Cancer Center Amsterdam

Onderzoekslijn Contingentie, Cultuur &  (CCO)

Central to our research line is the notion of ‘contingency’, understood as the experience of something befalling you in life that could have been otherwise. Contingency experiences may evolve into autobiographical disruptions and the inability of patients to live a meaningful life – of not being able to connect actions of the past with the role as a ‘patient’ in the present, nor with desires and goals for the future. A contingency experience, on the other hand, may also be a source for new possibilities for action. Our aim is to assist patients, who are in danger of identity shifts or even a loss of identity, to re-make meaning in life by exploring answers to existential concerns and to re-write their life-stories.  We facilitate this need by (1) investigating how patients, in the setting of their everyday lives, make meaning of their disease through social interaction and interaction with art and (popular) culture; and (2) by setting up so-called participatory arts-based interventions. Central question, here, is how we could design an ‘artistic landscape’ for diverse groups of patients (diversified by e.g. tumor type and sociodemographic variables including gender, age and socio-economic status) that affords patients in the reconstruction of their identity through narrative meaning-making.

Current Projects

(1) The Art of Creating New Stories

Working with Art-Based Learning (ABL) in Palliative Care (Art-PC)

This project investigates the potential of the art education method Art-Based Learning (ABL) for supporting the meaning-making processes of patients with incurable cancer.

Project team

• Project coordinator and Principal Investigator: prof.dr. Jeroen Lutters (ArtEZ, RUG)
• Principal Investigators: prof.dr. Gerben Westerhof; prof.dr. Hanneke van Laarhoven
• PhD Candidates: Shailoh Philips, MA, Marike Geurts, MA
• Other team members: dr. Fabiola Camuti (HKU University of the Arts Utrecht); dr. Michael Scherer-Rath (RUN); dr. Anneke Sools (University of Twente)

Meaning-making is, in fact, a creative process. However, little research has been done on meaning-making as the result of creative thinking as it can be stimulated by artistic interventions and by art education. In this project, we investigate the potential of the art education method Art-Based Learning (ABL) for supporting the meaning-making processes of patients with incurable cancer. The aim of this research is to integrate these results into educational programs for healthcare professionals, and also to be able to offer Art-based Learning as a method for patients in palliative care, whereby healthcare and arts professionals can expand their practice with new opportunities to support patients in meaning-making.

This project was developed together with arts education professionals and patients. In this study, through participatory research, we aim to gain an overview of factors important for creating an art exhibition suitable for ABL, for patients with incurable cancer. We also look at factors involved in creating and viewing an online exhibition. As part of the research, we put together a manual for curators on how to create an ABL exhibition. We then look at the experiences of patients viewing such an exhibition for meaning-making. We translate the analyses and conclusions into advice for application in training programs, both within palliative care and for arts education professionals.

(2) In Search of Stories-at-home

An innovative supportive care intervention with an online exhibition of co-created artworks (ISOS-at-home)

This project aims to make the ISOS-intervention (see “In Search of Stories” under Previous Projects) more accessible for patients in the palliative phase.

Project team:

• Project coordinator and Principal Investigator: prof.dr. Hanneke van Laarhoven (Amsterdam UMC)
• Project coordinator and senior researcher: dr. Niels van Poecke (Amsterdam UMC)
• PhD Candidate: Marike Geurts, MA
• Other team members: Nirav Christophe & Fabiola Camuti (HKU University of the Arts Utrecht)

Problem description: Patients with incurable cancer face disruptions in their life lines, so-called experiences of contingency, leading to existential concerns, and requiring a re-evaluation of their life story. In the KWF-funded project "In search of stories (ISOS)", spiritual counsellors and professional artists assisted patients through literature, life review interviews, Rich Pictures drawings, and a co-creation process: the ISOS-intervention. Patients deeply valued the ISOS-intervention, experiencing a profound sense of support. However, the requirement for in-person visits for the ISOS-intervention proved to be a significant barrier, as physical limitations precluded some from completing this essential component of the program. Thus, a more enduring approach is needed to make the ISOS-intervention available for all cancer patients in the palliative phase.

Research direction: From 11 January to 16 February 2024 nineteen artworks from the ISOS intervention were exhibited at Amsterdam UMC, arising from the fruitful collaboration between patients, spiritual caregivers, and artists (see the description of project WELLICHT (project 8) further down on this page)). As we observed during guided tours, the exhibition of the artworks and the stories of participating patients behind them prompted visitors to reflect on their own life stories. To bring this a step further, immersing in others' stories through a digitized exhibition may contribute to a novel ISOS intervention, ISOS-at-home, making the ISOS-intervention accessible in a sustainable manner. Aim of this project, therefore, is to investigate – in co-creation with patients, informal and formal caregivers, spiritual counselors, and artists how to design a follow intervention that enables patients to participate digitally, at home.

(3) Staging Cancer: Participatory Arts-Based Supportive Care for Advanced Cancer Patients holding Precarious Social Positions

‘Staging Cancer’ aims to investigate whether – and if so, how – participation in an arts-based intervention can support cancer patients holding marginalized social position in Dutch society in integrating the diagnosis of advanced cancer, as the experience of contingency, into their life-narratives.

