The Present State of Existential Interventions Within Palliative Care

Area of Science:

• Psychology
• Philosophy
• Medicine

Background:

• Existential psychotherapy draws from European existential philosophy, exploring themes of death, freedom, meaninglessness, and isolation.
• Key figures include Husserl, Heidegger, Camus, Sartre, and Merleau-Ponty, with early developments by Binswanger, Frankl, and Boss, and later by May, Laing, Yalom, and Wong.

Purpose of the Study:

• To review randomized controlled trials (RCTs) investigating existential psychotherapies for patients with advanced cancer or terminal care.
• To identify types of existential psychotherapy and their effects on existential or spiritual well-being.

Main Methods:

• A systematic review of 19 relevant RCTs was conducted.
• Nine types of existential psychotherapies were identified: Meaning-Centered Group Psychotherapy (MCGP), Individual Meaning-Centered Psychotherapy (IMCP), Meaning-Making intervention (MMi), Meaning of Life Intervention, Managing Cancer and Living Meaningfully (CALM), Hope Intervention, Cognitive and Existential Intervention, Dignity Therapy, and Life-Review Interviews.

Main Results:

• All reviewed interventions address core existential themes like death, meaninglessness, isolation, and freedom.
• Meaning-centered therapies (MCGP, IMCP, MMi, Meaning of Life, CALM) specifically focus on finding or creating meaning.
• Positive effects on existential or spiritual well-being were confirmed for MCGP, IMCP, Meaning of Life intervention, and Life-Review intervention, though based on limited studies.

Conclusions:

• Existential psychotherapy, particularly meaning-centered approaches, shows potential benefits for patients with advanced cancer.
• Heterogeneous findings and small study numbers necessitate further rigorous research to confirm efficacy.