Existential Healing at the End of Life: A Culturally Adapted Intervention for Turkish Women with Advanced Cancer

This quasi experimental study assessed the effectiveness of a 12 week Existential Based Cognitive Therapy (EBCT) program for women with metastatic cancer in Türkiye. Sixty participants were allocated to either the intervention or waitlist control group. The intervention integrated meaning centered exercises, symbolic expression, self compassion, and acceptance strategies within culturally congruent therapeutic frameworks. Outcomes were evaluated using validated Turkish versions of the Ryff Psychological Well Being Scale, FACIT Sp 12, and Beck Hopelessness Scale at baseline, mid intervention, and post intervention.Results showed that the EBCT group experienced statistically and clinically significant improvements across all outcome measures—particularly in autonomy, purpose in life, spiritual meaning, and reductions in hopelessness—while the control group displayed no meaningful change. Thematic analysis of anonymized session reflections provided illustrative context for participants’ experiences, highlighting culturally embedded meanings of illness, gendered caregiving roles, and spiritual coping frameworks.Findings suggest that EBCT, when culturally adapted to integrate existential themes with local meaning systems, can promote psychological and spiritual well being among women confronting life limiting illness. This study contributes to death studies literature by demonstrating how existentially grounded psychosocial interventions may support adaptive functioning in non Western settings confronting the existential challenges of advanced cancer.