Project team:

• Project coordinator and Co-Principal Investigator: dr. Niels van Poecke (Amsterdam UMC)
• Principal Investigators: prof.dr. Hanneke van Laarhoven (Amsterdam UMC), dr. Valentijn Visch (Delft University of Technology / Industrial Design Engineering (IDE)
• PhD Candidates: Mariana Gusso Nickel, MSc
• Lead artist: Gerty Van de Perre
• Other team members: dr. Jacqueline Tromp (Amsterdam UMC); dr. Michael Scherer-Rath (RUN); dr. Annemijn Aarts (Amsterdam UMC); dr. Annicka van der Plan (Amsterdam UMC)

Photograph by Cem AltinözThe diagnosis of (incurable) cancer may evoke experiences of contingency in patients: events that are perceived as constituting the ‘randomness’ of life – i.e., that could have been otherwise.Such experiences may evolve into identity challenges, shifts, or even into a crisis of identity at large, through their evocation of loss and crisis of meaning in life, threatening patients’ quality of life. It has been argued that cancer patients, after diagnosis, are hence necessitated to re-make meaning of their life with cancer by means of a reconfiguration of their life-story – a concept referred to as ‘narrative meaning making’. This process, however, is not merely intra-psychological. Rather, it as an ongoing relational and socio-cultural practice. That is, it is not undertaken in isolation, but is afforded and/or constrained in the interaction with significant others, societal discourses, and meaning making resources including the arts and (popular) culture; and by individual ‘dispositions’ premised upon one’s position in society and socialization and enculturation histories.

Participatory art refers to artworks centred on participation and co-creation (in this case between researchers, patients, caregivers, and artists), and which artistically value the act of collaboration as much as its ‘output’. It is directed towards, and argued to have, a supportive role in people’s lives by, for example, empowering individuals who are in precarious positions in processes of productive self-transcendence, (re)constructing identities, and pursuing social change. Very little research has been conducted, however, on the question of whether, and if so how, participatory art impacts upon individuals’ lives, nor on its practice in (and in relation to) oncological supportive care. Here, we aim to undertake such a task, as our project aims to understand whether – and if so, how – participatory arts-based research can afford the processes of narrative meaning making by advanced cancer patients holding marginalized positions in Dutch society.

To do so, we take a transdisciplinary approach to our investigation, co-developing and co-researching an innovative participatory artwork titled: ‘Staging Cancer’. We co-create this project in collaboration with artists, researchers, and two different patient groups: adolescents and young adults (AYA’s) and adults patients living-with a form of advanced cancer.

(4) Masculinities in Action (MiA)

Exploring the Role of Gender Discourses in Narrative Meaning Making by Male-Identifying AYA Patients With and Beyond

This research investigates how gender discourses may play a role in the experience of cancer as contingency for male-identifying young adult patients (AYA’s), in order to tailor narrative support for this group.

Project team:

• Project coordinator: dr. Niels van Poecke (Amsterdam UMC)
• Principal Investigator: prof.dr. Hanneke van Laarhoven (Amsterdam UMC)
• PhD Candidate: Mariana Gusso Nickel, Msc (Amsterdam UMC)
• Other team members: dr. Jacqueline Tromp (Amsterdam UMC), Alexa Gratama, MA (F|Fort Foundation), Collin Mous, MA (F|Fort Foundation)

Photograph participant 1

For AYAs, experiencing cancer as contingency—a disruption of one’s life narrative that may lead to a generalised loss of meaning—can be especially challenging, as AYA’s are yet to partake in transitional life-events to continue forming their narrative identities. Thus, AYA’s may need (additional) support for (re-)creating autobiographical meaning while living with cancer compared to adults, a process referred to as narrative meaning-making. Simultaneously, research on masculinities suggests that masculinities discourses—cultural stereotypes of how men’s lives are portrayed—shape men’s narratives of cancer, influencing the choice of which illness-related concerns men share, and how they talk about them. This research project, therefore, investigates how masculinities discourses may play a role in AYAs’ experiences of cancer as contingency, in order to tailor narrative support for this age group. Taking a sociological approach, we employ Participatory Arts Based Research (PABR) to gather knowledge on how meaning over masculinities, age, and cancer is (re-)created in the everyday lives of male-identifying AYAs (he, he/they) either undergoing curative/palliative treatment or situated in the post-treatment phase. Within PABR methods, image elicitation interviews and photovoice are chosen for their ability to elicit data on experiences possibly difficult to articulate with words, such as those linked with contingency and masculinity. Masculinities in Action is being developed in collaboration with the F|Fort Foundation as part of a broader art project on masculinities and cancer.

(5) Innovating Palliative Oncological Care Through Rich Pictures

Building a Repository and AI Analysis for Patient Narratives

This project aims to develop AI methods to support the analysis of patients’ Rich Pictures to contribute to patient-centered care strategies within palliative care.

