Twenty Years of Dignity Therapy: Evidence, Challenges, and Implications for Person-Centered Care.

Twenty years have passed since Dignity Therapy was introduced as a brief psychotherapeutic intervention grounded in the Model of Dignity in the terminally ill. Designed to address threats to personhood by supporting generativity, meaning, and legacy, it invites patients to create enduring documents that reflect their values, identities, and life narratives. Although initially conceived for end-of-life care, Dignity Therapy has since been adapted for diverse populations, including children, individuals with non-malignant illness, those experiencing cognitive decline, people who are grieving; and has been implemented across varied cultural and linguistic contexts. It is now among the most extensively studied non-pharmacological interventions in palliative care. This article reflects on two decades of experience with Dignity Therapy, examining feasibility, cost considerations, potential risks, and sources of variability in outcomes. Beyond measurable effects, Dignity Therapy exemplifies a narrative-informed, person-centered approach, which underscores the centrality of attending to patients' stories as an integral component of compassionate palliative care.