The Use of E-mail in the Therapy Process

Abstract

The therapeutic letter has a long history, with roots in psychoanalytic work and continuing application in family therapy. The advent of e‐mail has allowed another form for therapeutic written communication which, while incorporating the benefits of therapeutic letters, adds to these. It has also opened up some potential risks. This article incorporates a brief review of the literature covering therapeutic written communication and offers a case example where e‐mail was used as an adjunct in face‐to‐face therapy with a client who experienced attachment difficulties. This therapy was informed by systemic and psychoanalytic traditions. The authors explore a variety of technical matters including the timing and crafting of e‐mail responses, the integration of written communication with face‐to‐face therapy, impact on the therapeutic relationship and management of crisis. Ethical issues such as confidentiality and duty of care are also considered.

Virtual Relationships and Systemic Practices in the Digital Era

“…Most importantly: how can we respond to them therapeutically? Along with a variety of examples from clinical practice, it is worth highlighting the use of conclusive session feedback (Selvini Palazzoli et al 1978) via e-mail, where classical systemic thinking and contemporary digital devices meet (see also Hunt et al 2005).…”

Therapeutic Letters in Nursing

“…The practice of writing letters in clinical work was raised to another level of awareness through the work of David epston and Michael White (epston, 1989;1994;White & epston, 1990), who termed the practice therapeutic letters. Since that time, letters have been extensively taken up in many domains of, and with varying intents in, family clinical work (Bailey, Yager, & Jenson, 2002;Coles, 1995;elkaim, 1985;Freedman & Combs, 1996;griffiths, 2001;Harper-Jaques & Masters, 1994;Hatcher, 2001;Hunt, Schochet, & King, 2005;Lown & Britton, 1991;Marshall & Harper-Jaques, 2008;Ogden Burke, Harrison, Kauffmann, & Wong, 2001;Parry & Doane, 1994;Rudes, 1992;Shapiro & Schulman, 1996;Shilts & Ray, 1991;Sloman & Piptone, 1991;Wilcoxen & Fenell, 1983;Wojcik & Iverson, 1989;Wood & Uhl, 1988;Wright et al, 1996).…”

The Past and Future of Therapeutic Letters

“…Hatcher (2001) offered that e-mail allows a particular form of monitoring process that uncovers patterns of behaviors and needs. Hunt, Schochet, and King (2005) suggested there is a cultural component to the use of e-mail for letters; minority groups might feel less pressure than in a face-to-face meeting, and adolescents might find a greater fit with their preferred ways of communicating. The authors further claimed that email communication had the potential to ease communication and disinhibit the respondent, creating a climate of safety and comfort.…”

“…The authors further claimed that email communication had the potential to ease communication and disinhibit the respondent, creating a climate of safety and comfort. Ethical and legal issues around confidentiality, informed consent, risk management, documentation, and record keeping must also be considered (griffiths, 2001;Hunt et al, 2005;Shapiro & Schulman, 1996).…”