What is Dignity Therapy?
Maintaining dignity for patients approaching death is a core principle of palliative care. Translating that principle into methods of guiding care at the end of life can be a complicated and daunting task. Dignity therapy is a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as they grapple with the reality of life drawing to a close. [taken from Dignity Therapy, by Harvey Max Chochinov]
The first main component of Dignity Therapy is a guided conversation between the client and the therapist, addressing issues that the client deems most important (such as elements of their history, lessons learned, hopes and wishes to convey or blessings to bestow). The second component consists of creating a very special document. This Legacy Document is an edited record of their recorded session, which clearly captures the essence of the client's responses.
How does it work?
There are several meetings between the therapist and client during a seven - ten day period. The first meeting is to explain the protocol, gather basic background information and establish the framework for the client's session. The client receives a copy of the Question Protocol to review and is given time to consider possible responses.
The second meeting is the recorded session. It is a guided conversation utilizing the specific Dignity Therapy Question Protocol to generate the client's recollections. At the third meeting, the edited transcript is available for the client to review and make any desired deletions, corrections or additions. The finalized Legacy Document is presented to the client at the fourth meeting.
Who should not take part?
Anyone who is to ill and not expected to survive more than a few weeks should not, under normal circumstances, be considered for Dignity Therapy. The most common reason is they feel too ill. Advanced disease depletes people of their physical and mental energies.
The second most important reason to exclude someone from Dignity Therapy is impaired cognitive ability which limits the individual's capacity to provide meaningful and reflective responses.
Frequently asked questions
May a family member or a friend be present for the interview? Yes. The client may be accompanied by someone they know; other clients prefer to be alone so another's presence doesn't interfere with their candid discussion.
Where does the interview take place? Typically at the client's home or hospital room. All efforts to ensure privacy will be made.
Must it be recorded?
Yes, so an accurate documents may be compiled.
The History of Dignity Therapy
This psychological intervention was developed by Dr. Harvey Max Chochinov and his internationally lauded research group. It has been tested with patients with advanced illnesses in Canada, the United States, Australia, China, Japan, Scotland, England, Denmark and Portugal. Dignity therapy has been shown to benefit not only patients, but their families as well. Dr. Chochinov argues that dignity therapy offers a way to preserve meaning and hope for the patients approaching death. [taken from Dignity Therapy, by Harvey Max Chochinov]
Dr. Harvey Max Chochinov is an international leader in palliative care. He is the Distinguished Professor of Psychiatry at the University of Manitoba and Director of the Manitoba Palliative Care Research Unit at CancerCare Manitoba.
In June, 2012, Sue Joy-Sobota completed studies with Dr. Harvey Max Chochinov in Winnipeg, Manitoba and became a certified Dignity Therapist. Please refer to Schedule/Register to learn when Sue will be in Wisconsin or Florida.