writing in therapy a participatory approach

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@ The Association for Family Therapy 1996. Publishcd by Blackwcll Publishers, 108 CowlcyRoad, Oxford, OX4 IJF, U K and 238 Ma in Street, Cambr idgc, MA , USA.Journal of Family Therapy (1996) 18: 361-37301644445 3.00

Writing in therapy: a participatory approachGonzalo BacigalupeThis paper explores the potential of writing with rather than t or aboutclients, an approach which may foster new responses to clientsdilemmas in the face of institutional, cultural, ethnic, class and genderdiscrimination. A selective review of literature about writing in therapyand vignettes from my own work in a community mental health clinicsupport this enquiry. Some implications for training are also addressed.

Each of my works is part of my biography.(Foucault, 1988a: 11)

Writing wa s also impor tant in the cu lture of taking care of oneself. O n e of themain features of taking care involved taking notes on oneself to be reread,writing treatises a nd letters to friends to he lp them, and keeping notebooks inorder to reactivate for oneself the trut hs on e needed. Socrates letters are anexample of this self exercise. (Foucault, 198813: 27)Writing and the written text constitute and actively shape our lives,defining our identities and location in the larger social context(Clifford and Marcus, 1986; Roberts, 1994; White and Epston, 1990).In this paper, I will first review examples from the family therapyliterature that use writing as a communication from therapists toclients. I will then consider examples from the literature and from myown work which emphasize writing as a conjoint activity betweentherapist and client. Finally, I propose some questions about writingwhich we can usefully ask trainees and colleagues in supervision.

Writing about clients, the most extensive form of writing in theclinical professions, introduces the notion of how we define clients,therapists, and the relationships among them in the context of powerrelationships. The voices of clients in the writing of therapists arefrequently absent or filtered by the language of academic and

a Assistant Professor, Counseling and Psychology Department, University ofMassachusetts Boston, Graduate School of Education, 100 Morrissey Blvd. Boston,MA 02 125-3393, USA.


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362 Gonzalo Bacigalupeprofessional discourses. This is also the case in this paper; the authorwrites about clients, therapists and doing therapy to communicatewith other therapists, using a language that may be foreign to manyclients themselves.

The question of writing in therapy is also relevant to discussionsabout issues of social justice in therapy contexts (e.g. therapistsworking with minority families). Work in a community mental healthclinic can challenge therapists with questions about gender in-equalities, institutionalized racism, evolving ethnic and culturalvalues and classism. I propose that some of these issues can be mademore visible in a clinical practice that fosters collaborative therapeuticprocesses such as writing with clients.

The therapeutic encounter, including collaborative writing, occursin the context of wider social relationships. Therapy may re-create thesame social relationships that exist outside of the clinical context.Although as therapists we may strive to be neutral, we bring ourparticular values and location in society into the session. What wediscuss and write about with clients is influenced by age, gender, race,social class and our position of often being outsiders to the world ofclients. In this regard, postmodern systemic therapists (e.g. Andersonand Goolishian, 1988; Hoffman, 1993) have recognized the encounterof therapists and clients as being like that of the native and theethnographer in anthropological fieldwork (Clifford and Marcus,1986). However, postmodern family therapists often describe clientsand therapists as equal participants in the telling of stories during thetherapy conversation as if, by entering therapy, they all become equalco-participants in the story-making. In my view, this confuses thelaudable goal of equality with the realities of therapeutic encountersin which unjust social relationships may be reproduced in thetherapeutic encounter.

