Hostname: page-component-7479d7b7d-c9gpj Total loading time: 0 Render date: 2024-07-12T15:18:33.386Z Has data issue: false hasContentIssue false
  • English
  • Français

Meaning-centered dream work with hospice patients: A pilot study

Published online by Cambridge University Press:  15 October 2014

Scott T. Wright ,
Pei C. Grant ,
Rachel M. Depner ,
James P. Donnelly  and
Christopher W. Kerr
Scott T. Wright*
Affiliation:
University at Buffalo, State University of New York, Buffalo, New York The Center for Hospice and Palliative Care, Buffalo, New York
Pei C. Grant
Affiliation:
The Center for Hospice and Palliative Care, Buffalo, New York
Rachel M. Depner
Affiliation:
University at Buffalo, State University of New York, Buffalo, New York The Center for Hospice and Palliative Care, Buffalo, New York
James P. Donnelly
Affiliation:
Canisius College, Buffalo, New York
Christopher W. Kerr
Affiliation:
The Center for Hospice and Palliative Care, Buffalo, New York
*
Address correspondence and reprint requests to: Scott Wright, Research Department, The Center for Hospice and Palliative Care, 225 Como Park Boulevard, Cheektowaga, New York 14227. E-mail: scott.thomas.wright@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Hospice patients often struggle with loss of meaning, while many experience meaningful dreams. The purpose of this study was to conduct a preliminary exploration into the process and therapeutic outcomes of meaning-centered dream work with hospice patients.

Method:

A meaning-centered variation of the cognitive–experiential model of dream work (Hill, 1996; 2004) was tested with participants. This variation was influenced by the tenets of meaning-centered psychotherapy (Breitbart et al., 2012). A total of 12 dream-work sessions were conducted with 7 hospice patients (5 women), and session transcripts were analyzed using the consensual qualitative research (CQR) method (Hill, 2012). Participants also completed measures of gains from dream interpretation in terms of existential well-being and quality of life.

Results:

Participants' dreams generally featured familiar settings and living family and friends. Reported images from dreams were usually connected to feelings, relationships, and the concerns of waking life. Participants typically interpreted their dreams as meaning that they needed to change their way of thinking, address legacy concerns, or complete unfinished business. Generally, participants developed and implemented action plans based on these interpretations, despite their physical limitations. Participants described dream-work sessions as meaningful, comforting, and helpful. High scores on a measure of gains from dream interpretation were reported, consistent with qualitative findings. No adverse effects were reported or indicated by assessments.

Significance of Results:

Our results provided initial support for the feasibility and helpfulness of dream work in this population. Implications for counseling with the dying and directions for future research were also explored.