Project team:

• Principal Investigator: prof.dr. Hanneke van Laarhoven (Amsterdam UMC)
• Project coordinator and Co-Principal Investigator: dr. Niels van Poecke (Amsterdam UMC)
• Co-Principal Investigators: dr. Esther Helmich (Amsta/Sarphatihuis), prof.dr. Eric Postma (Tilburg University/School of Humanities and Digital Sciences), dr. Sharon Ong, dr. Samaneh Khoshrou & Juan Sebastian Olier (Tilburg University / School of Humanities and Digital Sciences)
• PhD Candidate: Rosa Dalhuisen, MSc

An increasing number of people are living longer with incurable cancer. Living with cancer is a complex experience that affects many aspects of life and can change over time. While various models and tools have been developed to understand this complexity, they have limitations in capturing individual experiences. Rich Pictures (RPs) can help encapsulate complex experiences in a single image. By collecting and analyzing large numbers of RPs, researchers and healthcare providers can gain a better understanding of the experiences of patients with incurable cancer, which is crucial for developing more effective, patient-centered care strategies. However, the current manual analysis of RPs is timeconsuming and hinders large-scale use in research and care.

Research Direction: By creating an extensive collection of Rich Pictures from cancer patients, we expect to gain unique insights into the complexity of their experiences. Subsequently, AI methods will be developed to partially automate the analysis of these images. The goal is to use Rich Pictures more effectively in both research and daily care practice, ultimately leading to a better understanding of and improved care for cancer patients in the palliative setting.

(6) Cancer in Everyday Life (CiEL): Exploring the Affordances of Music in Narrative Meaning-Making for Patients with Advanced Cancer

This project investigates whether and how engaging in daily life music practices enables meaning-making for advanced cancer patients.

Project team:

• Project coordinator and Co-Principal Investigator: dr. Niels van Poecke (Amsterdam UMC)
• Principal Investigator: prof.dr. Hanneke van Laarhoven (Amsterdam UMC)
• PhD Candidate: Mariana Gusso Nickel, MSc (Amsterdam UMC).
• Other team members:  dr. Jaqueline Tromp & dr. Arwieke Glas (UMC Utrecht)

Current research on music in hospital care largely concentrates on measuring effects of music interventions on clinical outcomes (e.g., reduced pain and recovery time), with a primary focus on (adult) surgical patients. However, music is not only a ‘medicine’ with medical benefits. Research in sociology shows that engaging with music enables people to conduct daily-life practices of self-care and meaning-making. Thus, music is a key instrument in the construction of autobiographical memory and narrative identity, also in the context of life-changing events, such as falling (severely) ill. Sociological research on the benefits of music in healthcare, however, has been rarely integrated in clinical practice. This pilot aims to fill this knowledge gap by exploring whether and how engaging in daily life music practices enables meaning-making for advanced cancer patients.

Previous Projects

(7) In Search of Stories (ISOS): A research project on narrative meaning making in advanced cancer patients

In Search of Stories aims to explore how spiritual caregivers and artists can support palliative oncology care patients in spiritual/existential meaning-making processes.

Project team:

• Project coordinator and Principal Investigator: prof.dr. Hanneke van Laarhoven (Amsterdam UMC)
• Principal Investigators: dr. Michael Scherer-Rath (RUN); dr. Esther Helmich (Amsta)
• PhD Candidates: Yvonne Weeseman, MA, MSc (Amsterdam UMC); dr. Zoë Bood (Amsterdam UMC); Emily Evans, MA (Amsterdam UMC)
• PostDoc researcher: dr. Niels van Poecke (Amsterdam UMC)
• Other project members: drs. Nirav Christophe (HKU), drs. Henny Dörr (HKU); prof.dr. Mirjam Sprangers (Amsterdam UMC)

When diagnosed with incurable cancer your life is suddenly turned upside down. This experience may evolve into a search for new (existential) meaning if life, and/or that patients are forced to find new (ultimate) goals in life. But how do you do this? Who or what helps you in this search for new meaning in life? How to integrate this major life event into your evolving life-story? The research project In Search of Stories aims to investigate how patients with a form of incurable cancer can be supported in their meaning making upon diagnosis. More specifically, the aim is to investigate how both spiritual counselors and professional artists can assist patients in the process of existential/spiritual meaning making and how their role could be (better) integrated into palliative oncological care.

Research aim

The aim of this research is to design an intervention that assists advanced cancer patients in their search for spiritual/existential meaning in life post-diagnosis.

Why is this research project relevant?

This research project is relevant as currently there are few intervention studies available for this particular group of advanced cancer patients on the subject of spiritual caregiving. The diagnosis non-curative cancer conjures up many existential questions and experiences. The search for new possibilities to deal with the diagnosis and to reconfigure the life-story, is a quest for existential/spiritual meaning, for which assistance is highly relevant and needed.

But how and what should such assistance be? One of the assumptions underlying this research project, is that meaning making unfolds in narrative practice. To rework major life events into a story with some sense of coherence and meaning, patients need to be assisted in rewriting their life-story. Art and culture may potentially have a major role in the process of making meaning after diagnosis, as rewriting the life-story unfolds in and through social interaction and through interaction with meaning making resources including art and culture. Elements of fictional stories in literature, poetry or (popular) music may be supportive to patients’ meaning making journeys. But whether – and is so, how – art and culture may assist patients in the process of narrative meaning making, is still an empirical question that will be addressed in this research project.

