Professor David Kissane AC

Professor David Kissane AC


Chair in Palliative Medicine Research

Email: david.kissane@nd.edu.au
Phone: (02) 8204 4484

  • Biography

    David William Kissane AC (born 1951) is an Australian consultation-liaison psychiatrist renowned for his research in Psycho-oncology, and Palliative Care. He holds the Chair in Palliative Medicine Research, School of Medicine, University of Notre Dame Australia.

    For psycho-oncology, Kissane developed the widely used Demoralization Scale (DS), which measures a state of lowered morale and poor coping with illness or a stressful predicament, and the Shame and Stigma Scale (SSS) in disfiguring head and neck cancers.

    For palliative care, he developed the Family Focused Grief Therapy (FFGT) to prevent complicated grief in dysfunctional families, and the Psycho-Existential Symptom Assessment Scale. He led trials of individual, group, couple, and family therapies in cancer care.

    Prior appointments have been as:

    Foundation Professor and Director of Palliative Medicine, University of Melbourne (1996-2003) where he established The Centre for Palliative Care. He introduced Diploma and Masters degrees in Palliative Medicine and a research centre which continues today.

    Chairman, Department of Psychiatry and Behavioral Sciences and the inaugural Jimmie C Holland Chair in Psychiatric Oncology, Memorial Sloan-Kettering Cancer Center (New York, NY) (2003-2012), where he was also a Professor of Psychiatry at Weill Medical College of Cornell University. In expanding the world’s premier psycho-oncology service, he established research laboratories in Psychotherapy (Dr W Breitbart), Communication (Dr C Bylund), Symptom Management (Dr S Passik), Cancer Prevention (Dr J Ostroff), Culture and Disparities (Dr F Gany), and Neurocognitive Effects of Cancer (Dr T Ahles). New clinical programs included the Family Clinic (Dr T Zaider), Sexual Health Clinics (Dr J Carter, Dr C Nelson), Bereavement (Dr W Lichtenthal), Caregivers (Dr A Applebaum), Smoking Cessation (Dr J Burkhalter) and Geriatric Psychiatry (Dr J Holland). Outpatient psycho-oncology clinics were expanded from Manhattan sites to Network sites on Long Island, New Jersey and Westchester.

    Head of the Department of Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University (2012-2019). He re-established a Master of Psychiatry degree within a parent course known as the Master of Mental Health Science suite of degrees. He was made Emeritus Professor of Psychiatry (2019) on his retirement from Monash University.

    In his studies of existential distress, Kissane recognized a mental state of poor adjustment to the threat of cancer which he termed demoralization. He validated a psychological measure, the Demoralization Scale (DS & DS-II), which came to be used in a number of international studies and from which subsequent systematic reviews revealed that 15% of patients in palliative care became demoralized. Loss of meaning, worthlessness and pointlessness, alongside hopelessness, helplessness, a sense of entrapment and disheartenment can lead to suicidal ideation. Demoralization has been recognised as a more potent mediator of a desire to hasten death than depression.

    In psychotherapy trials, Kissane led developmental studies of Meaning and Purpose Therapy (MaP) for patients with advanced cancer, Intimacy-Enhancing Couple Therapy (IECT) in the setting of prostate cancer, Cognitive-Existential Group Therapy (CEGT) for women with breast cancer, and Family-Focused Grief Therapy (FFGT) for dysfunctional families in palliative care, which have all led to improved adjustment and quality of life.

    As an educator, his contribution to the development of communication skills training is recognized with his senior editorship of a major textbook on Communication in cancer and palliative care with Oxford University Press. In the Comskil Laboratory at MSKCC, he led an institution-wide training program in challenging oncology communication predicaments for medical, surgical, radiation, palliative care and psychiatry fellows, which eventually expanded to cancer nursing and a range of allied health disciplines.

  • Research Expertise and Supervision

    Examples of Master’s degree students supervised to completion:

    • Jennifer Philip: thesis on pain in community palliative care. Now Professor of Palliative Medicine, University of Melbourne and Peter MacCallum Cancer Centre.
    • Peter Martin: thesis on iterative database for palliative care. Now Professor of Palliative Medicine, Deakin University and Barwon Health.
    • Alexandra Burke: thesis on oral health in palliative care. Now Palliative Care Consultant for Calvary Bethlehem health Care.

