Letter Therapy: A Model for Enhancing Counseling Intervention

M. Honoré France, Jan Cadieux and G. Edward Allen

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Based on 15 letters between a counselor and a female client, this article outlines and discusses a unique letter therapy process, which is loosely adapted from the Morita Therapy approach to counseling. The five-step Letter therapy approach consists of 1) opening up, 2) focusing on life themes, 3) redirecting toward strengths, 4) reinforcing actions, and 5) affirming a positive attitude toward life. Letter writing has the potential of being used by counselors either in conjunction with face-to-face counseling or as a separate therapeutic method.
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Letters are used by people to support, offer advice, or provide news to others regarding personal accomplishments, to clarify values, and for a multitude of other uses. Research on the effects of letter writing is scant, although one study found that those who write many letters visited physicians much less often than did those who did not (Pennebaker, Colder, & Sharp, 1990). Only the Japanese therapeutic approach of Morita Therapy specifically recommends the use of letters in counselor-client interaction.

Shoma Morita, who formulated this psychotherapy in 1917, "focused primarily on existential and transpersonal levels and little on pathologies" (Walsh, 1989, p. 547). The basic concepts that underlie Morita Therapy help clients to be more accepting of life and more obedient to the cycle of nature to resolve conflicting thoughts and to become free from fixations. The four phases of treatment consist of acceptance, reattribution, dereflection, and active engagement (Walsh, 1989). Letter writing between client and therapist has long been an accepted strategy for those using Morita Therapy. Letters are used in a similar manner as diary writing, except that the letters are interactive, giving the therapist an opportunity to offer advice or follow the progress of the client's experience in everyday living. According to Reynolds (1976), letter correspondence has the advantage of being convenient, allowing follow-up and continued contact, providing a permanent recording of client-therapist interaction, and reinforcing the Japanese tradition of "expressing inner conflicts and feelings through writing" (p. 44).

For some time it has been apparent to us that letters are a powerful counseling tool that can readily be adapted by helpers from a variety of theoretical backgrounds. We developed the model used in this article after extensive use with a number of clients. It should be remembered that letter therapy is not necessarily more valuable or effective than any other counseling method, but it has worked well for us with clients who are introspective or unable to schedule regular counseling sessions. It is made clear to all clients, however, that their counselor is always available in person or by telephone contact if the need arises.

The letters from the counselor (regardless of the stage or progress in the therapy) were structured in the following manner: (a) a summary of the contents of the previous letter; (b) exploration of feelings and thoughts; (c) positive reinforcement of the client's progress; and (d) homework assignments and advice on activities or thoughts. The letter therapy process is essentially one of focusing and refocusing the client's feelings, thoughts, and actions. The purpose is to allow the client an opportunity to reassess strengths, to focus on the positive, and to take responsibility for his or her actions. The process allows the client to reflect, experiment, and take action to solve his or her problem.

The following counselor-client interactions with a 35-year-old female client experiencing undefined stress is presented and discussed as an example of letter therapy. The decision to use letter writing was made with this client when she was unable to make regular office visits. She stated that it suited her perfectly, as she was an aspiring writer and felt that she did her best thinking when writing. The process is described in a series of steps; however, this does not necessarily imply that the process is linear.

The counseling interaction occurred over a 5-month period and consisted of the following: (a) an initial face-to-face encounter that outlined the letter therapy process; (b) discussion of confidentiality and trust; (c) seven letters from the client and eight letters from the counselor; and (d) a follow-up face-to-face encounter. The client was told that she could meet in person with the counselor or terminate the letter therapy at any time. Upon receiving the letters, the counselor responded immediately, but the client preferred to take more time (from 1 to 3 weeks).

STEP 1: OPENING UP

In the first letter the client was asked to vent her feelings by describing her condition, even to the point of exaggerating her experiences. She was instructed to allot a time and place to write her letters. Her initial letter covered a variety of issues that ranged from feeling under appreciated to anger at her spouse for not being supportive. The goal of the responding letter from the counselor was to concretely understand the client's feelings, define the problems, and help the client prioritize the issues that she wanted to work at resolving.

In the counselor's second letter to the client, specific emotional words used by the client were pointed out, including self esteem, resentment in a relationship, lack of meaningful work, lack of purpose, and frittering away resources. She was asked to comment on this observation. Her responses revealed feelings that seemed to conceptualize the type of life script she felt she was living at the moment.

STEP 2: FOCUSING ON LIFE THEMES

The client's thoughts were much more organized in her third letter, after the counselor had provided a theme structure based on previous letter content. The counselor had identified feelings and thoughts in relationship to behavior. When the client suggested that she viewed her life as a struggle, the counselor asked for more details on how

she achieved freedom through struggling. The aim was to obtain more details about this theme, but also to provide the client with an opportunity to describe how this theme had either enabled or blocked her living constructively. The Morita Therapy approach stresses that clients can regain control and become free of their symptoms by accepting and reinterpreting (Walsh, 1989).

