reduce stigma, and align with communal caregiving traditions commonly
observed in collectivistic societies (Forte et al., 2004; Maass et al., 2022).
Hybrid delivery formats may further enhance engagement by offering flexible combinations of individual,
family-based, and group sessions. Given the interdependent nature of collectivistic families, incorporating family
members into selected sessions can support relational healing and shared meaning-making. Such flexibility
acknowledges that grief is often negotiated within family systems rather than experienced solely at the individual
level (Klass et al., 2014).
Standardized screening procedures should also be incorporated prior to group entry. The use of culturally
sensitive assessment tools to identify individuals at elevated risk for prolonged or complicated grief allows
practitioners to make informed treatment-matching decisions. Early identification supports appropriate referral
pathways and safeguards group cohesion and emotional safety (Kokou-Kpolou et al., 2017; Maass et al., 2022).
Culturally responsive grief work benefits from adapting therapeutic techniques to reflect communal meaning-
making processes. Cultural narrative therapy approaches emphasize externalizing grief by separating the identity
of the bereaved from the pain of loss, while simultaneously honoring culturally specific spiritual and religious
beliefs. Narrative practices may be structured around ancestral storytelling, collective remembrance rituals, or
mindfulness traditions that resonate with clients’ belief systems, allowing grief narratives to be re-authored
without undermining cultural or spiritual meaning (Denborough, 2014).
Group psychotherapy settings also provide a powerful context for fostering emotional co-regulation, a process
through which individuals manage intense emotional experiences through shared witnessing, collective
reflection, and empathic resonance. Emotional co-regulation within groups has been associated with reduced
isolation, normalization of grief responses, and strengthened relational bonds, all of which are particularly
congruent with collectivistic values that prioritize shared emotional responsibility (Bowlby, 1982; Johnson,
2002; Greenberg & Watson, 2022).
In addition, integrating principles from positive psychology can broaden bereavement interventions beyond
pathology-focused models. Emphasizing strengths-based outcomes such as post-traumatic growth, altruism,
spiritual maturity, and life wisdom allows participants to recognize both personal and communal transformation
emerging from loss. This orientation affirms grief as a meaningful developmental experience rather than a
condition to be resolved (Klass et al., 2014; Maass et al., 2022).
Effective bereavement care in collectivistic contexts requires practitioners to prioritize cultural safety. This
includes engaging in accredited training that equips clinicians to recognize collective grief expressions and to
avoid mislabeling culturally normative behaviors; such as ritualized weeping, prolonged mourning, or communal
lamentation as psychopathology. Cultural humility and ongoing reflexivity are essential competencies when
working across diverse grief traditions (Haram, 2020).
Providing multilingual and culturally adapted educational materials further enhances accessibility and
engagement. Written and audiovisual resources delivered in the community’s primary language can demystify
therapeutic processes, reinforce psychoeducation, and support informed participation in group interventions
(American Psychological Association, 2018).
Finally, ethical practice in collectivistic settings requires viewing the therapeutic relationship as a cultural
partnership rather than a hierarchical expert model. Community networks, family systems, and spiritual
institutions should be recognized as primary sources of support, with psychotherapy functioning as a
complementary resource rather than a replacement. Such partnerships honor indigenous knowledge systems and
promote sustainable, community-centered approaches to bereavement care (Haram, 2020).
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In many collectivistic cultures, grief is deeply embedded within family and community structures where
maintaining social harmony and family reputation is paramount. Disclosure of personal distress or family
dysfunction to outsiders, including therapists or group members, may be perceived as bringing shame or “loss
of face” to the family. Such stigma can significantly inhibit open emotional expression in group psychotherapy
settings and may lead to guarded participation, partial disclosure, or early dropout. Cultural norms emphasizing
privacy and secrecy around suffering further complicate engagement, particularly when grief is associated with
socially sensitive deaths or unresolved family conflict (Adinkrah, 2016; Haram, 2020).
Group psychotherapy models may inadvertently conflict with religious or cultural norms governing gender
interaction, physical proximity, or spiritual conduct. In certain contexts, mixed-gender group settings or closed-
room discussions may violate religious laws or cultural expectations, creating ethical and practical barriers to
participation. Without careful cultural adaptation and community consultation, these constraints may limit
accessibility and undermine the perceived legitimacy of group-based interventions (Haram, 2020).
