Therapeutic letters (i.e., brief therapeutic messages that are sent to clients between counseling sessions) have been used since the days of Freud and have been shown to have beneficial therapeutic impacts. This article describes the use of therapeutic letters in couples and family counseling. The use of three types of therapeutic letter (letters of alliance, intensity, and meaning) are discussed. Ethical and legal issues pertaining to privacy and recommended practices for addressing such issues are reviewed.
Allgood, S.M., Parham, K.B., Salts, C.J., & Smith, T.A. (1995). The association between pretreatment change and unplanned termination in family therapy. American Journal of Family Therapy, 23, 195-202.
2.
Asay, T.P., & Lambert, M.J. (1999). The empirical case for the common factors in therapy: Quantitative findings. In M. A. Hubble , B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 33-56). Washington, DC : American Psychological Association.
3.
Bass, B.A., & Quimby, J.L. (2006). Addressing secrets in couples counseling: An alternative approach to informed consent. The Family Journal, 14, 77-80.
4.
Beyebach, M., Morejon, A.R., Palenzuela, D.L., & Rodriguez-Arias, J.L. (1996). Research on the process of solution-focused therapy. In S. D. Miller, M. A. Hubble, & B. L. Duncan (Eds.), Handbook of solution-focused brief therapy (pp. 299-334). San Francisco: Jossey-Bass.
5.
Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research, and practice, 16, 252-260.
6.
Bohart, A., & Tallman, K. (1999). What clients do to make therapy work. Washington, DC: American Psychological Association .
7.
Chen, M., Noosbond, J.P., & Bruce, M.A. (1998). Therapeutic document in group counseling: An active change agent. Journal of Counseling and Development, 76, 404-411.
8.
Ellis, A. (1965). Some use of printed, written, and recorded words in psychotherapy. In L. Pearson (ED.), The use of written communications in psychotherapy. Springfield, IL: Charles C Thomas.
9.
Fishel, A.K., Buchs, T., McSheffrey, C., & Murphy, C. (2001). Adding written reflections to the reflecting team . Journal of Family Psychotherapy, 12(3), 81-89.
10.
France, M.H., Cadieax, J., & Allen, G.E. (1995). Letter therapy: A model for enhancing counseling intervention. Journal of Counseling and Development, 73, 317-318.
11.
Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: Norton.
12.
Friedlander, M.L., Lambert, J.E., & Munez de la Pena, C. (2008). A step toward disentangling the alliance/improvement cycle in family therapy. Journal of Counseling Psychology, 55(1), 118-124.
13.
Gergen, K.J. (2006). Therapeutic realities. Chagrin Falls, OH: Taos Institute Publications.
14.
Goldman, G.A., & Anderson, T. (2007). Quality of object relations and security of attachment as predictors of early therapeutic alliance. Journal of Counseling Psychology, 54(2), 111-117.
15.
Haas, E., Hill, R.D., Lambert, M.J., & Morrell, B. (2002). Do early responders to psychotherapy maintain treatment gains? Journal of Clinical Psychology, 58, 1157-1172.
16.
Hatcher, R.L., & Barends, A.W. (1996). Patients' view of the alliance in psychotherapy: Exploratory factor analysis of three alliance measures. Journal of Consulting and Clinical Psychology, 64, 1326-1336.
17.
Howard, K.I., Kopta, S.M., Krause, M.S., & Orlinsky, D.E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41(2), 149-164.
18.
Janus, B. (2002) Therapeutic conversations in the looking glass: Sharing reflective case writings. Journal of Systemic Therapies , 21, 55-66.
19.
Johnson, L.N., Nelson, T.S., & Allgood, S.M. (1998). Noticing pretreatment change and therapy outcome: An initial study. American Journal of Family Therapy, 26, 159-168.
20.
Johnson, L.N., & Wright, D.W. (2002). Revisiting Bordin's theory on the therapeutic alliance: Implications for family therapy. Contemporary Family Therapy, 24(2), 257-269.
21.
Kennedy, S.G. (1999). Life review and heroic narrative: Embracing pathology and attention to context. Australian and New Zealand Journal of Family Therapy, 20(1), 1-10.
22.
Kim-Appel, D., Appel, J., Newman, I., & Parr, P. (2007). Testing the effectiveness of Bowen's concept of differentiation in predicting psychological distress in individuals age 62 or older. The Family Journal, 15, 224-233.
23.
