Psychiatric aspects of palliative care: meaning and existential issues in end of life care


Session type:

William Breitbart1
1Memorial Sloan-Kettering Cancer Center, New York, USA


This plenary lecture provides an overview of existential issues in end of life care, with an emphasis of the important role of 'meaning'. A novel counselling intervention for patients with advanced cancer, entitled 'Meaning Centered Psychotherapy (MCP)', will be described. The basic concepts of Meaning Centered Psychotherapy will be described. Two forms of MCP have been developed:  Meaning Centered Group Psychotherapy and Meaning Centered Psychotherapy. A detailed description of the interventions and the content of each session will be provided. Both interventions are manualised and several randomised controlled trials have been conducted. The results of these studies will be presented which demonstrate that MCP enhances spiritual wellbeing and meaning, improves quality of life, decreases depression, anxiety, hopelessness and desire for hastened death. In addition, adaptations of Meaning Centered Psychotherapy for bereavement, cancer survivors, cancer caregivers, and adolescents with cancer will be described.

Learning objectives:

1. You will become familiar with the concept of spirituality as a construct composed of faith and/or meaning.

2. You will become familiar with the importance of meaning, as a component of spiritual wellbeing, and its relationship to depression, hopelessness and desire for death.

3. You will become familiar with a structured, didactic and experiential eight-session intervention for advanced cancer patients aimed at sustaining or enhancing a sense of meaning in the face of terminal illness.