Writing to clientsWritten communications in family therapy have traditionally beenfrom therapist to client and have been used for a variety of purposes,such as engaging absent members of the family, acknowledgingattendance at therapy, focusing clients attention and clarifyingdirectives (Hare-Mustin and Tushup, 1977) prescribing paradoxicalinjunctions (Selvini Palazzoli et al., 1978), interrupting the externalchaos of the familys daily life (Lown and Britton, 1991: 43 ,communicating post-session thoughts and the teams understanding@ 1996 he Association f o r Family Therapy


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Writing in therapy 363of the problem (Street et al. 1991 summarizing new events (Hudsonand OHanlon, 1991), promoting change in the direction of clientsgoals (Nunnally and Lipchik, 1989), modifying the rules of the systemby reframing the symptom as being preferable to the therapeuticresult (Elkaim, 1985: 152) and terminating treatment (Wojcik andIverson, 1991). Lown and Britton (1991) suggested that letter-writingis effective in joining with the family and in organizing the treatment,enabling the therapist to maintain a sense of control, and creating newopenings in an otherwise stuck system (p. 43).

These authors often emphasize the therapists role in writing inorienting the client in specific directions which the therapist thinksrelevant. I t is a form of writing which pays less attention to the activeengagement of clients themselves in any writing for therapeuticpurposes and places the therapist more in control of ideas andsolutions.

Writing with clientsWriting with clients is designed to encourage participation in therapy.For instance, Kahn and Kahn (1990) encouraged adolescents to writetheir own books, and then to move through the therapeutic process bybecoming experts on their own problem area, such as the death of asibling. In the same vein, Epston (1983) motivated a client to write achapter about her childhood foster-care experience in order to advisewelfare workers. This participatory format challenges the boundariesbetween expert knowledge and local knowledge, making the clientan expert on herself. Therapists can also ask family members to writeto each other, emphasizing the interactive and participatory processoutside of the therapeutic session. Rudes (1992), for example, asked acouple to write letters to one another to aid them in reflecting abouttheir sexual problem without getting into their usual communicationdifficulties. The letters changed the participants punctuation of theirusual interactional exchanges. Thus letter-writing may aid coupleswho overly attune themselves to the unspoken and who experiencetheir relationship as unchangeable and mutually dissatisfying

Few authors have reported clients writing to therapists. Some haverequested clients to observe and make notes so that [clients] canreport back the next session (Nunnally and Lipchik, 1989: 8). Thegoal here has been to search for exceptions to clients description ofthe problem. These authors may, however, be more open to the

(pp. 190-191).

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364 Gonsalo Bacigalupemultiple meanings which clients can ascribe to the texts, andtherapists can be less concerned about orienting clients in one specificdirection and thus encouraging of a more reflexive agenda. This latteragenda is more explicit in the narrative approaches. Narrativetherapists use letters to privilege the persons lived experience, [to]encourage a perception of a changing world [and to] invite a reflexiveposture (White and Epston, 1990: 83). A narrative therapist wouldthen make the letters part of a context in which each participant isconstrued as a co-author of the stories told in and out of the therapyroom.

Similarly, Fox (1983) advocated a therapy that involves writingabout events in the life of the person and building a life-story reportcollaboratively. Biography in this case is ones view of ones ownhistory (Epston, 1986). The therapist and client become pattern-makers rather than pattern-finders as they re-create the past inwritten words. The power of this process may also be based on howmuch effort is placed in making writing an open process. In thisregard, opening up case records for clients to review has been found togenerate a more collaborative relationship between social workers andclients (Doe1 and Lawson, 1986). Penn and Frankfurt (1994) definethe written texts that emerge during the therapeutic process as aparticipant text composed of the voices of the family and thetherapists (p. 217). Writing as part of the therapeutic conversationelicits a reflexive process and fosters the exploration of multiplemeanings. Penn and Frankfurt believe that meanings made visibleduring the therapeutic conversation can be expanded and given voicethrough writing. In a similar way, Wood (1985) proposed writingletters and telling stories to the child on behalf of an imaginary personwho plays the role of co-therapist to understand effectively childrensown view of their world.

