Promoting psychological and spiritual wellbeing in palliative care: HammondCare’s Embrace Program
An article written by Dr Peter Archer, Head of Pastoral Care - HealthCare and Hospitals and Research, Greenwich Hospital
People facing life-limiting illness often experience profound psychological and existential distress. While palliative care aims to address these needs holistically, interventions that specifically target spiritual and emotional wellbeing remain limited. A HammondCare initiative, led by Professor Melanie Lovell, Dr Phillip Siddall, Rebecca McCabe, Dr Peter Archer, and Dr Kerry Warner, has developed a novel contribution called Embrace. Based on the principles of posttraumatic growth, it seeks to foster positive psychological change and spiritual wellbeing in palliative care settings.
Following the delivery of two pilot programs, an evaluation of its feasibility has recently been published. [1]
What is posttraumatic growth?
Posttraumatic growth (PTG) refers to the positive psychological changes that can emerge after struggle with adversity. These changes may include a deeper appreciation of life, renewed strength, closer relationships, fresh possibilities, and a clearer sense of meaning and purpose.
While PTG has been documented in contexts such as cancer survivorship, spinal cord injury, and chronic pain, little research has examined its place in palliative care, where the trauma of illness is ongoing, and the future is limited.
The Japanese art of kintsugi (repairing broken pottery with gold resin) became a central metaphor to describe this framework, helping participants see that life, though marked by illness, can still hold meaning and the potential for growth.
Co-designing with patients and practitioners
To address this gap, the research team used participatory action research, ensuring that patients, clinicians, and pastoral carers were involved at every stage of design.
Stakeholders were clear that language matters. The original title, ‘Fostering Hope’, was set aside in favour of ‘Embrace: Meeting the challenges of living with serious illness.’
The term ‘posttraumatic growth’ also felt disconnected from participants’ reality, as their trauma was ongoing. Instead, the phrase ‘positive psychological change’ resonated more deeply, capturing the possibility of finding meaning while still living with illness.
The Embrace Program
The program ran weekly over six two-hour sessions, in small, face-to-face groups. Sessions combined personal reflection, structured activities, and open conversation, with an extended break for morning tea.
The session themes were:
- What is our aim? – Creating a safe space and introducing the idea of growth through adversity.
- What changes are you facing? – Exploring loss, grief, and adjustment.
- What keeps you going? – Identifying sources of meaning and purpose.
- What matters most? – Clarifying values and priorities.
- How can I make a difference? – Recognising ongoing contributions and strengths.
- Where to from here? – Reflecting on the journey and celebrating growth.
What participants said
Across the two pilots (nine participants in total), people consistently valued the safety and connection these small groups provided through honest conversation sprinkled with tears and humour. Participants described leaving sessions with a renewed sense of meaning and purpose. For some, the process helped clarify priorities, such as how to spend time with family or how to speak more openly about death.
One participant reflected:
“Something can be broken and then be put together again… you can still have a functional life and give a lot out of your life.”
Another said:
“I really came away feeling like I still have hope, but hope is re-framed.”
Why the research matters
The co-design process has ensured the program is grounded in the real needs of patients in palliative care settings. Creating space and time where patients can explore these issues enhances the potential for growth beyond alleviating distress.
The Embrace program demonstrates:
- The feasibility of this type of intervention in the palliative care setting underscored by 96% attendance and full survey completion.
- That growth is possible even in the experience of serious and life limiting illness.
- The impact of language in these types of situations with the imperative to carefully handle concepts such as ‘trauma’, ‘growth’ and ‘hope’.
- That program effect will be elevated by competent and sensitive facilitators who have significant group skills and palliative care experience.
Next steps
HammondCare continues to offer Embrace to its patients. More than 30 people have now participated in the program with participants reporting its benefits and the experience of positive change.
Another paper is currently in preparation on the reported outcomes of Embrace through the two pilot programs.
The research team is looking to expand the availability of Embrace into diverse palliative care settings across NSW via in-person and online offerings.
An Embrace caregiver version of the program is in development. Consultations and two pilots have been completed, and it is undergoing analysis and review. The expectation is that this version will be offered to informal caregivers of HammondCare patients from 2026.
Conclusion
Palliative care, at its best, does not only ease suffering but assists people to embrace what is still possible.
Author
Dr Peter Archer
Head of Pastoral Care - HealthCare and Hospitals and Research
Greenwich Hospital