Therapeutic Letters and the Family Nursing Unit
Identifieur interne : 000B73 ( Istex/Corpus ); précédent : 000B72; suivant : 000B74Therapeutic Letters and the Family Nursing Unit
Auteurs : Janice M. Bell ; Nancy J. Moules ; Lorraine M. WrightSource :
- Journal of Family Nursing [ 1074-8407 ] ; 2009-02.
Abstract
This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.
Url:
DOI: 10.1177/1074840709331865
Links to Exploration step
ISTEX:E0F3A168B0D6699066DBC3DA54AF09F8101A8A6ALe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Therapeutic Letters and the Family Nursing Unit</title><author><name sortKey="Bell, Janice M" sort="Bell, Janice M" uniqKey="Bell J" first="Janice M." last="Bell">Janice M. Bell</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jmbell@ucalgary.ca</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada, jmbell@ucalgary.ca</mods:affiliation></affiliation></author><author><name sortKey="Moules, Nancy J" sort="Moules, Nancy J" uniqKey="Moules N" first="Nancy J." last="Moules">Nancy J. Moules</name><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation></author><author><name sortKey="Wright, Lorraine M" sort="Wright, Lorraine M" uniqKey="Wright L" first="Lorraine M." last="Wright">Lorraine M. Wright</name><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1177/1074840709331865</idno><idno type="url">https://api.istex.fr/document/E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000B73</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000B73</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Therapeutic Letters and the Family Nursing Unit</title><author><name sortKey="Bell, Janice M" sort="Bell, Janice M" uniqKey="Bell J" first="Janice M." last="Bell">Janice M. Bell</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jmbell@ucalgary.ca</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada, jmbell@ucalgary.ca</mods:affiliation></affiliation></author><author><name sortKey="Moules, Nancy J" sort="Moules, Nancy J" uniqKey="Moules N" first="Nancy J." last="Moules">Nancy J. Moules</name><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation></author><author><name sortKey="Wright, Lorraine M" sort="Wright, Lorraine M" uniqKey="Wright L" first="Lorraine M." last="Wright">Lorraine M. Wright</name><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>University of Calgary, Alberta, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Family Nursing</title><idno type="ISSN">1074-8407</idno><idno type="eISSN">1552-549X</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage CA: Los Angeles, CA</pubPlace><date type="published" when="2009-02">2009-02</date><biblScope unit="volume">15</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="6">6</biblScope><biblScope unit="page" to="30">30</biblScope></imprint><idno type="ISSN">1074-8407</idno></series><idno type="istex">E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A</idno><idno type="DOI">10.1177/1074840709331865</idno><idno type="ArticleID">10.1177_1074840709331865</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1074-8407</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.</div></front></TEI><istex><corpusName>sage</corpusName><author><json:item><name>Janice M. Bell</name><affiliations><json:null></json:null><json:string>E-mail: jmbell@ucalgary.ca</json:string><json:string>University of Calgary, Alberta, Canada, jmbell@ucalgary.ca</json:string></affiliations></json:item><json:item><name>Nancy J. Moules</name><affiliations><json:string>University of Calgary, Alberta, Canada</json:string><json:string>University of Calgary, Alberta, Canada</json:string></affiliations></json:item><json:item><name>Lorraine M. Wright</name><affiliations><json:string>University of Calgary, Alberta, Canada</json:string><json:string>University of Calgary, Alberta, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>therapeutic letters</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Family Nursing Unit</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Family Systems Nursing</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>family nursing intervention</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>illness suffering</value></json:item></subject><articleId><json:string>10.1177_1074840709331865</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>other</json:string></originalGenre><abstract>This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.</abstract><qualityIndicators><score>7.792</score><pdfVersion>1.7</pdfVersion><pdfPageSize>396 x 612 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>420</abstractCharCount><pdfWordCount>10440</pdfWordCount><pdfCharCount>56690</pdfCharCount><pdfPageCount>25</pdfPageCount><abstractWordCount>66</abstractWordCount></qualityIndicators><title>Therapeutic Letters and the Family Nursing Unit</title><genre><json:string>other</json:string></genre><host><volume>15</volume><publisherId><json:string>JFN</json:string></publisherId><pages><last>30</last><first>6</first></pages><issn><json:string>1074-8407</json:string></issn><issue>1</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1552-549X</json:string></eissn><title>Journal of Family Nursing</title></host><categories><wos><json:string>social science</json:string><json:string>nursing</json:string><json:string>family studies</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>nursing</json:string></scienceMetrix></categories><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1177/1074840709331865</json:string></doi><id>E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Therapeutic Letters and the Family Nursing Unit</title><title level="a" type="sub" xml:lang="en">A Legacy of Advanced Nursing Practice</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>SAGE Publications</publisher><pubPlace>Sage CA: Los Angeles, CA</pubPlace><availability><p>SAGE</p></availability><date>2009</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Therapeutic Letters and the Family Nursing Unit</title><title level="a" type="sub" xml:lang="en">A Legacy of Advanced Nursing Practice</title><author xml:id="author-1"><persName><forename type="first">Janice M.