Writing with clients may create a setting in which client andtherapist can more actively collaborate. A technique that has proveduseful in my work is to review and write the progress note with clients.Progress notes include an account of what we talked about,assessment of any accomplishments, the therapists reflections orquestions that were not useful, an evaluation of what we want toaccomplish next, questions the client may want to address, etc. Whenthe writing procedures become part of the therapeutic activities, theclient may have a greater opportunity to take a proactive stance intherapy. In a study about the impact of client involvement in caserecording, Badding (1989) found that the practice of case workers and@ 1996 The Association f o r Family Therajy


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Writing in therapy 365clinicians improved if clients became involved in case recording; ithelped clients make more sense of their lives, and they were moreinvolved and felt in more control of the therapy.I will now describe some examples of the usefulness of writing withclients in a community mental health clinic.

A letter to the principalA therapist whom I supervised worked with a fourteen year-old boywho was referred because of rudeness and defiance in the classroom.After a few sessions with the child and a considerable number ofconsultations with teachers, the childs conduct had not changed andhe was not well engaged in the therapy. I suggested that the therapisttalk with the child about larger system issues, and later to write downwhat he said. The therapist suggested during the next session that sheand the child write a letter (a memorandum) to the principal. At thenext meeting, the child began to speak about the unjust conditions athis junior high school. Th e childs comments were recorded by thetherapist, and transcription and editing were worked on later by bothof them.I just wanted to let people know . what it was like to go to school where theteachers and the students had to suffer because the Town did not think wewere worth having what other towns have. A lot of kids have been gettinginto trouble, and teachers think it is because we are lazy, but they never stopto think that we are bored because no one is excited about teaching us.All Ive seen is a lot of mad teachers. People tell me that the teachers are madbecause they are overworked and nobody care about education, specially forLatinos a lot of kids get blamed for what happens at the schools .everybody should know that I am not stupid, I am bored, and I dont haveproblems at home.The principal agreed with the letters content, and the childscredibility improved (though he did not support the therapists andchilds desire to send the letter to a newspaper). Coincidentally, afederal grant increased the amount of resources in the school system.As a result, the school was able to reopen extracurricular activities,including sports, so that school life became less dull and moreinteresting, and the child developed a more positive att itude towardsthe school. The childs sense of agency changed as he saw thepossibilities of using writing to communicate with others and todocument his reality. The writing may have provided another form oftelling others what he felt and how the larger context may be

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366 Gonzalo Bacigaluperesponsible for what powerful adults construe as individual devia-tion.

This example highlights the potential difficulties in working withclients who have a limited writing ability and who may havedifficulties in engaging in the process of documenting their lives. Thetherapist needs, then, to ask how far any letter reflects the therapistsideas rather than the clients. In this particular case, to lessen thistrap the therapist had suggested that the boy record some ideas athome on his own after a tough day at school. Even if the writing isdiscontinuous, awkward, and unfinished, these same characteristicsmay point towards fruitful areas for further exploration (Rasmussenand Tomm, 1992: 7) .

Another relevant dimension is the timing of clients decisions to gopublic about their story. The issue of timing needs careful attention,so that, for example, we can prevent a too early interventiotl thatalienates the participants in the presenting problem (Perry, 1988).This is especially relevant when the clients story is of a traumaticevent and safety is paramount. In the case above, issues of timingwere careftilly evaluated taking into account the risk of the child beingejected from the school as a result of sharing the memorandum.

A last chapterI asked one of my clients to write the last chapter of the first volumeof her memoirs. When I suggested this idea to her, I did not directlyimply the notion of a reconstructed past or a desired future; the taskwas ambiguous, letting her decide the content and its intention. Shewas in the process of alcohol recovery and dealing painfully yet firmlywith memories of incest. Her past was filled with traumatic events:her husbands death, her oldest sons death in a gang-relatedaccidental killing, a long history of victimization by men and thefrustration of having had a daughter whom she could not raisebecause she had been too young to take care of her. Her last chapterincluded a story about parenting her two children, who were living atthat moment with a foster-parent. Being alone at this point in her lifewith someone taking care of her children was construed by herpositively, allowing her to be concerned with her own care. Since thefoster-parent was aware of her role as a temporary caretaker, it easeda revision in therapy of how to be taken care of, who couldtemporarily care for her two children, and it changed negative socialstereotypes about foster parents. The writing fostered an inner@ 1996 The Association fo r Family Therapy


