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Description of a training protocol to improve research reproducibility for dignity therapy: an interview-based intervention

Published online by Cambridge University Press:  26 May 2021

Tasha M. Schoppee Open the ORCID record for Tasha M. Schoppee [Opens in a new window] ,
Lisa Scarton ,
Susan Bluck ,
Yingwei Yao ,
Gail Keenan ,
George Handzo ,
Harvey M. Chochinov ,
George Fitchett ,
Linda L. Emanuel  and
Diana J. Wilkie Open the ORCID record for Diana J. Wilkie [Opens in a new window]
Tasha M. Schoppee*
Affiliation:
University of Florida, Gainesville, FL Community Hospice & Palliative Care, Jacksonville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Lisa Scarton
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Susan Bluck
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Yingwei Yao
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
Gail Keenan
Affiliation:
University of Florida, Gainesville, FL Center for Palliative Care Research & Education, University of Florida, Gainesville, FL
George Handzo
Affiliation:
HealthCare Chaplaincy Network, New York, NY
Harvey M. Chochinov
Affiliation:
CancerCare Manitoba, Winnipeg, MB, Canada
George Fitchett
Affiliation:
Rush University Medical Center, Chicago, IL
Linda L. Emanuel
Affiliation:
Northwestern University, Chicago, IL
Diana J. Wilkie
Affiliation:
Center for Palliative Care Research & Education, University of Florida, Gainesville, FL Florida-California Cancer Research Education and Engagement Health Equity Center (CaRE2 Center), University of Florida, Gainesville, FL
*
Author for correspondence: Tasha M. Schoppee, 4266 Sunbeam Rd., Building 100, Jacksonville, FL 32257, USA. E-mail: tasha.schoppee@ufl.edu
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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.

Keywords

Cancer careDignity therapyHospiceLife reviewPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 2 , April 2022 , pp. 178 - 188
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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