Research design

In Search of Stories is a collaboration between oncologists, (health) researchers, spiritual caregivers, and professional artists. The intervention study consists of several elements: First, questionnaires are used to gain insight into how patients have experienced and dealt with major life events or experiences of contingency. Second, patients are invited to visualize their illness experiences through the drawing of a Rich Picture. Both the questionnaire and the Rich Picture serve as input for a first conversation in the hospital with a spiritual counsellor. Accordingly, patients are invited to select a story from a collection of stories that all revolve around a protagonist experiencing contingency in life: the experience that some-thing befalls him/her that could have been otherwise. Some of the stories specifically deal with cancer, others are more broadly resonating with the notion of contingency, and range from Franz Kafka’s ‘The Metamorphosis’ to Jonah/Yunus and the Whale. It is anticipated that elements within the story, particularly those dealing with how protagonists are confronted and deal with the experience of contingency in life, might resonate with and potentially also help patients reflecting about their own contingency experiences. Also, the reading experiences; i.e., how the patient connects with the story and how the reading of the story might facilitate a reflection upon the own life-story, are discussed with a spiritual counsellor in a follow-up conversation. Towards the end of this conversation, patients are asked about personal preferences regarding art and culture in general and what their wishes and needs would be in collaborating with a professional artist. The final element of the intervention study, hence, is a co-creation process between the patient and a professional artist, during which the patient is further assisted in exploring possibilities to reconfigure the life-story. On the co-creation process and the final end product (an art work), the patient reflects during a third meeting with a spiritual counsellor, after which the patient draws a second Rich Picture. Also the second Rich Picture is discussed with a spiritual counsellor during a fourth meeting. Finally, the patient evaluates his/her participation in the project with one of the researchers involved in the project.

Expected outcomes

At the end of the project, it will be evaluated to if an intervention, based on our narrative and arts-based approach, is feasible and to what extent participating in the intervention is perceived as feasible and relevant by participating patients. On the basis of the project’s final results, it will be evaluated whether – and if so, how – the current study can be extended into further larger studies.

In Search of Stories is a collaboration between Amsterdam UMC, Radboud University Nijmegen & HKU University of the Arts Utrecht, and is financially supported by KWF Dutch Cancer Society.

(8) WELLICHT: In Search Of Stories Exhibition

The exhibition WELLICHT: In Search Of Stories (Location VUmc, 2024) was organised as part of the In Search of Stories project, which explored how spiritual caregivers and artists can support patients within oncology care in their search for meaning and significance, and the rewriting of their life stories after diagnosis.

In the exhibition, 19 artworks which emerged from the fruitful collaboration (co-creation) between patients, spiritual carers and artists were on view. These co-creations offered insight into the personal stories and experiences of patients with cancer, and illustrated how spiritual care, art and research come together in improving existential supportive care for these patients.

Audience present at the official opening of the exhibition. Photo: Franz Mueller Schmidt.

Transdisciplinary collaborationWELLICHT was a production of the Department of Medical Oncology (Amsterdam UMC) and HKU University of the Arts Utrecht, in collaboration with the Art Department of Amsterdam UMC. It showed the added value of a transdisciplinary collaboration between scientists, healthcare providers and artists in supporting people with cancer in their search for meaning and significance after their diagnosis.

Foto: Franz Mueller Schmidt

WELLICHT: the filmClick the link below to watch a short film on the exhibition, featuring: Prof Hanneke van Laarhoven (project leader In search of stories); Tjallien Walma van der Molen (artist and exhibition maker); Hugo Vlug (spiritual caregiver) and Paul Piket (participant).

Levensverhalen van patiënten met kanker in de tentoonstelling ‘Wellicht – Op zoek naar verhalen’ – YouTube(NL)

Life stories of cancer patients in the exhibition ‘Wellicht – In Search of Stories.’ (youtube.com)(ENG)

(9) Spiritual care for patients with cancer: the role of supportive structured reflection on ultimate life goals to improve patients' quality of life and empowerment

‘Spiritual care for patients with cancer’ (2010-2014) explored whether supportive structured reflection on one's ultimate life goals and means of coping with experiences of contingency would improve the quality of life of patients with cancer.

Project team:

• Principal Investigators: prof.dr. H.W.M. van Laarhoven (Amsterdam UMC), prof.dr. M. Scherer-Rath (Radboud University), prof.dr. J.B.A.M. Schilderman (Radboud University)
• Other project members: dr. R. Kruizinga, prof.dr.P. Verschuren, prof.dr. C. Hermans, prof.dr. K. Vissers, dr. P. Ottevanger, prof.dr. J. Prins, prof.dr. C. van Weel, dr. W. Smeets, drs. J. van der Loos, prof.dr. D. Richel,prof.dr. M. Sprangers.

Spirituality plays an important role in the well-being of patients with cancer. Spirituality can be understood as the personal expression of ultimate life goals. Ultimate life goals are the most important goals people pursue in their lives. They determine the more personal/instrumental life goals a person has. Ultimate life goals give life direction; they provide motivation to live and answer the question of why people live.

Spiritual care can help patients make sense of experiences of contingency in the life story by supporting patients in the process of clarifying their ultimate life goals. In this project, we investigated whether a structured reflection on ultimate life goals and experiences of contingency strengthens patients with cancer in maintaining and improving their quality of life. It started from the question: does a supportive structured reflection on one's ultimate life goals and means of coping with contingency improve the quality of life of patients with cancer?

