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Effect of methodically writing the spiritual autobiography on personal life orientation and resilience for people treated for cancer.

A Randomized controlled trial study.



A cancer diagnosis and the associated intensive medical treatment profoundly confront people with the limits of their existence and death. This will often invoke existential questions. On the one hand, these are questions about identity, such as "Who am I ',' what can I do',' what do I want? On the other hand, these are questions about meaning: 'what is the meaning, purpose and direction in my life" and "what is of ultimate concern to me"? This existential questioning can have such impact, that it results in a crisis of meaning and meaning making. Research shows that seventy percent of people with cancer in the Netherlands say they are struggling with the above questions and many report that they need professional assistance with this.
An estimated 400,000 people in the Netherlands live with a cancer diagnosis and this number will increase further. As a result, the number of outpatient, ambulatory patients will grow strongly. Simultaneously, evidence-based outpatient interventions aimed at existential questions, are not yet available.
To meet the growing demand for outpatient spiritual care, the Pastoral and Spiritual Care Department at VU University Medical Center developed the intervention 'Methodically writing the Spiritual Autobiography", based on existing methodology and clinical experience. It is the aim of the intervention that reflecting on one’s own life experiences, will result in an articulation and transformation of one’s life-orientation and resilience. Life-orientation refers to a reflected or non-reflected personal vision on what is of ultimate concern to a person and how he or she gives concrete form to this in their life. Resilience refers to the ability to tap into internal and external sources to deal with setbacks and threats. The idea is that awareness and / or transformation of personal life-orientation will strengthen resilience, and enable to fit cancer into one’s life and shape one’s future.



  1. Determining the effectiveness of the intervention "methodically writing spiritual autobiography" (immediately, 10 weeks and 9 months after the intervention) in terms of personal life orientation and resilience (primary outcomes) and psychological well-being, coping and quality of life (secondary outcome measurements).

  2. Gain insight into the way in which the intervention contributes to the degree of reflection, shaping and appropriating one’s personal life orientation and its effect on resilience.

  3. Gain insight into predictive factors for success of the intervention


Randomized, controlled trial with two study arms (n = 63 per arm). The experimental group receives 'care as usual’ and the intervention ‘methodically writing the spiritual autobiography’. The control group will receive during the study period (six months) only "care as usual” and will be put on a waiting list. After the study period, the intervention will still be offered to them.
The effect of the intervention is measured and explained in quantitative and qualitative research. In the quantitative part psychological questionnaires are composed, using several reliable and valid instruments. The qualitative part consist of a content analysis of the texts that participants have written, and of semi-structured interviews with 20 randomly invited participants in the experimental group nine months after the intervention.


The research objectives are examined in the following ways:

  1. The primary outcome measures are the effect on personal life-orientation (Spiritual Attitude and Interest List and Northwestern Ego Integrity Scale) and the effect on resilience (Ryff conceptual well-being scale). Secondary outcome measures are the effect on the psychological well-being (Hospital Anxiety and Depression Scale), adjustment to cancer (Mental Adjustment to Cancer Scale) and quality of life (EORTC QLQ-C30).
  2. The relationship between the intervention, resilience and personal life orientation is examined by content analysis of the texts written during the intervention and verbata of semi-structured interviews. Texts and interviews are analyzed for content, categorized and rated using a coding system based on scientific analysis of autobiographical material as developed by McAdams (1999)
  3. To understand the predictors of success of the intervention, a regression analysis will be performed with socio-demographic, medical and psychological factors as independent variables.

Not available yet

Project duration
3,5 year

Permission METC
Not applicable.

Adessium Foundation; Roomsch Catholijck Armen en Ouderen Kantoor; VU University Medical Center (VUmc)

L. Post, MA, Theologian, PhD student, dpt. of Pastoral and Spiritual Care, VUmc
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech and Language Therapist, Linguïst, dpt. Otolaryngology-Head&Neck Surgery, VUmc.

Prof R.R. Ganzevoort, PhD  Professor of Practical Theology, VU Faculty of Theology

For questions, please contact:
Lenneke Post, MA, Theologian
E-mail: h.post@vumc.nl

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News flashes


PhD thesis Mirjam de Vries

March 22, 2019 Mirjam de Vries defended her thesis “Physicians‘ defence mechanisms during communication with advanced cancer patients”. 


PhD thesis Joeri Kalter

September 28, 2018 Joeri Kalter defended his thesis “Exercise and psychosocial interventions to improve quality of life in patients with cancer”. 


PhD thesis Sanne Duman-Lubberding

July 4, 2018 Sanne Duman-Lubberding defended her thesis "Online Patient Reported Outcome Measures to faciltate supportive care in Head and Neck Cancer patients".


PhD thesis Femke Jansen

January 15, 2018  Femke Jansen defended her thesis “Supportive care in head and neck cancer patients. Patient-reported needs and costs”. 

PhD thesis Janneke Rood

September 11, 2017 Janneke Rood defended her thesis "Perceived need for information and treatment decision-making in patients with hematological malignancies: not "one size fits all".


Amsterdam Public Health project

Within the context of the alliance VUmc-AMC Prof dr Ellen Laan (AMC) and prof dr Irma Verdonck-de Leeuw (VUmc) received a grant for the project "Sexual well-being in head and neck cancer patients".


Treatment of psychological distress in patients with head and neck or lung cancer cost-effective.
A recent study of PhD-student Femke Jansen and colleagues, recently published in the Journal of Clinical Oncology


PhD thesis Nadine Köhle

December 15, 2016 Nadine Köhle defended her PhD thesis "Hold on, for each other. Supporting partners of cancer patients via eHealth and positive psychology". 