    Examples of Doctoral Degree students supervised to completion:

    • Jeremy Couper MD: thesis on adjustment of wives of men with prostate cancer. Now Assoc Professor of Psychiatry, Eastern Health
    • Carrie Lethborg PhD: thesis on hope and meaning-based coping. Now Director of Psycho-oncology at St Vincent’s Melbourne.
    • Denise Cooper PhD: thesis on the distinction between killing and letting die. Now Consultant on Bioethics for Anglican Church, Australia.
    • Hoda Barazandeh PhD: thesis on schemas in borderline personality disorder.
    • Dzenana Katal PhD: thesis on refugee trauma and acculturative stress
    • Sophie Robinson DPsych: thesis on revalidation of the Demoralization Scale-II
    • Alexandra Creighton DPsych: thesis on anxiety disorders in residential aged care facilities
    • Rebecca Chau DPsych: thesis on depressive disorders in residential aged care facilities

    Examples of Postgraduate Fellowships supervised to completion:

  • Books

    • Kissane DW, Bloch S. (2002). Family Focused Grief Therapy: A Model of Family-centred Care during Palliative Care and Bereavement. Open University Press, Buckingham and Philadelphia. [Translated into Japanese (2003) and Danish (2004)]. Reprinted 2003 and 2008.
    • Kissane DW, Bultz BD, Butow PN, Finlay IG, Editors (2010). Handbook of Communication in Oncology and Palliative Care. Oxford University Press, Oxford.
    • Kissane DW, Maj M, Sartorius N, Editors (2011). Depression and Cancer. Wiley-Blackwell, Chichester.
    • Watson M, Kissane DW, Editors (2011). Handbook of Psychotherapy in Cancer Care. Wiley-Blackwell, Chichester. [Translated into Japanese (2013) and Mandarin (2016)].
    • Kissane DW, Parnes F. (2014). Bereavement Care for Families. Routledge, New York.  [Translated into Mandarin, Peking University Press, 2016].
    • Kissane DW, Bultz BD, Butow PN, Bylund CL, Noble S Wilkinson S, Editors (2017). Oxford Textbook of Communication in Oncology and Palliative Care. Oxford University Press, Oxford.
    • Watson M, Kissane DW, Editors (2017). Psycho-Oncology Care - Companion Guides for Clinicians I: The management of clinical depression and anxiety. Oxford University Press, New York.
    • Watson M, Kissane DW, Editors (2020). Psycho-Oncology Care – Companion Guides for Clinicians II: Sexuality, Fertility and Relationships in Cancer Care. Oxford University Press, New York.

