Palliative and Supportive Care

Original Articles

The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy

Carrie Lethborga1 c1, Penelope Schofielda2 and David Kissanea3

a1 Oncology Department, Saint Vincent's Hospital, Fitzroy, Victoria, Australia

a2 Nursing and Supportive Care Research Group, Peter MacCallum Cancer Centre, Melbourne, Australia

a3 Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York


Objective: The objective of this study was to describe the experience of undertaking meaning and purpose (MaP) therapy for patients with advanced cancer, with an aim of refining therapeutic processes involved prior to pilot testing. Specifically, we were interested in examining the themes arising from participation in the intervention in relation to our therapeutic goals, and how acceptable both the number of sessions and processes used were.

Method: A convenience sample of people living with advanced cancer was recruited to participate in this process, resulting in 24 therapy sessions for analysis.

Results: A thematic analysis of each session illustrated that the process of MaP therapy is one that encourages reflection, offers insights, and can be confrontational, but can also allow participants to “shift” their perspective and focus onto meaningful goals. Results illustrate how the therapist creates a therapeutic frame that holds up a poignant portrayal of the meaning of life lived, and mirrors this to the patient, such that they grasp its rich texture. Participants' descriptions showed how they were buoyed forward as a result, with renewed vigor and enthusiasm, despite their illness and any physical restrictions that it imposed.

Significance of results: A planned pilot test of this intervention will enable us to determine potential effect sizes of this therapy in reducing distress and increasing meaning prior to a full randomized controlled trial. Understanding the processes involved and the experiences of participation in meaning-based therapies is crucial to the future strength of this area of psychotherapy.

(Received August 19 2010)

(Accepted June 13 2011)


c1 Address correspondence and reprint requests to: Carrie Lethborg, Oncology Department, St. Vincent's Hospital, Fitzroy, Victoria, Australia, 3104. E-mail: