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Title: Letters in cognitive analytic therapy : the patient's experience
Author: Hamill, Michelle C.
ISNI:       0000 0001 3528 227X
Awarding Body: University of East Anglia
Current Institution: University of East Anglia
Date of Award: 2006
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"Written words don't fade, they endure through space and time, bearing witness to the work of therapy and immortalising it" (Epston, 1994: p31) Aim: This study explored how the therapeutic letters, which are used as a standard procedure in Cognitive Analytic Therapy (CAT), contribute to the therapy from the perspective of patients. Background: CAT is a structured, time-limited psychotherapy (Ryle & Kerr, 2002). Letters form an important part of the reformulation and ending stages in CAT. However, little is known about the impact these letters have on the therapeutic process and how they are used from the perspective of the patient. Exploring the meaning and use of letters may further our understanding of this process, as well as giving value to patients' opinions. Method: Semi-structured interviews were used to elicit eight participants' perspectives of how the letters in CAT contributed to their therapy. A thematic analysis based on certain grounded theory principles was used to analyse the interview transcripts. Results: The analysis of participants' accounts suggested that the letters in CAT contributed to therapy through a process of `connecting' patients in varying degrees in the following four ways to: `understanding and awareness of self', `relationship with therapist', `perception of the structure and process of therapy', and `communicating self with others'. CAT theory has addressed many of these findings. However, the dilemmas and risk associated with the letters, such as re-invoking painful emotions by re-reading them and whether to share them with others, pervaded patients' accounts, offering a more complex understanding of the part the letters played, beyond those currently proposed by CAT theory. Discussion: It is proposed that it is the letters' ability to tap into patients' experience of connecting and relating, internally and externally, and the difficulties entailed in this that makes them such potentially powerful therapeutic tools. Clinical and theoretical implications and suggestions for future research are also discussed
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available