Tasha M Schoppee1,2,3, Lisa Scarton1,3, Susan Bluck1,3, Yingwei Yao1,3, Gail Keenan1,3, George Handzo4, Harvey M Chochinov5, George Fitchett6, Linda L Emanuel7, Diana J Wilkie3,8. 1. University of Florida, Gainesville, FL. 2. Community Hospice & Palliative Care, Jacksonville, FL. 3. Center for Palliative Care Research & Education, University of Florida, Gainesville, FL. 4. HealthCare Chaplaincy Network, New York, NY. 5. CancerCare Manitoba, Winnipeg, MB, Canada. 6. Rush University Medical Center, Chicago, IL. 7. Northwestern University, Chicago, IL. 8. Florida-California Cancer Research Education and Engagement Health Equity Center (CaRE2 Center), University of Florida, Gainesville, FL.
Abstract
BACKGROUND: Dignity Therapy (DT) has been implemented over the past 20 years, but a detailed training protocol is not available to facilitate consistency of its implementation. Consistent training positively impacts intervention reproducibility. OBJECTIVE: The objective of this article is to describe a detailed method for DT therapist training. METHOD: Chochinov's DT training seminars included preparatory reading of the DT textbook, in-person training, and practice interview sessions. Building on this training plan, we added feedback on practice and actual interview sessions, a tracking form to guide the process, a written training manual with an annotated model DT transcript, and quarterly support sessions. Using this training method, 18 DT therapists were trained across 6 sites. RESULTS: The DT experts' verbal and written feedback on the practice and actual sessions encouraged the trainees to provide additional attention to eight components: (1) initial framing (i.e., clarifying and organizing of the patient's own goals for creating the legacy document), (2) verifying the patient's understanding of DT, (3) gathering the patient's biographical information, (4) using probing questions, (5) exploring the patient's story thread, (6) refocusing toward the legacy document creation, (7) inviting the patient's expression of meaningful messages, and (8) general DT processes. Evident from the ongoing individual trainee mentoring was achievement and maintenance of adherence to the DT protocol. DISCUSSION: The DT training protocol is a process to enable consistency in the training process, across waves of trainees, toward the goal of maintaining DT implementation consistency. This training protocol will enable future DT researchers and clinicians to consistently train therapists across various disciplines and locales. Furthermore, we anticipate that this training protocol could be generalizable as a roadmap for implementers of other life review and palliative care interview-based interventions.
BACKGROUND: Dignity Therapy (DT) has been implemented over the past 20 years, but a detailed training protocol is not available to facilitate consistency of its implementation. Consistent training positively impacts intervention reproducibility. OBJECTIVE: The objective of this article is to describe a detailed method for DT therapist training. METHOD: Chochinov's DT training seminars included preparatory reading of the DT textbook, in-person training, and practice interview sessions. Building on this training plan, we added feedback on practice and actual interview sessions, a tracking form to guide the process, a written training manual with an annotated model DT transcript, and quarterly support sessions. Using this training method, 18 DT therapists were trained across 6 sites. RESULTS: The DT experts' verbal and written feedback on the practice and actual sessions encouraged the trainees to provide additional attention to eight components: (1) initial framing (i.e., clarifying and organizing of the patient's own goals for creating the legacy document), (2) verifying the patient's understanding of DT, (3) gathering the patient's biographical information, (4) using probing questions, (5) exploring the patient's story thread, (6) refocusing toward the legacy document creation, (7) inviting the patient's expression of meaningful messages, and (8) general DT processes. Evident from the ongoing individual trainee mentoring was achievement and maintenance of adherence to the DT protocol. DISCUSSION: The DT training protocol is a process to enable consistency in the training process, across waves of trainees, toward the goal of maintaining DT implementation consistency. This training protocol will enable future DT researchers and clinicians to consistently train therapists across various disciplines and locales. Furthermore, we anticipate that this training protocol could be generalizable as a roadmap for implementers of other life review and palliative care interview-based interventions.
Entities:
Keywords:
Cancer care; Dignity therapy; Hospice; Life review; Palliative care
Authors: Harvey Max Chochinov; Linda J Kristjanson; William Breitbart; Susan McClement; Thomas F Hack; Tom Hassard; Mike Harlos Journal: Lancet Oncol Date: 2011-07-06 Impact factor: 41.316
Authors: Harvey Max Chochinov; Beverley Cann; Katherine Cullihall; Linda Kristjanson; Mike Harlos; Susan E McClement; Thomas F Hack; Tom Hassard Journal: Palliat Support Care Date: 2012-03
Authors: Sheri Kittelson; Lisa Scarton; Paige Barker; Joshua Hauser; Sean O'Mahony; Michael Rabow; Marvin Delgado Guay; Tammie E Quest; Linda Emanuel; George Fitchett; George Handzo; Yingewi Yao; Harvey Max Chochinov; Diana Wilkie Journal: JMIR Res Protoc Date: 2019-04-17
Authors: Marina Martínez; María Arantzamendi; Alazne Belar; José Miguel Carrasco; Ana Carvajal; María Rullán; Carlos Centeno Journal: Palliat Med Date: 2016-08-26 Impact factor: 4.762
Authors: Karen L Lewis; Carrie A Bohnert; Wendy L Gammon; Henrike Hölzer; Lorraine Lyman; Cathy Smith; Tonya M Thompson; Amelia Wallace; Gayle Gliva-McConvey Journal: Adv Simul (Lond) Date: 2017-06-27
Authors: Tasha M Schoppee; Lisa Scarton; Susan Bluck; Yingwei Yao; Gail Keenan; Virginia Samuels; George Fitchett; George Handzo; Harvey M Chochinov; Linda L Emanuel; Diana J Wilkie Journal: BMC Palliat Care Date: 2022-01-11 Impact factor: 3.113