Dignity Therapy as a Method of Palliative Psychological Assistance

Abstract

Methodological and theoretical grounding of a brief psychological intervention, new for Ukraine, are presented ‒ of so-called dignity therapy created by a Canadian researcher Harvey M. Chochinov the aim of which is fostering the feeling of the personhood of patients, actualization of their feeling of dignity and, as a result, decreasing of sufferings and increasing the quality of their lives. The scope of requests and conditions where dignity therapy could be helpful is defined, palliative care and psychological support of the elderly in particular. The factor contents of the model of dignity around which the intervention is constructed is revealed: feelings around the illness, behavioural repertoire related to the feeling of dignity, and the social model of dignity. The stages of dignity therapy implementation (preparatory, the stage of interview, and the stage of creating Generativity Document), its eight components (setting, comprehension check, probing questions, exploration of one's life path, refocusing, encouraging for meaningful expressions, general processes of the therapy) as well as questions that a therapist asks a patient in order to start a foreseen process are listed and described. Approximate contents of Generativity Document which is a key material product of dignity therapy on the example of summarized results of thematic analysis in the relevant research from different countries is presented (the developed themes include “Family”, “Pleasure”, “Caring”, “A Sense of Accomplishment” and others). The description of the procedure of estimation of efficacy of dignity therapy is provided, in particular through the use of self-reports and with the inclusion of groups of experts. A brief outline of the demands for therapists who implement the intervention is defined (namely, the standardized training with standardized teaching materials, the work at standardized cases, providing supervisions and additional expert support). The importance of the attitude of a specialist towards realization of dignity therapy is stressed ‒ sensitive, self-aware as well as self-reflective.

Keywords

• palliative care
• elderly age
• existential feelings
• death
• quality of life