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Writing in therapy 367dialogue with herself in which she valued the possibility of being takencare of versus being the only caretaker. Thus, the foster-parent wasdescribed in her story as an adult who would support her so shewould not have to rely on her children for protection. Th is is a passagefrom that writing:I finally fixed that hole in my sons wall, I guess I know now that I can dosome things for them well, like not drinking now when I feel alone Ivisit three, four, or five groups [AA meetings] . I can get from them thecompany I was just finding in my children I meet some old friends theretoo.Coincident with these writings, the client began to contact her sistersand in-laws whom she had not seen for many years, contacts whichallowed her to see herself as part of a network of family members andwomen survivors also affected by trauma, although they had beencoping with it in a less destructive way. The writing exercise became aform ofjournal writing, although I kept reminding her that i t was stillpart of an unfinished chapter and book, emphasizing the evolvingaspects of story-telling and actual experiences in the present. Thefollowing is an excerpt of that work:Yesterday I came back from Maine, I visited them [two of her sisters], andwe have a wonderful weekend. they told, well I did too, about all that, myfather coming to our rooms in the night we did not talk those nights .but, we closed the door as firm we could. . There was a perpetuallypounded, engulfing and overwhelming silence. The silence to the outsideworld said: Look we have no problems. The silence was to the members ofthe family and screamed DO N O T TALK. Thcy all remember that and forthe first time, in a long time, we said it They told me about missing meall this time and about coming next summer all the girls to have areunion. in the photo we are in that new house [she had inserted a photo],and I left my photo there where I slept. Now I am planning that visit toConnecticut and later to New York. . Now I can face them, again I have aplace there. Someday theyll have one here too.She wrote about her family of origin in a way she had not been able tobefore, and reframed her siblings past in a different light and in thecontext of a hopeful present. Her writing probably reflected some ofthe work being done in the therapy. As Metzger 1992)writes, whenwriting about ourselves or an event that we know well, we sometimesfind that the story itself is going elsewhere . . that i t is taking adirection we never expected (p. 56). For this client, her traumaticstory took a direction that focused on what she could reconstruct@ 1996 The Association for Family Therapy


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368 Gonzalo Bacigalupeanew. For instance, she later wrote a penultimate chapter to the firstvolume that helped her to redefine difficult situations in the light ofprevious traumatic events. She was also able to handle thosesituations in part because she learned new organizing skills throughthe writing. For instance, in one session I suggested the possibility ofdesigning a ritual to mark her childrens return from the foster hometo her home. In the next session, she announced that she had invitedthe foster-mother to have lunch during the childrens weekend visit.At that lunch, she asked the foster-mother about ideas for this ritual,and invited her to the next therapy session.

Writing for this client provided a gentle way of connecting previoustraumatic memories and linking them with the present challenges inher life. As narrative therapists have written, narratives can beanchored in the past and the present or in future projects andexpectations. I n this regard, Parry (1991)has asked clients to write ornarrate the next chapter of their own life story as they would like it tounfold (p. 46 , a more directive approach to the one I employed inthe case described above. Such narratives are the story of a life andthe social history of interconnected lives. In the context of a reflexiveand collaborative therapy, client and therapist become conscious oftheir locations in larger narratives, and of their responsibilities in thecreation of those stories. The written stories in therapy also reflect amultiplicity of voices, an internal dialogue. In a participativetherapeutic process, we reconstruct with the client what she experi-ences as a fixed story, a single-voiced story (Penn and Frankfurt,1994).