  • Journal articles and proceedings

    Demoralization studies

    • Kissane DW. (2000) Distress, demoralization and depression in palliative care. Current Therapeutics, June 2000, 14-19. https://research.monash.edu/en/publications/distress-demoralisation-and-depression-in-palliative-care
    • Kissane DW, Kelly BJ (2000) Demoralization, depression and desire for death: problems with the Dutch guidelines for euthanasia of the mentally ill. Aust NZ J Psychiatry 34(2): 325-333. https://doi.org/10.1080/j.1440-1614.2000.00692.x.
    • Kissane DW. (2001) Demoralization – a useful conceptualization of existential distress in the elderly. Australasian Journal on Ageing, 20: 110 – 111https://doi.org/10.1111/j.1741-6612.2001.tb01770.x
    • Kissane DW, Clarke DM, Street AF. (2001) Demoralization syndrome - a relevant psychiatric diagnosis for palliative care. Journal of Palliative Care, 17: 12-21. 130 citations https://europepmc.org/article/med/11324179
    • Kissane DW. (2001) Demoralization – its impact on informed consent and medical care. Medical Journal of Australia, 174: 537-539. http://europepmc.org/article/MED/11795544
    • Clarke DM, Kissane DW. (2002) Demoralization: its phenomenology and importance. Australian & New Zealand Journal of Psychiatry 36: 733-742. Citations 506 https://doi.org/10.1046/j.1440-1614.2002.01086.x
    • Kissane DW, Wein S, Love A, Lee XQ, Kee PL, Clarke DM. (2004) The Demoralization Scale: a preliminary report of its development and preliminary validation. Journal of Palliative Care; 20(4): 269-276. https://europepmc.org/article/med/15690829 citations 270
    • Kissane DW (2004) The Contribution of Demoralization to End-of-life Decision Making.  The Hastings Center Report, 34(4):21-31.  https://doi.org/10.2307/3528690 citations 83
    • Clarke DM, Kissane DW, Trauer T, Smith GC (2005) Demoralization, anhedonia and grief in patients with severe physical illness. World Psychiatry; 4(2): 96-105. PMC1414748 citations 131
    • Kissane DW(2014). Demoralization – A life-preserving diagnosis to make in the severely medically ill. Journal of Palliative Care, 30(4): 255-258 https://doi.org/10.1177/082585971403000402
    • Robinson S, Kissane, DW, Brooker, J, Burney, S. (2015) A Systematic Review of the Demoralization Syndrome in Individuals With Progressive Disease and Cancer: A Decade of Research. Journal of Pain and Symptom Management, 49(3): 595-610. doi:10.1016/j.jpainsymman
    • Robinson S, Kissane DW, Brooker J, Michael N, Fischer J, Franco M, Hempton C, Sulistio M, Pallant J, Clarke D, Burney S. (2016) Refinement and Revalidation of the Demoralization Scale: The DS-II ‒ Internal Validity. Cancer, 122: 2251-2259. https://doi.org/10.1002/cncr.30015
    • Robinson S, Kissane DW, Brooker J, Hempton C, Michael N, Fischer J, Franco M, Sulistio M, Clarke D, Ozmen M, Burney S. (2016) Refinement and revalidation of the Demoralization Scale: The DS-II ‒ External Validity. Cancer, 122: 2260-2267. https://doi.org/10.1002/cncr.30012/pdf
    • Robinson S, Kissane DW, Brooker J, Hempton C, Burney S (2017).  The relationship between poor quality of life and desire to hasten death:  A multiple mediation model examining the contributions of depression, demoralization, loss of control, and low self-worth.  Journal of Pain and Symptom Management, 53(2): 243-249. https://doi.org/10.1016/j.jpainsymman.2016.08.013
    • Kissane DW, Bobevski I, Gaitanis P, Brooker J, Michael N, Lethborg C, Richardson G, Webster P, Hempton C. (2017). Exploratory examination of the utility of demoralization as a specifier for adjustment disorder and major depression. General Hospital Psychiatry, 46: 20-24. https://doi.org/10.1016/j.genhosppsych.2017.01.007
    • Vehling S, Kissane DW, Lo C, Glaesmer H, Hartung TJ, Rodin G, Mehnert A. (2017). The association of demoralization with mental disorders and suicidal ideation in patients with cancer. Cancer, 123(17): 3394-3401. https://doi.org/10.1002/cncr.30749 
    • Bobevski I, Kissane DW, Vehling S, McKenzie D, Glaesmer H, Mehnert A. (2018). Latent class analysis differentiation of adjustment disorder and demoralization, more severe depressive-anxiety disorders, and somatic symptoms in a cohort of patients with cancer. Psycho-Oncology, 27(11), 2623-2630, https://doi.org/10.1002/pon.4761
    • Cheng J, Chen J, Zhang Y, Kissane D, Yan J. (2019). Translation and psychometric properties for the Demoralization Scale in Chinese breast cancer patients.  European Journal of Oncology Nursing 42: 134-140. https://doi.org/10.1016/j.ejon.2019.09.001
    • Belvederi Murri M, Zerbinatia L, Ounallia H, Kissane D, Casonia B , Leonia M, Rossia G, Dall'Olioa R, Carusoa R, Nannia MG, Grassi L. (2019) Assessing demoralization in medically ill patients: Factor structure of the Italian version of the demoralization scale and development of short versions with the item response theory framework. J Psychosomatic Research, 2020, 128: 109889 https://doi.org/10.1016/j.jpsychores.2019.109889
    • Belvederi Murri M, Caruso R, Ounalli H, Zerbinati L, Berretti E, Costa S, Recla E, Folesani F, Kissane DW, Nanni MG, Grassi L. (2020). The relationship between demoralization and depressive symptoms among patients from the general hospital: network and exploratory graph analysis. Journal of Affective Disorders 276: 137-146. https://doi.org/10.1016/j.jad.2020.06.074
    • Kissane DW. (2020). Education and assessment of psycho-existential symptoms to prevent suicidality in cancer care. Psycho-Oncology vol 29, no 9; https://doi.org/10.1002/pon5519