PhD thesis Anne-Marie Krebber

December 2, 2016 Anne-Marie Krebber defended her PhD thesis "Stepped care targeting psychological distress in head and neck cancer and lung cancer patients".


PhD thesis Nadia van der Spek

September 7, 2016, Nadia van der Spek defended her PhD thesis "Meaning-centered group psychotherapy for cancer survivors: development, efficacy, and cost-utility". 


EORTC QLG Newsletter Spring 2016
The EORTC QLG  Spring Meeting took place on April 20th and 21th 2016 in Oslo. The Spring newsletter of the EORTC QLG is now available. 

PhD thesis Ingrid Cnossen

April 12, 2016, Ingrid Cnossen defended her PhD thesis entiteld “Self-management Supporting Rehabilitation in Head and Neck Cancer Patients”. 


VU/VUmc and Red-kite sign agreement for the provision of the Oncokompas in healthcare.

The VU University Amsterdam and VUmc Cancer Center Amsterdam work with Red-kite, distributor of software for hospitals in Netherlands. (November 3, 2015)


PhD thesis Christine van Gogh

December 4, 2015, Christine van Gogh defended her PhD thesis entiteld “Functional outcome of early glottic cancer”. 

Book presentation

On June 15th, 2015, Irma Verdonck presented the book "In Tune Without Cords" (in Dutch: VerderZonderStembanden) to Rob Burdorf, the president of the patient society for patients after laryngectomy.


PhD thesis Florien Boele

May 11 Florien Boele defended her PhD thesis, entitled "Towards improving health-related quality of life in glioma patients and their informal caregvers".


PhD thesis Trille Kristina Kjaer

May 8, Trille Kjaer will defend her PhD thesis entitled "Late effects after treatment of head and neck cancer and use of patient reported outcomes in clinical practice." Irma Verdonck is member of the committee.


Niels Stensen Fellowship
Florien Boele has received a Niels Stensen Fellowship. This is a scholarship that is awarded annually to a number of outstanding researchers who have recently obtained their PhD degree, to gain working experience abroad. Florien Boele will go to Pittsburgh (United States) and Edinburgh (Scotland) in 2015 and 2016.

Key paper

The publication “Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments” of A.M.H. Krebber et.al is chosen by the Editors as one of the key papers in Psycho-oncology, (issue June 2014).


On April 10th, 2014, the first edition of the Value Based Healthcare Prize took place. The prize for the most exceptional initiative in collaborations went to Jippa, a collaborative by VUmc, CZ, Radboud UMC and Tilburg University.


In November 2013 the NVPO organised the International Congress "Innovation in Psycho-Oncology". The researchgroup held several presentations and posters.


Interested in oncological care chain? Come 2 October 2013 to the 3rd MuON symposium in hospital Gelderse Vallei. Keynote speaker Michel van Schaik (Director Rabobank) about Innovation in the care!


12 april 2013: KWF Kankerbestrijding / Alpe d’HuZes has granted the research proposal Netherlands Quality of life and Biomedical Cohort Studies in Cancer (NET-QUBIC).

Marieke de Bruijn will defend her PhD thesis on 10 juni 2013 at 15.45 pm.

Support our bicycle team for Alpe d'HuZes 2013!

On 6 June 2013 our team living together with cancer will cycle the Alpe d'HuZes! This in the fight against cancer. At this moment there is already more than 1500 euro donated. Do you support us too?


The 15th World Congress of Psycho-Oncology and Psychosocial Academy will be held in Rotterdam, 4-8 November 2013. www.ipos-society.org/ipos2013/.


29 January 2013. Pink Ribbon has granted a project to develop and evaluate an online training for cancer patients with insomnia (Annemieke van Straten), and a project to develop and evaluate a breast cancer module for the OncoKompas (Nelly van Uden).


Charity Symposium "Living with cancer"

On December 19, 2012 there will be a Symposium ''Living with Cancer''. This is a charity symposium on meaning centered psychotherapy for cancer patients. Read more about it at the tab News at the left.


15 November 2012: Hoe?Zo! Radio interview with Irma Verdonck on stress and cancer.


October 2012: Interview with Irma Verdonck in Psychologie Magazine.


September 9, 2012. Interview Hans van Willigenburg with Irma Verdonck on Radio 5.


August 2012. Five students finish their MSc thesis and graduate as MSc in Clinical PSychology.


June 28-30, 2012: International symposium on Supportive Care in Cancer (MASCC ISOO) at New York. Kevin Yap and Irma Verdonck organise a workshop on e-health and supportive care.


Record for Alpe d'HuZes 2012. The sponsor action Alpe d'HuZes (6 and 7 June) 2012 has already yielded the record amount of 28.5 million euros.


June 6-8, 2012: Our research group contributes to Alpe d'HuZes as volunteers.


April 20, 2012: Nelly van Uden will give a presentation about OncoKompas at a conference about  ICT in health care in Barcelona.


March 16, 2012: NVPO congress in Utrecht, we contribute with 2 oral and 2 poster presentations and a workshop.


January 1, 2012: The project POLARIS project has officially started.


December 22, 2011: Radio program DeGids.fm, Felix Meurders interviews Corien Eeltink on sexuality and cancer. 


November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.


October 30, 2011 In the national television program "Gesprek op 2", Daphne Bunskoek interviewed Irma Verdonck on living with cancer.


October 28, 2011: www.oncokompas.nl is online!


October 23, 2011: Alpe d'HuZes hands over more than 20 million euros to the Dutch Cancer Society!



Team work

Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl

We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial  improving research and translating results into clinical practice.

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