While group psychotherapy offers communal support, it also presents inherent risks. Exposure to others’
traumatic loss narratives may intensify distress for some participants, leading to emotional overwhelm or
secondary traumatization. Group processes may also give rise to unhelpful dynamics, such as competitive
expressions of grief, emotional withdrawal due to lack of trust, or interpersonal tensions and jealousy.
Additionally, group formats may not provide sufficient individualized attention for participants experiencing
complex or prolonged grief, necessitating supplementary individual support (Forte et al., 2004; Maass et al.,
2022).
The effectiveness of culturally responsive interventions such as Narrative Therapy and mindfulness-based
approaches is highly dependent on therapist skill and cultural competence. Practitioners must navigate nuanced
belief systems related to death, rebirth, ancestral presence, and spirituality, requiring advanced training,
reflexivity, and cultural humility (Denborough, 2014; White, 2007). Moreover, despite cultural adaptations,
many therapeutic models remain rooted in Western psychological assumptions, such as prioritizing individual
autonomy and self-expression. These assumptions may conflict with collectivistic values emphasizing
interdependence, familial obligation, and communal identity, potentially limiting cultural congruence if not
critically examined (Neimeyer et al., 2014; Neimeyer, 2019).
Empirical research on bereavement group psychotherapy in collectivistic contexts remains limited. Existing
studies are often constrained by small sample sizes, short follow-up periods, and a lack of randomized controlled
trials involving diverse non-Western populations. These limitations restrict generalizability and hinder the
development of evidence-based guidelines for large-scale implementation. Questions regarding long-term
sustainability, cost-effectiveness, and integration into existing community systems remain insufficiently
addressed in the current literature (Forte et al., 2004; Maass et al., 2022).
Structural barriers further complicate implementation, including the scarcity of bilingual and bicultural mental
health professionals capable of facilitating groups in participants’ native languages. Additionally, some
individuals in collectivistic communities may prefer directive, problem-solving approaches to grief support
rather than exploratory or emotion-focused models. This preference may reduce engagement with therapies that
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emphasize prolonged emotional processing, highlighting the need for flexible, culturally responsive intervention
designs that integrate structured, solution-oriented elements where appropriate (Haram, 2020; Forte et al., 2004).
The integration of group psychotherapy for bereavement grief in collectivistic cultures offers a powerful
framework for healing, that emphasizes the importance of shared experiences and community support. Through
a comprehensive review of existing literature, this article has highlighted the therapeutic benefits of group
therapy, particularly in collectivistic cultures, where communal bonds and shared rituals play a central role in
healing. Group psychotherapy provides not only an environment of mutual support and understanding but also
facilitates meaning making reconstruction, a key aspect of grieving in collectivistic settings (Maass et al., 2022;
Mathew, 2021). The blending of Western therapeutic practices with traditional collectivistic rituals creates a
holistic approach that acknowledges both individual emotional processing and the need for collective healing.
Research demonstrates that group therapy interventions, such as those incorporating psychoeducation, emotional
expression, and cognitive-behavioral techniques, are effective in reducing grief symptoms and enhancing
resilience (Zimpfer, 1991; Forte et al., 2004). These interventions are further enriched by culturally relevant
practices that reinforce community connections and provide a sense of continuity and shared meaning in the face
of loss (Forte et al., 2004; Walls & Meyers, 1984). Moreover, the impact of such interventions is amplified when
tailored to the cultural context, with participants benefiting from the collective engagement and spiritual
practices common in collectivistic cultures (Mathew, 2021).
As bereavement care continues to evolve, the importance of culturally sensitive interventions cannot be
overstated. For collectivistic cultures, group psychotherapy offers an opportunity to weave together diverse
cultural rituals and modern therapeutic techniques, creating a more inclusive and effective approach to grief.
Future research should continue to explore the long-term effects of these integrated models, examining their
efficacy in diverse cultural contexts, expanding the understanding of how shared community rituals can support
grief processing and recovery and, test the proposed group psychotherapy framework in this article. While the
proposed framework offers culturally grounded practice implications, its application must be understood within
the contextual, methodological, and systemic limitations discussed.
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