I dont know what comes nextA twelve-year-old girl, soon to deliver her first baby, came to thecounselling centre with her mother after the state child protectiveagency mandated counselling. Protective case workers had threatenedthe family with the girls removal from home if she was seen with hereighteen-year-old boyfriend, who stood accused of her statutory rape.The mother reported that her daughters boyfriend has a job and acar, what else does anyone want? Th e mothers ideas were powerfulenough to become the dominant story in the therapy session, althoughthis was a counter-productive story in conversations with protectiveworkers. In both situations, the girl appeared as an object ofinterventions by others. T o counteract this and to foster a more activestance for the girl, I suggested she write a letter to each participant in@ 1996 The ssociation f o r Family Therapq


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Writing in therapy 369the situation. The content and form of the letter were defined by her,but I aided her to reflect upon its effect on the readers. She wrote toher mother, her boyfriend, the child protective agency and to herunborn child. In each letter she asked for forgiveness and requestedtheir collaboration in the future. Although I was not comfortable withthe notion of forgiveness in the case of someone who had beenabused, she felt that it would make sense within the cultural andgender context in which she was located. The following excerpt isfrom the letter she wrote to the child protective agency:Im scared and I dont know how things are going to go, or how they aregoing to get solved, and I dont know ifwriting to you will help. I dont knowwhat to do for the best, nor do I know what to say to the therapist you wantme to visit. The other girls in the school have had their children . and theschool supports them, but I dont want to have more problems. . . You haveto forgive us.

The letters created a less defensive attitude in the other participantsand fostered a better understanding of each ones role as a facilitatoror impeder of change. Following the letters, the participants weremore open to conversations in which their own agendas could betaken into account in the light of the clients and the familys evolvingneeds. The girls letter to her unborn child became a letter to herselfas a child at risk:Somehow, I am afraid of how things could turn out for you, I couldnt let youdown, you have to be happy, not sad, not alone, it will be warm then, nobodywill do things to you, it has to be different.The letters were an invitation for the girl to organize her story anew,and they worked as pragmatic interventions to counteract the well-intentioned yet disciplinary power of all the service providers,including myself as the therapist. The letter to her mother was neversent because the girl felt that her mother was being supportive to herand she was embarrassed to let her mother know how critical she felt.This letter, however, became an important reminder of the themes shecould potentially address with her mother in the future.Its hard to be your daughter now. I wouldnt like to be in your shoes, beingangry and also having to love me. You didnt like him [boyfriend] and nowhe brings something. We havent talk about anything yet, raising this childand all the rest.The letters became a tool for the client to manage her own case andher words became constant reminders of her personhood for the@ 1996 The Association f o r Family Therapy


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370 Gonzalo Bacigalupeprofessionals who usually describe clients in the language of psycho-pathology and/or systems.

In these examples, writing aided in redefining an aspect of theclients identities and relationships with the larger context and inredefining complex dilemmas in the past or the present. Writing withclients invited a critical analysis of the larger context and anempowering resolution of clients dilemmas in a supportive milieurather than representing a technical manoeuvre managed by thetherapist.

Addressing writing in therapy in a training/supervisory contextTo engage in dialogue with trainees or supervisees about therelationship between writing and therapy, I designed a set ofquestions aimed at qucstioning taken-for-granted writing about andto clients. The underlying rationale for each question emerged fromconversations with therapists in training and in supervision; thequestions are used as need arises.

Addressing the impact o f writing in professional practiceThe following questions introduce the importance of writing in thetherapeutic process and highlight the therapists attention to the linkbetwccn writing procedures and treatment decisions. H ow would yourclinical practice change ifyou were not to take notes during or after the therapysession? How would yo ur practice be differen t i fyou had access to a transcript ofeach session?Addressing issues o f empathy , respect and the client-therapist relationshipFirst, clinicians can explore the oppressive dimensions of casedocumentation and issues of power, such as the distance createdbetwccn the lived experience of clients and the clinicians notesthrough the use of technical words and abstractions. If yo ur clients wereto readyour3les, reports, or any written communication about them, would theyunderstand the contents and intentions ofyour writing? Another possibility isto imagine the clinician in the clients position, or in family therapy, toreflect on the weight given to each members agenda. I f yo u wereyourclient, would yo u like to be pictured in the text as you represented yo ur client? I nthe case o f a letter written to a fa mi ty , how would yo u react f y o u were aparticular member o f that famity?

