1.  Finding Strength

• Inquire about patient’s resources

"When bad things have happened to you before, how have you coped?"
"What are your sources of strength?"
"Who will you turn to for support?"
• Prescribe resources available to the patient 
• Regular follow-up 
• Psychologist, social worker, home care referral
• Chaplain or other clergy
• Reading materials
• Disease Specific Organizations
• Internet news groups, bulletin boards, chat rooms
• Support groups

• Inquire about compensatory pleasures and skills

"Even though thre are some things you can no longer go, what activities can you still enjoy?"
"Are there things about you this disease does not affect?"
"Can you imagine getting better?"
• Prescribe steps toward growth
• Find times of growth in the past
• Encourage volunteering
• Challenge the patient's sense of limitation

• Inquire about current feelings and desires

"What do you feel like doing right now?"
"Do you have any secret dreams or desires?"
"Is there something you've always wished you could do? What is stopping you from doing it?"
"How are you feeling today?"
• Prescribe a redirections toward current reality
• Help set priorities
• Coordinate treatment with with personal goals
• Meditation

• Inquire about the patient’s disease model & meaning of illness

"How are you doing withing yourself?"
"What does this news mean to you?"
"Does this news casre you in any way?"
What do you think caused your illness?"
"Where do you think your illness came from?"
"Why did you come down with this now?"
• Prescribe life examination exercises
• Journaling writing, autobiography
• Painting, deawing
• Reminiscence
• Life review
• Revisit the past with photos, Visits to people, Travel

• Inquire about personal dissatisfaction

"What are you hardest on yourself about?"
"What is the wrost thing you've ever done?"
"Is there anything you've done in your life that you cannot forgive yourself for?"
• Prescribe steps toward self-acceptance
• Advanced care planning - make arrangements for when the patient is sicker or deceased
• Discuss Durable Power of Attorney for Health Care
• Distribute personal possessions
• Goodbyes
• Inquire about estranged relationships

"Is there anyone you really want to talk to before you die?"
"Is there someone you've never been able to forgive?"
• Prescribe reconciliation with significant others 
• Communication by letter, visit, telephone, e-mail
• Physician can offer to be present at diffiuclt meetings

• Inquire about spiritual and religious beliefs

"Are you a spiritual or religious person?"
"Do you ever pray or meditate?"
"Has your life ever changed dramatically before?"
• Prescribe movement toward transcendence
• Spiritual mentor
• Prayer
• Letters to loved ones that an be opened after the patient's death