0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters to the Editor   |    
A Novel Use of Dignity Therapy
Jonathan D. Avery, M.D.; Adam J. Savitz, M.D., Ph.D.
Am J Psychiatry 2011;168:1340-1340. doi:10.1176/appi.ajp.2011.11030444
View Author and Article Information

Dr. Avery reports no financial relationships with commercial interests. Dr. Savitz is employed full-time by Johnson & Johnson Pharmaceutical Research and Development and has received research support from Abbott Laboratories and Sanofi-Aventis.

Accepted for publication in June 2010.

New York

Copyright © American Psychiatric Association

Accepted June , 2011.

To the Editor: Dignity therapy is a brief psychotherapeutic intervention for terminally ill patients (1). In this therapy, patients generate a document to pass on to loved ones that contains details of the patient's life, life lessons, and declarations of affection. Clinicians help create such documents by recording the patient's story over several interviews and then transcribing and editing the patient's words. We report the case of a 55-year-old man with severe mental illness who participated in dignity therapy while awaiting transfer to a state hospital.

“Mr. J” is a 55-year-old man with schizoaffective disorder and multiple psychiatric hospitalizations who was admitted for worsening paranoia and agitation. Despite stabilization with medications, he continued to require hospitalization because of his poor self-care, and he was referred to the state hospital.

While awaiting transfer, Mr. J worried that he would never spend meaningful time with his adult children, and he agreed to undergo dignity therapy to tell his life story to his children. He was too paranoid to participate in a recorded interview, but he agreed to write his story following the prompts in the dignity psychotherapy protocol (1), which contains questions about life history, dreams, and accomplishments. He wrote his own answers in a simple, grammatically incorrect style, but one of the authors (J.D.A.) typed up his words, edited them, and reviewed them with him. Mr. J focused primarily on the births of his children and the course of his illness, and he concluded by expressing his love toward his children. He distributed 10 copies of his story to family and friends. He reported that dignity therapy had “restored hope” and enabled him to communicate better with his children, who stated that they could now better understand their father.

In this case, dignity therapy helped a patient with a debilitating mental illness face a negative life event much in the way it helps those facing terminal illness. In palliative care, dignity therapy has helped patients achieve a greater sense of purpose and will to live and reduced their suffering and depressive symptoms (1). Such gains would be beneficial for individuals with chronic mental illnesses, who have often suffered many personal losses and have low quality-of-life scores (2). Dignity therapy, along with other forms of psychotherapy (3), has the potential to improve patients' personal narratives, and future research to adapt dignity therapy for people with mental illness may increase patients' self-worth and coping abilities.

Chochinov  HM;  Hack  T;  Hassard  T;  Kristjanson  LJ;  McClement  S;  Harlos  M:  Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life.  J Clin Oncol 2005; 23:5520–5525
 
Hofer  A;  Kemmler  G;  Eder  U;  Edlinger  M;  Hummer  M;  Fleischhacker  WW:  Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects.  J Clin Psychiatry 2004; 65:932–939
 
Lysaker  PH;  Glynn  SM;  Wilkniss  SM;  Silverstein  SM:  Psychotherapy and recovery from schizophrenia: a review of potential applications and need for future study.  Psychol Serv 2010; 7:75–91
 
References Container
+

References

Chochinov  HM;  Hack  T;  Hassard  T;  Kristjanson  LJ;  McClement  S;  Harlos  M:  Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life.  J Clin Oncol 2005; 23:5520–5525
 
Hofer  A;  Kemmler  G;  Eder  U;  Edlinger  M;  Hummer  M;  Fleischhacker  WW:  Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects.  J Clin Psychiatry 2004; 65:932–939
 
Lysaker  PH;  Glynn  SM;  Wilkniss  SM;  Silverstein  SM:  Psychotherapy and recovery from schizophrenia: a review of potential applications and need for future study.  Psychol Serv 2010; 7:75–91
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 1

Related Content
Books
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 67.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 21.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 36.  >
Topic Collections
Psychiatric News
PubMed Articles