Keywords

Dream workMeaningEnd of lifeHospicePalliative careExistential well-being
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 5 , October 2015 , pp. 1193 - 1211
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Anderson, F., Downing, G.M., Hill, J., et al. (1996). Palliative performance scale (PPS): A new tool. Journal of Palliative Care, 12, 5–11.Google Scholar
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th ed. (DSM–IV–TR). Washington, DC: American Psychiatric Association.Google Scholar
Barrett, W. (1926). Death-bed visions: The psychical experiences of the dying. London: Aquarian Press.Google Scholar
Blinderman, C.D. & Cherny, N.I. (2005). Existential issues do not necessarily result in existential suffering: Lessons from cancer patients in Israel. Palliative Medicine, 19, 371–380.Google Scholar
Boston, P.H. & Mount, B.M. (2006). The caregiver's perspective on existential and spiritual distress in palliative care. Journal of Pain and Symptom Management, 32, 13–26.CrossRefGoogle ScholarPubMed
Brayne, S., Farnham, C. & Fenwick, P. (2006). Deathbed phenomena and their effect on a palliative care team: A pilot study. The American Journal of Hospice & Palliative Medicine, 23, 17–24.CrossRefGoogle ScholarPubMed
Brayne, S., Lovelace, H. & Fenwick, P. (2008). End-of-life experiences and the dying process in a Gloucestershire nursing home as reported by nurses and care assistants. The American Journal of Hospice & Palliative Medicine, 25, 195–206.CrossRefGoogle Scholar
Breitbart, W. (2003). Reframing hope: Meaning-centered care for patients near the end of life. Interview by Karen S. Heller. Journal of Palliative Medicine, 6, 979–988.Google Scholar
Breitbart, W. & Applebaum, A. (2011). Meaning-centered group psychotherapy. In Handbook of psychotherapy in cancer care, Watson, M. & Kissane, D.W. (eds.), pp. 137–148. West Sussex: John Wiley and Sons.Google Scholar
Breitbart, W., Gibson, C., Poppito, S.R., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49, 366–372.Google Scholar
Breitbart, W., Rosenfeld, B., Gibson, C., et al. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: A pilot randomized controlled trial. Psycho-Oncology, 19, 21–28.Google Scholar
Breitbart, W., Poppito, S., Rosenfeld, B., et al. (2012). Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology, 30, 1304–1309.Google Scholar
Brink, T.L. (1977). Dream therapy with the aged. Psychotherapy: Theory, Research and Practice, 14, 354–360.CrossRefGoogle Scholar
Bufford, R.K., Paloutzian, R.F. & Ellison, C.W. (1991). Norms for the Spiritual Well-Being Scale. Journal of Psychology and Theology, 19, 56–70.Google Scholar
Chochinov, H.M. (2006). Dying, dignity, and new horizons in palliative end-of-life care. CA: A Cancer Journal for Clinicians, 56, 84–105.Google Scholar
Chochinov, H.M., Hack, T., Hassard, T., et al. (2004). Dignity and psychotherapeutic considerations in end-of-life care. Journal of Palliative Care, 20, 134–142.Google Scholar
Chochinov, H.M., Hassard, T., McClement, S., et al. (2009). The landscape of distress in the terminally ill. Journal of Pain and Symptom Management, 38, 641–649.CrossRefGoogle ScholarPubMed
Davis, T.L. & Hill, C.E. (2005). Spiritual and nonspiritual approaches to dream work: Effects on clients' well-being. Journal of Counseling & Development, 83, 492–503.Google Scholar
de Boer, A.G.E.M., van Lanschot, J.J.B., Stalmeier, P.F.M., et al. (2004). Is a single-item visual analog scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Quality of Life Research, 13, 311–320.Google Scholar
DeCicco, T.L., Lyons, T., Pannier, W., et al. (2010). Exploring the dreams of women with breast cancer: Content and meaning of dreams. International Journal of Dream Research, 3, 104–110.Google Scholar
Ellison, C.W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11, 330–340.CrossRefGoogle Scholar
Epstein, S. (1994). Integration of the cognitive and the psychodynamic unconscious. The American Psychologist, 49, 709–724.CrossRefGoogle ScholarPubMed
Erikson, E.H. (1980). Identity and the life cycle. New York: W.W. Norton.Google Scholar
Fenwick, P., Lovelace, H. & Brayne, S. (2010). Comfort for the dying: Five year retrospective and one year prospective studies of end-of-life experiences. Archives of Gerontology and Geriatrics, 51(2), 173–179.Google Scholar
Frankl, V.E. (2006). Man's search for meaning. Boston: Beacon Press.Google Scholar
Freud, S. (1998). The interpretation of dreams. Strachey, J., trans., ed. New York: Avon Books.Google Scholar
Goelitz, A. (2001). Nurturing life with dreams: Therapeutic dream work with cancer patients. Clinical Social Work Journal, 29, 375–385.CrossRefGoogle Scholar
Goelitz, A. (2007). Exploring dream work at end of life. Dreaming, 17, 159–171.Google Scholar
Gurney, E., Myers, F.W.H. & Podmore, F. (1886). Phantasms of the living. London: Rooms of the Society for Psychical Research, Trübner and Company.Google Scholar
Heaton, K.J., Hill, C.E., Hess, S.A., et al. (1998). Assimilation in therapy involving interpretation of recurrent and nonrecurrent dreams. Psychotherapy: Theory, Research, and Practice, 35, 147–162.Google Scholar
