Psychological support
11. Hope therapy
Hope can be trained. It has three trainable parts: goals, pathways, and agency.
PatientCaregiverFamily
The model
- Goals — something worth moving towards. Without one, hope has no object.
- Pathways — the routes. Illness blocks routes, so hopeful people practise generating alternatives.
- Agency — the belief you can travel one of them, and permission to be helped along it.
Training pathways
- 1Take one blocked goal.
- 2Write five alternative routes, including ones requiring help, money or adaptation.
- 3Cross out none of them yet — quantity first.
- 4Pick the most feasible for a bad week, not a good one.
- 5Identify the obstacle most likely to stop it, and plan for that obstacle specifically.
Hope in advanced illness
When cure is no longer the goal, hope moves rather than ends: comfort, presence, unfinished conversations, a grandchild's wedding, dying at home, being remembered a particular way.
Clinicians who ask 'what are you hoping for?' rather than 'do you understand the prognosis?' usually get a truer and more useful answer. You can ask yourself the same question.
Where to go next
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.