In the first phase of the project, an interview model, based on previous research for the structured clarification of ultimate life goals and experiences of contingency, was further refined. In the second phase, patients with advanced cancer were included in a randomised control trial. The control group received usual care, while the intervention group had two consultations with a spiritual director according to the interview model developed in phase 1. During the study, patients completed questionnaires on quality of life, empowerment, depression, anxiety, hopelessness, and care consumption.

For results, see the Publications list below.

Other related projects

Forgiveness at the End of Life PhD Candidate: Clàudia Rossy Parés

Introduction: End of life is the last phase of a person's existential journey. It is a very delicate moment, in which one's own life is reviewed by oneself, with the intention of integrating both successes and failures, in order to find a satisfactory life meaning and leave this world in peace. The need for forgiveness can become an essential task for this transition, however, there is little knowledge about the psychology of forgiveness and its importance in the end-of-life context, as well as how a terminal patient's request for forgiveness should be addressed by professionals. Hypothesis: This project is based on the hypothesis that forgiveness is a relevant process for people who are at the end of life, so that higher levels of forgiveness, less suffering and higher quality of life. Objectives: One of the objectives of this project is to explore the management and perspective of spiritual counselors when assisting requests for forgiveness from people with advanced illness. Material and methods: Qualitative study using an interpretative phenomenological analysis (IPA) of forgiveness in a sample of Dutch spiritual counselors of people with advanced and terminal illness. Preliminary results: Spiritual counselors do not frequently treat forgiveness in their conversations with patients but think that, although forgiveness is very complex and difficult to talk about it with patients, it is relevant and that can positively impact patient’s physical and psychological well-being.

Meet the team/researchers

Amsterdam UMC researchers:

Prof.dr. Hanneke van Laarhoven, MD, PhD, PhD Hanneke W.M. van Laarhoven is professor of translational medical oncology at the University of Amsterdam and head of the Department of Medical Oncology of Amsterdam University Medical Centers. Van Laarhoven is a staunch advocate of interdisciplinarity, as is evidenced by her two masters – in Medicine and Theology (both cum laude), as well as her two PhDs – in Medical Oncology (cum laude) and Religious Studies. In her quest for new, better treatment options for cancer patients, she seeks collaboration with both the (bio-)medical sciences and the humanities. She is leading several multi-center investigator-initiated clinical trials. Furthermore, she is one of the founding mothers of a prospective database for the collection of real-world clinical data and patient reported outcomes of patients with esophagogastric cancer (www.pocop.nl) and pancreatic cancer (www.pacap.nl). Currently, she is supervising more than 30 PhD students, post-docs and research assistants from different backgrounds, such as medicine, biology, artificial intelligence, international health, humanities, and psychology. Van Laarhoven published more than 390 peer-reviewed articles and numerous abstracts for national and international meetings.

Dr. Niels van PoeckeNiels van Poecke, PhD is Senior Researcher at the department of Medical Oncology, Amsterdam UMC. He holds degrees in sociology (MA), philosophy (MA) and cultural sociology (PhD) and has expertise in both theoretical and qualitative empirical research in the fields of cultural sociology and art theory. He published about participatory art, the relationship between culture/music and social inequality, and the everyday use of music as self-care instrument and medium for the construction of narrative identity.

Drs. Emily EvansEmily Evans, MA, is a PhD researcher in the Department of Medical Oncology at Amsterdam UMC, where she works on the projects ‘Staging Cancer’ and ‘In Search of Stories’. She has an academic and professional background in the arts, culture, and sociology, with a specialization in socially engaged art practice and participatory arts-based research. Emily graduated from the Winchester School of Art (UK) and holds an MA in Arts, Culture and Society from Erasmus University Rotterdam (NL). She also has experience as a producer and programmer for socially engaged arts organizations.

Drs. Marike GeurtsMarike Geurts, MA, is a PhD student at Amsterdam UMC. Her research is part of the interdisciplinary research project The Art of Creating New Stories: Working with Art-Learning in Palliative Care. She is academically trained as an art and cultural historian. During the master, she worked for Studio I - platform for inclusive culture, a collaboration between the Van Abbemuseum and the Stedelijk Museum Amsterdam, in which she dealt with inclusion and diversity issues in the cultural sector. During the corona pandemic, she retrained as a nurse with a specialization in elderly care. In her work as a nurse, she gained extensive experience in palliative care. She now combines this broad knowledge and experience in her research on what art-based learning can do for oncology patients in the palliative phase.

Drs. Shailoh PhilipsShailoh Phillips is an artist, educator, and researcher with 20+ years of experience in community-based, transdisciplinary projects. Her work supports individuals and communities navigating transitions and crises, exploring how art and education foster systemic change and resilience. With a background in anthropology, philosophy, and interaction design, she holds an MA in Education in Arts (Piet Zwart Institute). Shailoh teaches at art academies and co-develops collective platforms such as Salwa and Reschooling.org. Her PhD research, part of The Art of New Narratives, investigates how curatorial and pedagogical practices can support people with incurable cancer through Art-Based Learning.

