ABSTRACT
Drawing on over 15 years of empirical research and clinical experience, this chapter provides a detailed description of Dignity Therapy, one of the most novel and studied psychosocial interventions in palliative care. Dignity Therapy is rooted in our research group’s studies, which found that depression, desire for death, hopelessness, feelings of being a burden, and poorer quality to life were higher in terminally ill patients who reported that their dignity had been undermined. That research led to the development of the empirically derived theoretical model of dignity in the terminally ill and an innovative dignity-conserving approach to palliative care. This approach extends beyond the management of pain and other physical symptoms to strategies and interventions broadly addressing the physical, psychological, social, spiritual, and existential aspects of the end-of-life experience. In Dignity Therapy, a trained therapist uses a question protocol to guide a patient through a discussion about their feelings, values, roles, accomplishments and their hopes, dreams, and advice for their loved ones to identify matters that are most important to the patient and/or that they most want others to remember about them. The discussion is audio-recorded, transcribed, and then edited by the therapist to produce a generativity document for the patient, which is meant for them to bequeath to family and friends. This chapter describes the process of Dignity Therapy, reviews the empirical evidence base, and identifies uncertainties, gaps, and directions for future research. Case examples are woven throughout the narrative, along with descriptions of applications in diverse patient populations, geographic locations, and innovative modes of delivery.