Heintz, A.P.M. (2007). Quality of dying. Journal of Psychosomatic Obstetrics and Gynaecology, 28, 1–2.CrossRefGoogle ScholarPubMed
Henoch, I. & Danielson, E. (2009). Existential concerns among patients with cancer and interventions to meet them: An integrative literature review. Psycho-Oncology, 18, 225–236.CrossRefGoogle ScholarPubMed
Hess, S.A., Knox, S., Hill, C.E., et al. (2013). Exploring the dreams of hospice workers. The American Journal of Hospice & Palliative Care, 31(4), 374–379.Google Scholar
Hill, C.E. (1996). Working with dreams in psychotherapy. New York: Guilford Press.Google Scholar
Hill, C.E. (2004). Dream work in therapy: Facilitating exploration, insight, and action. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Hill, C.E. (ed.). (2012). Consensual qualitative research: A practical resource for investigating social science phenomena . Washington, DC: American Psychological Association.Google Scholar
Hill, C.E. & Goates, M.K. (2004). Research on the Hill cognitive–experiential dream model. In Dream work in therapy: Facilitating exploration, insight, and action. Hill, C.E. (ed.), pp. 245–288. Washington, DC: American Psychological Association.Google Scholar
Hill, C.E., Zack, J.S., Wonnell, T.L., et al. (2000). Structured brief therapy with a focus on dreams or loss for clients with troubling dreams and recent loss. Journal of Counseling Psychology, 47, 90–101.CrossRefGoogle Scholar
Jacobsen, J.C., Vanderwerker, L.C., Block, S.D., et al. (2006). Depression and demoralization as distinct syndromes: Preliminary data from a cohort of advanced cancer patients. Indian Journal of Palliative Care, 12, 8–16.Google Scholar
Jung, C.G. (2010). Dreams. Hull, R.F.C., trans. Princeton: Princeton University Press.Google Scholar
Kerr, C.W., Donnelly, J.P., Wright, S.T., et al. (2014). End-of-life dreams and visions: A longitudinal study of hospice patients' experiences. Journal of Palliative Medicine, 17(3), 296–303.CrossRefGoogle ScholarPubMed
Kon, A.A. & Ablin, A.R. (2010). Palliative treatment: Redefining interventions to treat suffering near the end of life. Journal of Palliative Medicine, 13, 643–646.Google Scholar
Magee, J.J. (1992). Dream analysis as an aid to older adults' life review. Journal of Gerontological Social Work, 18(3/4), 163–173.Google Scholar
Mashele, M.H., Sumithra, J.M., Paul, L.S., et al. (2007). A pooled analysis of quality of life measures and adverse events data in north central cancer treatment group lung cancer clinical trials. Cancer, 109, 787–795.Google Scholar
Mazzotti, E., Mazzuca, F., Sebastiani, C., et al. (2011). Predictors of existential and religious well-being among cancer patients. Supportive Care in Cancer, 19(12), 1931–1937.Google Scholar
Mok, E., Lau, K., Lam, W., et al. (2010). Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Journal of Advanced Nursing, 66, 1510–1522.Google Scholar
Muff, J. (1996). Images of life on the verge of death: Dreams and drawings of people with AIDS. Perspectives in Psychiatric Care, 32, 10–21.Google Scholar
Nosek, C.L., Kerr, C.W., Woodworth, J., et al. (2014). End-of-life dreams and visions: A qualitative perspective from hospice patients. The American Journal of Hospice & Palliative Care, January 16. Epub ahead of print.Google Scholar
Pesant, N. & Zadra, A. (2004). Working with dreams in therapy: What do we know and what should we do? Clinical Psychology Review, 24, 489–512.Google Scholar
Prince, P.N. & Hoffmann, R.F. (1991). Dreams of the dying patient: An exploration of content. Omega: Journal of Death and Dying, 23, 1–11.Google Scholar
Saunders, C. (1988). Spiritual pain. Journal of Palliative Care, 4(3), 29–32.Google Scholar
Schuman-Olivier, Z., Brendel, D.H., Forstein, M., et al. (2008). The use of palliative sedation for existential distress: A psychiatric perspective. Harvard Review of Psychiatry, 16, 339–351.Google Scholar
Seymour, J. (2012). Combined qualitative and quantitative research designs. Palliative & Supportive Care, 6, 514–524.Google Scholar
Spiritual Well-Being Scale (1995). In The twelfth mental measurements yearbook. Lincoln, NE: Buros Center for Testing. Available from http://www.unl.edu/buros/bimm/index.html.Google Scholar
Spitzer, W.O., Dobson, A.J., Hall, J., et al. (1981). Measuring the quality of life of cancer patients: A concise QL index for use by physicians. Journal of Chronic Diseases, 34, 585–597.Google Scholar
Tien, H., Chen, S. & Lin, C. (2009). Helpful components involved in the cognitive–experiential model of dream work. Asia Pacific Education Review, 10, 547–559.CrossRefGoogle Scholar
Vehling, S., Lehmann, C., Oechsle, K., et al. (2012). Is advanced cancer associated with demoralization and lower global meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients. Psycho-Oncology, 21, 54–63.Google Scholar
Wills-Brandon, C. (2000). One last hug before I go: The mystery and meaning of deathbed visions. Deerfield Beach, FL: Lightning Source Incorporated.Google Scholar
Wonjin, S., Hill, C.E., Chowdhury, S., et al. (2010). Problems and action ideas discussed by first- and second-generation female East Asian students during dream sessions. Dreaming, 20, 42–59.Google Scholar