Drs. Rosa Dalhuisen Rosa Dalhuisen, MSc, is a PhD-student involved in the ‘Rich Pictures’ project of the department of Medical Oncology, Amsterdam UMC. Rosa received her BA in Language and Culture studies at Utrecht University, with a focus on intercultural communication. With a MSc in Medical Humanities, she focused on doctor-patient communication, and took subjects in the direction of art, philosophy, ethics and history of healthcare. After this, she worked for one and a half years as an assistant in the research line of Medical Communication (Medical Psychology, AMC), where she worked on projects focused on shared decision making and information tailoring in the oncological setting.

Drs. Mariana Gusso NickelMariana Gusso Nickel, reMA, is a PhD student at the Department of Medical Oncology, Amsterdam UMC, where she works on the projects “Staging Cancer,” “Cancer in everyday life,” and “Masculinities in Action.” A graduate of the Master of Art and Performance Research Studies at the University of Amsterdam, she is interested in research at the intersection of art and “life-writing” studies.

Drs. Yvonne WeesemanYvonne Weeseman, PhD,conducted research for the In Search Of Stories project of the department of Medical Oncology, Amsterdam UMC. Her background is in Clinical Psychology, Spiritual Care, Child & Family studies and Art Therapy.

Research partners In Search of Stories

Dr. Michael Scherer-Rath Dr. Michael Scherer-Rath, PhD, works as associate professor for empirical religious studies and supervisor (LVSC) at de Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen. He conducts empirical research in spiritual counseling and diagnostics and has expertise in research into experiences of contingency in everyday life. As researcher he participates in all projects under the research line ‘Contingency, Culture & Oncology’; in ‘In Search of Stories’ he is involved as principal investigator.

Dr. Esther HelmichEsther Helmich, MD, PhD, is an elderly care physician, working at Amsta, healthcare organization in Amsterdam. She has extensive experience in qualitative research, in particular with the (longitudinal/repeated) use of interviews and visual methods. Together with colleagues from Western University (London, Ontario, Canada), she has introduced and developed the application of ‘rich pictures’ as a research method in medicine. As a senior researcher, she is involved in the ‘In search of stories’ project.

Drs. Nirav ChristopheNirav Christophe writes for theatre and radio and his radio plays have been broadcast in twelve countries. For nine years, he was artistic leader of the first four-year theatre- writing BA-course in the Netherlands. He is an internationally-renowned creative writing lecturer and pedagogue.He is an expert on creativity processes, especially transdisciplinary co-creative processes and is currently Professor of Expanding Artistic Processes at HKU University of the Arts Utrecht.

Drs. Henny DörrHenny Dörr, MA is senior lecturer at HKU, University of the Arts Utrecht, working in the field of expanding artistic practices, within the professorship of the same name. The Care-Labs research environment of the professorship enables research on co-creative strategies and transdisciplinary collaboration between art, science and (health)care. They participate in transdisciplinary research projects such as ‘In search of Stories’; ‘If you’re not there where are you’ (on the experiences of Absences) and ‘Prikkel’ (on sensory integration). Within the educational programs of HKU, Henny Dörr developed a range of bachelor and master courses on theatre design, (interactive) performance design and scenography. As course director and tutor they challenge conventional views of knowledge transfer. Currently they offer courses on methods and dissemination forms for artistic research practices. Originally a dramaturg that graduated in Theatre Studies at UvA in 1986, their perspective has always been on the creative and performative processes and practices that transgress the boundaries of disciplines. They have a vast international network within the expanded fields of scenography.

Research partners The Art of Creating New Stories:

Jeroen Lutters is professor Art education as Critical Tactics (AeCT) at ArtEZ University of the Arts. He propagates the importance of arts and humanities in-and outside of formal educational contexts. His main research focus is on creative theory, creative experiments, mapping and tracking creative interventions, and curating a radical creative turn in society. He developed the Art-Based Learning (ABL) approach and is the founder of the ABL centre, where hundreds of professionals are trained nowadays. As an independent curator and educator, he designed several exhibitions. In several monographies, he demonstrates how the work of modern artists, like Gerhard Richter and Cy Twombly, can be seen as research-based art in connection to creative thinking. At the moment, he supervises 6 PhD students in interdisciplinary contexts (arts, humanities, social science and medical research) and has recently published a handbook on art-based learning.

Prof.dr. Gerben WesterhofGerben Westerhof is professor of Narrative Psychology and Technology at the University of Twente. He is interested in how stories about one’s own life are related to meaning in life, well-being and health. Besides theoretical and methodological work on this theme, he has applied insights from his work in the design and evaluation of several narrative interventions. He directs the Story Lab which brings together narrative research at the University of Twente. Over the past five years, he attracted 4.0 million euro of funding as (co-)applicant of research projects. He supervises about 10 PhD students and published more than 120 articles in peer-reviewed journals. He also edited several handbooks and was co-author of intervention protocols.

