A Qualitative Study of Good-Bye Letters in Prison Therapy

Background: Self-harm rates among imprisoned women in the UK are extremely high and there are limited psychological therapies available to support them in prison. This paper presents women's subjective accounts of receiving good-bye letters at the end of brief psychodynamic interpersonal therapy (PIT) and how these letters positively impacted on their incidents of self-harm. Aims: This study presents the accounts of 13 imprisoned women who self-harmed and received letters following completion of a minimum of four sessions of brief PIT in prison. Method: A semi-structured interview covered several aspects of their experience, which included details of self-harm since completing brief therapy as well as usage of a good-bye letter and its impact. The interviews were analyzed using thematic analysis. Results: Three themes emerged from the analysis: connecting with the therapist: receiving the letter; connecting to self: understanding and awareness; and connecting to others: sharing the good-bye letter. Conclusion: Findings show the positive impact the letters had for the women following therapy. The preliminary impressions suggest that letters may be a helpful tool enhancing the benefits of brief PIT therapy with imprisoned women who self-harm.