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Writing in therapy 37 1Addressing the link between institu tional practices and the therapeutic sessionThe following questions address the degree to which the clientparticipates in treatment decisions. H o w would you describe the access oyour clients to yo ur writing about them i n jiles? W hat are y o u r thoughts aboutyour clients participation in the documentation and design o their therapy? Aform of future questioning may allow therapists to imagine possiblescenarios in which writing becomes a participatory process, and inwhich they become confident about sharing the documentationprocess. What would the issues be in the therapeutic relations hi^ i thedocumentation o f the therapy was kept in clients homes instead o f in theclinic?Addressing institutional limitations in therapyInstitutional values and organizational preferences frequently limitthe perspectives we may take and may determine the process,duration, themes and assumptions underlying the therapy. Accord-ingly, to help in expanding the limits imposed in particular contextson the therapy, i t is important to clarify the institutional contextunder which clinicians work at the moment of writing and practisingtherapy. The following questions foster clinicians awareness of theirinternal dialogue and to whom they respond in the therapy. Ho w mucho y o u r writing is done having in mind supervisors, colleagues, clients, insuranceco~panies ,~ourna leview board members, etc.? I f you were presenting the casein the context o f a paper or conference presentation, what would your clientsreaction be i f they were spectators or readers?Addressing therapists stories and their connection with clients storiesThere is the potential for therapists as well as clients to see themselvesas storied individuals, their lives as an evolving text. I f y o u were to writea novel ofyour life , wh at would the title be? In that novel, what chapter s) wouldinclude your clients? I f you were to ask yo ur clients, what chapter s) would youoccupy in their novel? W ha t have you learned f r o m this client and previous clients?How would you wri te about the experience o f learning f r o m clients? I havefound these questions very useful in encouraging therapists to reviewthe influence clients have had on them. Being able to map the clientseffect on the therapist is a relevant task, particularly when workingwith supervisees who have to addrcss power issues in work withsurvivors of abuse. violcncc and trauma.@ 1996 The ssociation Jar Family Therapy


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372 Gonzalo BacigalupeConclusionWriting can play an important role in aiding clients and therapists toinclude multiple voices and diverse positions in their communications.Writing in systemic therapy can help clients to distance themselvesfrom problem-saturated descriptions, mobilize multiple meanings andvoices and facilitate the re-storying of their dilemmas. It encouragesclients to choose written communication either as an invitation to areflexive conversation, as a direct intervention in the search forchange, or both.

Hopefully, these ideas challenge the tendency to perceive therapists'mission as isolated from a commitment to social justice. T hemovement from writing about and to clients to writing with clients is astep forward in integrating collaborative, reflexive and liberatingaspects of postmodern systemic therapy. This kind of writing does notnecessarily provide a complete solution to the complex dilemmas ofaddressing social -justice in therapy, but it may counteract proceduresinsensitive to the commitment to a therapy of partnership.

AcknowledgementsI would like to thank ,Janine Roberts, Patricia Romney, AnnFerguson, Pilar Hernandez and Shelley Green for their contributionsto this paper.

