Table 3 Case reports of dignity therapy use

Avery & Savitz, 2011 [44]

US patient with schizoaffective disorder in inpatient psychiatric unit

DT protocol questions used by patient to write life story, prompted by worries of not spending time with family because of illness. Investigator typed and edited narrative and discussed with patient.

• Patient reported that narrative had ‘restored hope’ to him. Patient shared copies of document with loved ones.

• Investigators note DT could be beneficial for pts with chronic mental illness, “improving patient narratives”.

Avery & Baez, 2012 [43]

US patient with major depressive disorder in inpatient setting

DT protocol used by investigator to aid patient in ‘gaining fresh perspective’ after severe depression following loss of job.

• Patient reported DT aided her in ‘finding hope’, and improved her mood.

• Investigator notes use of DT to make sense of major life event and loss.

• Investigator posits DT legacy document may be supportive to family members of patients with chronic mental illness.

Hall et al., 2013 [34]

3 UK patients with advanced cancer in high distress, sample from Hall et al., 2011 [32,33]

Focus on ‘dignity-related problems’ expressed by patients, qualitative review of DT legacy documents.

• Investigators note DT administered in a context of complex and quickly changing circumstances.

• Distressed patients may find focus on ‘overarching truths, feelings and insights’ as indicated in DT protocol very difficult.

• DT therapeutic relationship is challenging with patients who are distressed given short time-frame of interaction.