Spirituality, psychotherapy and music in palliative cancer care: research projects in psycho-oncology at an oncology center in Switzerland.

It is recognized as increasingly important in palliative care that spiritual needs of terminally ill patients should be acknowledged and addressed. Two research projects investigated the feasibility of psychotherapeutic and music therapeutic assistance offered to advanced cancer patients. The first project (1998-2000) sought to improve the understanding of the effect of therapeutic support given to 80 patients and the characteristics of the dying process. The second project (2000-2003) assessed the significance of spiritual experiences in illness and affliction. Empathic therapeutic assistance, observations and systematic record keeping were combined with statistical assessment in an interdisciplinary approach. A respectful attitude and spiritual care were taken to perceive and analyse changes in border areas of life. The first project studied the rules and methods of terminal communication and described three stages in the dying process. After a 'passing through,' the dying often had a spiritual opening leading in a state beyond all pain. The second project concentrated on spiritual experiences. Of 251 treated patients, 135 had such experiences. Spiritual experiences can have a great impact on physical and emotional well-being (alleviate pain, release from anxiety and despair, engender feelings of serenity and wholeness) and facilitate dying. Music therapy, psychotherapy and spiritual assistance offer essential methods for psycho-oncology and palliative care. A holistic and interdisciplinary approach is needed to assist patients in their complex suffering. Our findings on spiritual experience and terminal communication should stimulate further research in a still unexplored territory of clinical research.