In following letters, the client was asked to free-associate words she consistently used in her letters: focus, frustration, scared, and scattered. Her responses produced more specific information about her actions, and her style of expression helped the counselor better understand the client's lack of action in solving her life's problems.

STEP 3: REDIRECTING THE CLIENT TOWARD STRENGTHS

In her letters, the client had consistently written about her ills and problems. She seemed to be getting more depressed about her situation the longer she dwelled on it. To activate a more positive frame of reference, she was asked to write about her accomplishments. The assumption behind this strategy was that once she realized her power to solve problems, she could channel her energy towards rectifying her situation. One of the strategies was to ask her to explore how she benefited from her struggles. Although her statements were not extensive, they were specific and concrete (i.e., "I am creative, resourceful, adventurous, loving, understanding, and fun loving"). As a means to encourage her to look for patterns in her previous behavior and to find answers for herself, the client was constantly given positive reinforcement for insights. She became aware that her emotions followed a natural cycle and that "properly directed attention will allow these feelings to run their natural course quickly without unnecessary restrictions on behavior" (Reynolds, 1976, p. 9).

STEP 4: REINFORCING ACTIONS

The counselor's questions and homework assignments were designed to get the client activated. The questions allowed her to reflect on her feelings, but they also made it more difficult for her to avoid the obvious; for example, in earlier letters she stated how she had, against all odds, decided what she wanted to do and then went on to do it (i.e., nontraditional job and extensive traveling). Reminding the client of these examples of achievements and endeavors encouraged her to refocus from the negative to the positive.

In this step, the counselor focused on actions in the present. To ensure that the tasks would not be sabotaged, stressful, or too difficult, the counselor chose easily obtainable objectives. The client's written response to these activities clearly indicated how they affected her general sense of power and well-being: "This was a powerful exercise. I now realize by being more aware of my interactions, I feel more self-confident."

STEP 5: AFFIRMING A POSITIVE ATTITUDE

Finally, the client was assisted in developing an attitude that moved her away from despair toward using the resources she had. Consistently throughout the letter writing, the counselor had reinforced the positive. This was designed to make her use whatever strengths she had to work out solutions, to view her problems in a more realistic manner, and to use her strengths to cope. Typically, the counselor used reinforcing comments such as the following: "You mentioned in your letter that you appreciated my support and encouragement. Can you make a point to do something that is supportive once every day with those you care about?" The decision to end the letter therapy was initiated by the client who felt more positive about her ability to overcome her frustrations and live a more constructive life. Based on her positive attitude and a plan of action for dealing with her relationships and job search, it was concluded that the treatment was a success.

CONCLUSION

The use of systemized letter writing in therapy offers counselors another option for providing help that goes beyond the confines of face-to-face interaction. The client-counselor interaction described illustrates the potential letter therapy has for those who enjoy writing and receiving letters. Clients who have opted for this strategy have responded positively about the process. The number of letters included in the interaction depends on the client's issue (and the amount of time the counselor needs).

Not all clients may benefit from this strategy. Although there is little doubt that important interpersonal elements such as eye contact, nonverbal cues, and body language enhance counseling relationships, the letter therapy strategy can provide a viable, if not optimum, alternative when these face-to-face details cannot be actualized due to physical constraints (e.g., resistance or personal reluctance to verbalize face-to-face). The most crucial factor for choosing this method of counseling is the client's willingness to write letters and communicate thoughts and feelings to writing in a therapeutic context. At present, the letter therapy model is being used successfully with a number of clients who do not have regular physical access to a counselor and as a follow-up with other clients who have requested the letter therapy strategy.

REFERENCES

Junn, E. (1987). "Dear mom and dad": Using personal letters to enhance students' understanding of developmental issues. Teaching of Psychology, 35(3), 135-139.

Pennebaker, J. W., Colder, M., & Sharp, L. R. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58(3), 528-537.

Reynolds, D. (1976). Morita psychotherapy, Berkeley, CA: University of California Press.

Walsh, R. (1989). Asian psychotherapies. In R. Corsini & D. Wedding (Eds.), Current psychotherapies (4th ed.). Itasca, IL: Peacock.

M, Honore France is an associate professor in the Facultv of Education at the University of Victoria, British Columbia. Canada. Jan Cadieux is in private practice in Victoria, BC, Canada. G. Edward Allen is an associate professor at the University of Winnipeg, Canada.

Journal of Counseling & Development
Published by the American Counseling Association
Volume 73 Number 3 January/February 1995