    Randomised controlled trials

    • McLachlan SA, Allenby A, Matthews J, Kissane DW, Bishop M, Wirth A, Zalcberg J. (2001)  A randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve psychosocial functioning of patients with cancer. Journal of Clinical Oncology, 19: 4117-4125. Citations 300 https://doi.org/10.1200/JCO.2001.19.21.4117
    • Kissane DW, Bloch S, Smith GC, Miach P, Clarke DM, Ikin J, Love A, Ranieri N, McKenzie DP. (2003) Cognitive-existential group psychotherapy for women with primary breast cancer: a randomized controlled trial.  Psycho-Oncology, 12: 532-546. Citations 420 https://www.chicom.be/sites/default/files/2003_cegt_psychoonc_kissane.pdf
    • Kissane DW, Love A, Hatton A, Bloch S, Smith GS, Clarke DM, Miach P, Ikin J, Ranieri N, Snyder RD. (2004) The effect of cognitive-existential group therapy on survival in early stage breast cancer. Journal of Clinical Oncology, 22(21): 4255 - 4260. Citations 193 https://ascopubs.org/doi/full/10.1200/jco.2004.12.129
    • Kissane DW, McKenzie M, Bloch S, Moskowitz C, McKenzie DP, O’Neill I (2006) Family focused grief therapy: a randomized controlled trial in palliative care and bereavement. American Journal of Psychiatry, 163:1208 - 1218. Citations 322 https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.2006.163.7.1208
    • Kissane, D.W., Grabsch, B. Clarke, D.M., Smith, G.C., Love, A.W., Bloch, S., Snyder, R.D., Li, Y. (2007). Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Psycho-Oncology, 16(4), 277-286. Citations 394 https://doi.org/ 10.1002/pon.1185
    • Manne SL, Kissane DW, Nelson CJ, Mulhall JP, Winkel G, Zaider T (2011). Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. Journal of Sexual Medicine 8(4): 1197-1209. doi: 10.1111/j.1743-6109.2010.02163.x Citations 131
    • Manne SL, Virtue SM, Ozga M, Kashy D, Heckman C, Kissane D, Rosenblum N, Morgan M, Rodriquez L (2017). A comparison of two psychological interventions for newly-diagnosed gynecological cancer patients. Gynecologic Oncology, 144(2): 354-362. doi: 10.1016/j.ygyno.2016.11.025
    • Parker PA, Banerjee SC, Matasar MJ, Bylund CL, Rogers M, Franco K, Schofield E, Li Y, Levin TT, Jacobsen PB, Astrow AB, Leventhal H, Horwitz S, Kissane D. (2018). Efficacy of a survivorship-focused consultation versus a time-controlled rehabilitation consultation in patients with lymphoma: A cluster randomized controlled trial. Cancer. 124(23):4567-4576. doi: 10.1002/cncr.31767
    • Kissane DW, Lethborg C, Brooker J,  Hempton C, Burney S, Michael N, Staples M. Oscika T, Sulistio M, Hiscock H. (2019). Meaning and Purpose (MAP) Therapy II: Feasibility, acceptability from a pilot study in advanced cancer. Palliative and Supportive Care, 17(1): 21-28. doi: 10.1017/S1478951518000883
    • Manne SL, Kashy DA, Zaider T, Kissane D, Lee D, Kim IY, Heckman CJ, Penedo FJ, Murphy E, Virtue, SM. (2019). Couple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial. British Journal of Health Psychology, 24(2): 396-418. doi: 10.1111/bjhp.12359

    Grief and Bereavement Studies

    • Kissane DW, Bloch S, Dowe DL, Snyder RD, Onghena P, McKenzie DP, Wallace CS (1996). The Melbourne family grief study I: perceptions of family functioning in bereavement. American Journal of Psychiatry, 153: 650-658. Citations 201 https://ajp.psychiatryonline.org/doi/full/10.1176/ajp.153.5.650
    • Kissane DW, Bloch S, Onghena P, McKenzie DP, Snyder RD, Dowe DL (1996). The Melbourne family grief study II:  psychosocial morbidity and grief in bereaved families. American Journal of Psychiatry, 153: 659-666. Citations 176 https://ajp.psychiatryonline.org/doi/full/10.1176/ajp.153.5.659
    • Kissane DW, McKenzie M, Bloch S, Moskowitz C, McKenzie DP, O’Neill I (2006) Family focused grief therapy: a randomized controlled trial in palliative care and bereavement. American Journal of Psychiatry, 163:1208 – 1218. Citations 322. https://ajp.psychiatryonline.org/doi/full/10.1176/ajp.2006.163.7.1208
    • Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Asian M, Kissane DW, et al (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-II. PLoS Med 6(8): e1000121. https://doi.org/10.1371/journal.pmed.1000121 citations 1443
    • Kissane DW, Zaider TI, Li Y, Hichenberg S, Schuler T, Lederberg M, Lavelle L, Loeb R, Del Gaudio F (2016). Randomized controlled trial of family therapy in advanced cancer continued into bereavement. Journal of Clinical Oncology,  34:1921-1927. https://ascopubs.org/doi/10.1200/JCO.2015.63.0582 citations 43