Dr. Fabiola CamutiFabiola Camuti(she/her) is professor (‘lector’), researcher and lecturer at the HKU University of the Arts, Utrecht. She has been researcher and practitioner in different countries and institutions (Italy, France, Denmark, UK, NL) and has worked as Lecturer at the Departments of Theatre Studies (University of Amsterdam) and Media and Culture (Utrecht University). Her research is strongly characterized by interdisciplinary methodology which involves the dialogue between humanities, cognition, and spirituality. She conducts research, leads projects, and gives seminars on topics that include embodied and socially-just pedagogies, participatory arts, performance & politics, politics of arts and cultural education, non-hierarchical learning, arts education in a more-than-human world.

Research partner Forgiveness at the End of Life:

Claudia Rossy, PhD is a health psychologist practitioner, teacher and coordinator of the subject Health and Well-being Psychology in UIC, Barcelona.

Publications

Co-creation:

1. Integration of experiences of contingency in patients with advanced cancer supported by a multimodal art approach. Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Sprangers M, Helmich E, (…), van Laarhoven HMW. (2025) PLoS ONE 20(4): e0319918. https://doi.org/10.1371/ journal.pone.031991.
2. Emerging Possibilities: Co-creative art processes with advanced cancer patients: integrating experiences of contingency into the life narrative. Weeseman Y. University of Amsterdam. 2024. (PhD thesis)
3. Exploring resonance theory and uncontrollability during co-creative art making: A qualitative study among cancer patients. Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Helmich E, Sprangers MAG, van Poecke N, van Laarhoven HWM. Cancer Med. 2024 Apr;13(7):e7044. doi: 10.1002/cam4.7044. PMID: 38545808 Free PMC article.
4. The expression of ultimate life goals in co-creative art processes with palliative cancer patients. Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Helmich E, Sprangers MAG, van Poecke N, van Laarhoven HWM. BMC Palliat Care. 2023 Nov 2;22(1):169. doi: 10.1186/s12904-023-01294-2. PMID: 37919685 Free PMC article.
5. Co-creative art processes with cancer patients from the artists’ perspective: a qualitative study exploring resonance theory. Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Helmich E, Sprangers MAG, van Poecke N, van Laarhoven HWM. Support Care Cancer. 2023 Apr 20;31(5):287. doi: 10.1007/s00520-023-07744-0. PMID: 37079143 Free PMC article.
6. Co-creative art processes with patients: A theoretical framework and qualitative study among artists. Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Bood ZM, Sprangers MAG, Helmich E, van Laarhoven HWM. PLoS One. 2022 Apr 7;17(4):e0266401. doi: 10.1371/journal.pone.0266401. eCollection 2022. PMID: 35390040 Free PMC article.

Art-Based Learning:

1. Art-Based Learning in the last stage of life: An exploratory study on how cancer patients create meaning in relation to artworks. Russel S, Westerhof G, Scherer-Rath M, Camuti F, Kamstra S, Bood ZM, van Poecke N, Lutters J, van Laarhoven HW. Palliat Med. 2023 Sep;37(8):1280-1282. doi: 10.1177/02692163231180655. Epub 2023 Jun 15. PMID: 37318210 Free PMC article. No abstract available.

Rich Pictures:

1. This is what life with cancer looks like: exploring experiences of adolescent and young adults with cancer using two visual approaches. Bood ZM, van Liemt F, Sprangers MAG, Kobes A, Weeseman Y, Scherer-Rath M, Tromp JM, van Laarhoven HWM, Helmich E. Support Care Cancer. 2022 Apr;30(4):3353-3361. doi: 10.1007/s00520-021-06775-9. Epub 2022 Jan 5. PMID: 34988705 Free PMC article.
2. Repeated use of rich pictures to explore changes in subjective experiences over time of patients with advanced cancer. Bood ZM, Scherer-Rath M, Sprangers MAG, Timmermans L, van Wolde E, Cristancho SM, Heyning F, Russel S, van Laarhoven HWM, Helmich E. Cancer Rep (Hoboken). 2022 Jan;5(1):e1428. doi: 10.1002/cnr2.1428. Epub 2021 Jul 26. PMID: 34313027 Free PMC article.
3. Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients. Bood ZM, Scherer-Rath M, Sprangers MAG, Timmermans L, van Wolde E, Cristancho SM, Heyning F, Russel S, van Laarhoven HWM, Helmich E. Cancer Med. 2019 Sep;8(11):4957-4966. doi: 10.1002/cam4.2342. Epub 2019 Jul 6. PMID: 31278862 Free PMC article.

Reading Stories:

1. Narrative recognition and identification: a qualitative pilot study into reading literary texts with advanced cancer patients. Kamp A, Bood Z, Scherer-Rath M, Weeseman Y, Christophe N, Dörr H, Sanders J, Sprangers M, Helmich E, Timmermans L, van Wolde E, van Laarhoven HWM. J Cancer Surviv. 2022 Jun;16(3):531-541. doi: 10.1007/s11764-021-01048-0. Epub 2021 Jun 15. PMID: 34129212 Free PMC article.
2. Narrative meaning-making at the crossroads between life and death: a qualitative study into contemplating literary texts with advanced cancer patients. van Poecke, N., Scherer-Rath, M., Weeseman, Y.(…), van Laarhoven HWM.(2025). https://doi.org/10.1007/s11764-025-01765-w

Spiritual Care:

1. Images of God and attitudes towards death in relation to spiritual wellbeing: an exploratory side study of the EORTC QLQ-SWB32 validation study in palliative cancer patients. Kruizinga R, Scherer-Rath M, Schilderman JBAM, Weterman M, Young T, van Laarhoven HWM. BMC Palliat Care. 2017 Dec 8;16(1):67. doi: 10.1186/s12904-017-0251-7. PMID: 29216857 Free PMC article.
2. Toward a Fully Fledged Integration of Spiritual Care and Medical Care.  Kruizinga R, Scherer-Rath M, Schilderman HJBAM, Puchalski CM, van Laarhoven HHWM. J Pain Symptom Manage. 2018 Mar;55(3):1035-1040. doi: 10.1016/j.jpainsymman.2017.11.015. Epub 2017 Nov 21. PMID: 29169995
3. Professional identity at stake: a phenomenological analysis of spiritual counselors’ experiences working with a structured model to provide care to palliative cancer patients. Kruizinga R, Helmich E, Schilderman JB, Scherer-Rath M, van Laarhoven HW. Support Care Cancer. 2016 Jul;24(7):3111-8. doi: 10.1007/s00520-016-3115-4. Epub 2016 Feb 26. PMID: 26917229 Free PMC article.
4. The effect of spiritual interventions addressing existential themes using a narrative approach on quality of life of cancer patients: a systematic review and meta-analysis. Kruizinga R, Hartog ID, Jacobs M, Daams JG, Scherer-Rath M, Schilderman JB, Sprangers MA, Van Laarhoven HW. Psychooncology. 2016 Mar;25(3):253-65. doi: 10.1002/pon.3910. Epub 2015 Aug 10. PMID: 26257308 Review.

Contingency & Narrative Meaning-Making:

1. An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study). Kruizinga R, Scherer-Rath M, Schilderman JB, Hartog ID, Van Der Loos JP, Kotzé HP, Westermann AM, Klümpen HJ, Kortekaas F, Grootscholten C, Bossink F, Schrama J, Van De Vrande W, Schrama NA, Blokland W, De Vos FY, Kuin A, Meijer WG, Van Oijen MG, Sprangers MA, Van Laarhoven HW.Palliat Med. 2019 Feb;33(2):221-231. doi: 10.1177/0269216318816005. Epub 2018 Dec 5. PMID: 30516096 Free PMC article.
2. Relating to the Experience of Contingency in Patients With Advanced Cancer: An Interview Study in U.S. Patients. Kruizinga R, Jafari N, Scherer-Rath M, Schilderman H, Bires J, Puchalski C, van Laarhoven H. J Pain Symptom Manage. 2018 Mar;55(3):913-921. doi: 10.1016/j.jpainsymman.2017.11.007. Epub 2018 Feb 4. PMID: 29154890.
3. Narrative meaning making and integration: Toward a better understanding of the way falling ill influences quality of life. Hartog I, Scherer-Rath M, Kruizinga R, Netjes J, Henriques J, Nieuwkerk P, Sprangers M, van Laarhoven H. J Health Psychol. 2020 May;25(6):738-754. doi: 10.1177/1359105317731823. Epub 2017 Sep 26. PMID: 28948830 Free PMC article.
4. Modes of relating to contingency: An exploration of experiences in advanced cancer patients-ERRATUM. Kruizinga R, Hartog ID, Scherer-Rath M, Schilderman H, Van Laarhoven H. Palliat Support Care. 2017 Dec;15(6):755. doi: 10.1017/S1478951517000049. Epub 2017 Feb 20. PMID: 28215184 No abstract available.
5. Modes of relating to contingency: An exploration of experiences in advanced cancer patients. Kruizinga R, Hartog ID, Scherer-Rath M, Schilderman H, Van Laarhoven H. Palliat Support Care. 2017 Aug;15(4):444-453. doi: 10.1017/S1478951516000936. Epub 2016 Dec 20. PMID: 27995821 Clinical Trial.
6. The life in sight application study (LISA): design of a randomized controlled trial to assess the role of an assisted structured reflection on life events and ultimate life goals to improve quality of life of cancer patients. Kruizinga R, Scherer-Rath M, Schilderman JB, Sprangers MA, Van Laarhoven HW. BMC Cancer. 2013 Jul 26;13:360. doi: 10.1186/1471-2407-13-360. PMID: 23889978 Free PMC article. Clinical Trial.
7. Reconstructing Disruptive Life-Events Using the RE-LIFE Questionnaire: Further Validation of the ‘Narrative Meaning Making of Life Events’ Model Using Multiple Mediation Analysis.   Hartog I, Scherer-Rath M, Oreel T, Netjes J, Henriques J, Lemkes J, Vonk A, Sprangers MA, Nieuwkerk P, Van Laarhoven HW. Journal of Empirical Theology. 2019 Nov 11; 32(2):251-80. doi: https://doi.org/10.1163/15709256-12341394.
8. Shattered worlds and new possibilities: How narrative integration of contingent life events influences people’s quality of life. Hartog I. Doctoral dissertation, Radboud Universiteit Nijmegen, 2021.

Contact

If you would like to reach out to us, please contact Niels van Poecke (Senior Researcher ‘Contingency, Culture & Oncology’): n.vanpoecke@amsterdamumc.nl