Kindsvatter, A., Duba, J.D., & Dean, E.P. (in press). Structural techniques for engaging reluctant parents in counseling. The Family Journal.
24.
Lambert, M.J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldstein (Eds.), Handbook of psychotherapy integration (pp. 94-129). New York: Basic Books.
25.
Lawson, D. (1994). Identifying pretreatment change. Journal of Counseling and Development, 72, 244-248.
26.
Levy, J. (2006). Using a metaperspective to clarify the structural-narrative debate in family therapy. Family Process, 45, 55-73.
27.
Mahaffey, B.A., & Granello, P.F. (2007). Therapeutic alliance: A review of sampling strategies reported in martial and family therapy studies . The Family Journal, 15, 207-216.
28.
Miller, S.D. (1992). The symptoms of the solution. Journal of Strategic and Systemic Therapies, 11(1), 1-11.
29.
Minuchin, S., & Fishman, H.C. (1981). Family therapy techniques. Cambridge, MA: Harvard University Press.
30.
Ness, M.E., & Murphy, J.J. (2001). Pretreatment change reports by clients in a university counseling center: Relationship to inquiry techniques, client, and situational variables. Journal of College counseling, 4, 20-31.
31.
Ng, K., & Smith, S.D. (2006). The relationships between attachment theory and intergenerational family systems theory. The Family Journal , 14, 430-440.
32.
Nylund, D., & Thomas, J. (1994). The economics of narrative. Family Therapy Networker, 18(6), 38-39.
33.
Palazzoli, M.S., Boscolo, L., Cecchin, G., & Prata, G. (1978). Paradox and counterparadox. Northvale, NJ: Jason Aronson.
34.
Payne, M. (2006). Narrative therapy: An introduction to counselors (2nd ed.). London: Sage.
35.
Rait, D.S. (2000). The therapeutic alliance in couple and family therapy. Journal of Clinical Psychology/In Session: Psychotherapy in Practice, 56(2), 211-224.
36.
Riordan, R.J. (1996). Scriptotherapy: Therapeutic writing as a counseling adjunct. Journal of Counseling and Development, 74, 263-269.
37.
Schustov, D., & Lester, D. (1999). Counseling the suicidal client by letter. Crisis, 20(3), 127-131.
38.
Shilts, L.G., & Wendel, R.A. (1991). Therapeutic letters: Pacing with the system. Journal of Strategic and Systemic Therapies, 10(3), 92-99.
39.
Symonds, D., & Horvath, A.O. (2004). Optimizing the alliance in couples therapy. Family Process, 43, 443-455.
40.
Throckmorton, W., Best, J.D., & Alison, K. (2001). Does a prompting statement impact client-reported pretreatment change? An empirical investigation. Journal of Mental Health Counseling, 23, 48-56.
41.
United States Department of Health and Human Services. (2003, May). Summary of the HIPAA privacy rule. Retrieved February 28, 2008, from http://www.hhs.gov/ocr/hipaa/
42.
Vogel, D.L., Wester, S.R., & Larson, L.M. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling and Development , 85, 410-422.
43.
Wagner, V., Weeks, G., & L'Abate, L. (1980). Enrichment and written messages with couples. American Journal of Family Therapy, 8, 36-44.
44.
Wampold, B.E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum.
45.
Weiner-Davis, M., de Shazer, S., & Gingerich, W.J. (1987). Building on pretreatment change to construct the therapeutic solution: An exploratory study. Journal of Marital and Family Therapy, 13, 359-363.
46.
White, M. (1995). Re-authoring lives: Interviews and essays. Adelaide, Australia: Dulwich Centre Publications.
47.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.
48.
White, V.E., & Murray, M.A. (2002). Passing notes: The use of therapeutic letter writing in counseling adolescents. Journal of Mental Health Counseling , 24, 166-176.
49.
Wilcoxon, S.A., & Fenell, D.L. (1986). Linear and paradoxical letters to the non-attending spouse: A comparison of engagement rates. Journal of Marital and Family Therapy, 12, 191-193.
50.
Wojcik, J.V., & Iverson, E.R. (1989). Therapeutic letters: The power of the printed word. Journal of Strategic and Systemic Therapies, 8(2), 77-81.
51.
Wood, C.D., & Uhl, N.E. (1988). Post-session letters: Reverberations in the family treatment systems. Journal of Strategic and Systemic Therapies , 7(3), 35-44.