ReferencesAnderson, H . and Gool ish ian , H. (1988) H um an systems as linguistic systems:preliminary and evolving ideas about the implications for clinical theory. FamilyProcess, 27: 37 1-393.Bad ding, N . (1989) Client involvement in case recording. Social Casework: The Journal

o Contemporary Social Wor k, 70: 539-548.Clifford, J a n d M a r c u s, G . F. (eds) (1986) Writing Culture: The Poetics and Politics ofEthnography. Berkeley: University of California Press.I h e l , M . and Lawson , H (1986) Op en records: the cl ient s right to pa rtnership.British Journal o Social Work, 6: 407-430.Elkaim, M . (1985) From general laws to singularities. Family Process, 24: 151-164.Epston , 1 . 1983) Cheryl-Anne s new autobiogra phy. Australian Journal o FamilyEpston , 13 1986) Writ ing your biography. Family Therapy Case Studies, 1 1): 13-18.Foucaul t , M. 1988a) T ru th , power, self an interview with Michel Foucault . InL. M a r t i n , H . G u t m a n a n d P. H u t t o n ( e d s ) , Technalogiegies o the Self (pp. 9-15).Amherst , MA: Universi ty of' M assachu set ts Press.

Therapy, 4 (4 ): 259-261.

@ 1 096 The A c c ociatinnb r Family Theraby


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Writing in therapy 373Foucault, M . (1988b) Technologies of the self. In L. M a r t i n , H . G u t m a n a n dP. Hutton (eds), Technologies ofthe SeEf(pp. 16-49). Amherst , MA: Universi ty ofMassachusetts Press.Fox, R. (1983) The past is always present: creat ive method for capturing the l i festory. Clinical Social Wor k Journal, : 368-378.Hare-Must in , R. and T ush up , R . (1977) Main ta in ing a sense of contact with thepat ient during therapist absences. Journal of Clinical Psychology, 33 (2): 531-534.Hoffman, L. (1993) Exchanging Voices: A Collaborative Approach to Family Therapy.London: Ka rna c Books.Hudson, P. an d OH anlon, W . (1991) Rewriting Love Stories: Brief Marital Therapy. NewYork: Norton.Kahn, B. and K ah n, W. (1990) I am the au tho r of books. Elementary School Guidance

and Counseling, 25 (2): 153-157.Lown, N. and Bri t ton, B . (1991) Engaging families through the letter writingtechnique. Journal o f Strategic and Systemic T herapies, 10 (2): 43-48.Metzer, D. (1992) Writ ing oryour Li fe . San Francisco: HarperCol l ins .Nunnally, E . a nd Lipch ik, E. (1989 ) Som e uses of writing in so lution focused briefParry, A. (1991) A u niverse of stories. Family Process, 30: 37-54.Penn, P. an d Frankfu rt , M . (1994) Cr ea t ing a part icipan t text . Writ ing, mult iplevoices, narrativ e mu ltiplicity. Family Process, 33: 21 7-231.Perry, R . (1988) Inst rum en ts of instant chang e? A quest ion of t iming. Australian and

Ne w Zealand Journal o f Family Therapy, 9 2 ) :89-94.Rasmussen , P . a nd T om m , K . (1992) Guided le tter writ ing: a long brief therapymethod. Journal of Strategic and Systemic Therapies, 4) : 1-18.Roberts, J. (1994) Tales and Transformations: Stories in Families and Family Therapy. NewYork: Norton.Rudes, J 1992) Interactional letters: a reorganization of a couples communication.

Journal o f Marital and Family Therapy, 8: 189-192.Selvini Palazzoli, M., Boscolo, C., Cecchin, G. a n d P ra t a , G. (1978). Paradox andCounterparadox. New York: Jason Aronson.Street, E., Downey, J and Brazier , A. (1991) T h e development of therapeut icconsultations in child-focused family work. Journal of Family Therapy, 13, 31 1-334.White, M. and Epston, D. (1990) Narratzue Means for Therapeutic Ends. New York:Norton.Wojcik,J an d Iverson, E. (1991) Th era pe utic let ters: the power o f th e printed word.Journal o f Strategic and Systemic Therapies, : 77-8 1Wood, A. (1985) King Tiger and the roar ing tummies: a novel way of helpingchildren and their families change. Dulwich Centre Reuiew: 4 1-49.

therapy. Journal of Independent Social Work, 4 (2 ) : 5-20.

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writing in therapy a participatory approach

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