A Twice−Told Ending: Goodbye Letters in Cognitive Analytic Therapy

 CAT theory proposes that the preparation and exchange of goodbye letters plays an important role in managing the ending of therapy and "ending well". However, there is very little research into patients’ experiences of goodbye letters and, so far as the researchers are aware, there is no research into therapists’ experiences of goodbye letters.

The aim of the research study is to explore and describe the experience of writing and receiving goodbye letters in CAT from the perspectives of patients and their therapists. Each patient and therapist participant will complete a short satisfaction questionnaire in relation to the therapy and its ending, followed by a detailed semi-structured interview. The interview data will be analysed using Interpretative Phenomenological Analysis (IPA), which is a qualitative method of analysis that aims to explore systematically and in detail participants' personal perspectives and experiences.

The intended sample size is four to five therapists with two patients each (i.e. a total of four to five therapists and eight to ten patients).

The research will take place in the CAT service of the adult outpatient Halliwick Psychotherapy Department at St Ann's Hospital, London N15 3TH. The study is Henry Clements’ research project for his Doctorate in Clinical Psychology and is being supervised by Shirley Akgun, Consultant Specialist in Psychotherapy at the Halliwick Psychotherapy Department, and Dr Nancy Pistrang, Senior Lecturer in Clinical Psychology at University College London.

Call for research

So far as the researchers are aware, only two studies to date have examined goodbye letters. The first is an unpublished study (Rayner (2005)) that used grounded theory to study nine patients’ experiences of CAT tools. The second is a study by Hamill et al (2008) which examined patients’ experiences of letters in CAT. The researchers would be very interested to receive details of any other ongoing or completed studies in relation to goodbye letters.


Data collection will start in summer 2008 and it is anticipated that the research will be completed by June 2009.

Contact Details

Further information about the study can be obtained from Henry Clements, Trainee Clinical Psychologist, University College London, tel: 07877 127863, email: henry.clements@hotmail.co.uk

November 2014 Update:
Research completed but not yet published

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