    Shame and Stigma

    • Kissane DW, Patel SG, Baser RE, Bell R, Farberov M, Ostroff JS, Li Y, Singh B, Kraus DH, Shah JP (2013). Preliminary evaluation of the reliability and validity of the shame and stigma scale in head and neck cancer. Head & Neck. 35(2):172-183. https://doi.org/10.1002/hed.22943 Citations 62

    How to conduct therapy

    • Kissane DW, Miach P, Bloch S, Seddon A, Smith GC. (1997) Cognitive-existential group therapy for patients with primary breast cancer. Psycho-Oncology, 6: 25-33. Citations 193 Https://doi.org/10.1002/(SICI)1099-1611(199703)6:1<25::AID-PON240>3.0.CO;2-N
    • Kissane DW, Bloch S, McKenzie M, McDowall C. & Nitzan R. (1998) Family grief therapy:  a preliminary account of a new model to promote healthy family functioning during palliative care and bereavement.  Psycho-Oncology, 7: 14-25. Citations 149 https://doi.org/10.1002/(SICI)1099-1611(199801/02)7:1<14::AID-PON313>3.0.CO;2-D
    • Kissane DW, Grabsch B, Clarke DM, Christie G, Clifton D, Gold S, Hill C, Morgan A, McDermott F, Smith GC (2004) Supportive-expressive group therapy: the transformation of existential ambivalence into creative living while enhancing adherence to anti-cancer therapies.  Psycho-Oncology, 13(11):755-68. Citations 127 https://psycnet.apa.org/record/2004-21345-001
    • Gueguen J, Bylund CL, Brown, R, Levin TT, Kissane DW (2009). Conducting Family Meetings in Palliative Care:  Themes, Techniques and Preliminary Evaluation of a Communication Skills Module. Palliative & Supportive Care 7(2):171-9. Citations 62 https://doi.org/10.1017/S1478951509000224
    • Dumont, I, Kissane DW (2009). Techniques for Framing Questions in Conducting Family Meetings in Palliative Care. Palliative & Supportive Care 7(2):163-70. https://doi.org/10.1017/S1478951509000212
    • Lethborg C, Schofield P, Kissane D (2012). The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy. Palliative and Supportive Care 10(3): 177-188 doi:10.1017/S147895151100085X
    • Kissane, DW (2012). The relief of existential suffering. Archives of Internal Medicine, 172(19): 1501-1505, doi: 10.1001/archinternmed.2012.3633 Citations 121
    • Lethborg C, Kissane DW, Schofield, P. (2019). Meaning and Purpose (MAP) Therapy I: Therapeutic processes and themes in advanced cancer. Palliative and Supportive Care, 17(1): 13-20. doi: 10.1017/S1478951518000871

    Communication Skills Training

    • Kissane DW, Bylund CL, Banerjee S, Bialer P, Levin T, Maloney EK, D’Agostino T (2012). Communication skills training for oncology professionals. Journal of Clinical Oncology 30(11): 1242-1247. Citations 238 https://doi.org/10.1200/JCO.2011.39.6184
    • Banerjee SC, Matasar MJ, Bylund CL, Horwitz S, McLarney K, Levin, T, Jacobsen PB, Parker P, Astrow A, Kissane, DW. (2015). Survivorship care planning after participation in communication skills training intervention for a consultation about lymphoma survivorship. Translational Behavioral Medicine, 5: 393-400. doi: 10.1007/s13142-015-0326-z
    • Bylund CL, Banerjee SC, Bailer PA, Manna R, Levin TT, Parker PA, Schofield E, Li Y, Bartell A, Chou A, Hitchenberg SA, Dickler M, Kissane DW. (2018). A rigorous evaluation of an institutionally-based communication skills program for post-graduate oncology trainees. Patient Education and Counselling, 101(11): 1924-1933. https://doi.org/10.1016/jpec.2018.05.028

  • Awards

    • President Emeritus for the International Psycho-Oncology Society (IPOS) (2000-2003) https://www.ipos-society.org/
    • Arthur Sutherland Memorial Award for Lifetime Achievement, IPOS, 2008
    • Klerman Award for Psychotherapy Research, Weill Cornell Medical College, 2012
    • Honorary Fellow of the Academy of Consultation-Liaison Psychiatry, USA, 2014
    • Dame Cecily Saunders Memorial Lecture for Kings College, London, 2017
    • Clinical Oncology Society of Australia (COSA) Australian Psycho-Oncology Award, 2017
    • Companion of the General Division of the Order of Australia Award, 2018