</forename><surname>Bell</surname></persName><email>jmbell@ucalgary.ca</email><affiliation></affiliation><affiliation>University of Calgary, Alberta, Canada, jmbell@ucalgary.ca</affiliation></author><author xml:id="author-2"><persName><forename type="first">Nancy J.</forename><surname>Moules</surname></persName><affiliation>University of Calgary, Alberta, Canada</affiliation><affiliation>University of Calgary, Alberta, Canada</affiliation></author><author xml:id="author-3"><persName><forename type="first">Lorraine M.</forename><surname>Wright</surname></persName><affiliation>University of Calgary, Alberta, Canada</affiliation><affiliation>University of Calgary, Alberta, Canada</affiliation></author></analytic><monogr><title level="j">Journal of Family Nursing</title><idno type="pISSN">1074-8407</idno><idno type="eISSN">1552-549X</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage CA: Los Angeles, CA</pubPlace><date type="published" when="2009-02"></date><biblScope unit="volume">15</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="6">6</biblScope><biblScope unit="page" to="30">30</biblScope></imprint></monogr><idno type="istex">E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A</idno><idno type="DOI">10.1177/1074840709331865</idno><idno type="ArticleID">10.1177_1074840709331865</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>therapeutic letters</term></item><item><term>Family Nursing Unit</term></item><item><term>Family Systems Nursing</term></item><item><term>family nursing intervention</term></item><item><term>illness suffering</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="other" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">spjfn</journal-id><journal-id journal-id-type="publisher-id">JFN</journal-id><journal-title>Journal of Family Nursing</journal-title><issn pub-type="ppub">1074-8407</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage CA: Los Angeles, CA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/1074840709331865</article-id><article-id pub-id-type="publisher-id">10.1177_1074840709331865</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Therapeutic Letters and the Family Nursing Unit</article-title><subtitle>A Legacy of Advanced Nursing Practice</subtitle></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bell</surname><given-names>Janice M.</given-names></name><aff>University of Calgary, Alberta, Canada, <email xlink:type="simple">jmbell@ucalgary.ca</email></aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Moules</surname><given-names>Nancy J.</given-names></name><aff>University of Calgary, Alberta, Canada</aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Wright</surname><given-names>Lorraine M.</given-names></name><aff>University of Calgary, Alberta, Canada</aff></contrib></contrib-group><pub-date pub-type="ppub"><month>02</month><year>2009</year></pub-date><volume>15</volume><issue>1</issue><fpage>6</fpage><lpage>30</lpage><abstract><p>This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.</p></abstract><kwd-group><kwd>therapeutic letters</kwd><kwd>Family Nursing Unit</kwd><kwd>Family Systems Nursing</kwd><kwd>family nursing intervention</kwd><kwd>illness suffering</kwd></kwd-group><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Letter</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>6 Therapeutic Letters and the Family Nursing UnitA Legacy of Advanced Nursing Practice SAGE Publications, Inc.200910.1177/1074840709331865 Janice M.Bell University of Calgary, Alberta, Canada, jmbell@ucalgary.ca Nancy J.Moules University of Calgary, Alberta, Canada Lorraine M.Wright University of Calgary, Alberta, Canada This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention. therapeutic letters Family Nursing Unit Family Systems Nursing family nursing intervention illness suffering In the Family Nursing Unit (FNU), University of Calgary, we have used therapeutic letters as a Family Systems Nursing intervention for more than 22 years and written hundreds of letters to families (Levac et al., 1998; Moules, 2000, 2002, 2003, 2009b [this issue]; Moules, Thirsk, & Bell, 2006; Wright & Bell, in press; Wright & Simpson, 1991; Wright & Watson, 1988; Wright, Watson, & Bell, 1996). It has been noted in FNU Watson, 1988; Wright, Watson, & Bell, 1996). It has been noted in FNU outcome studies and in-session comments that families report a valuing and appreciation of the letters and, in many instances, attribute the letter with substantial credit for therapeutic change and softening of illness suffering in the context of their clinical work. Prior to the doctoral research by Moules in 2000, therapeutic letters had not been studied in nursing, although they have been presented in clinical and theoretical family nursing literature surrounding the clinical work of Lorraine Wright, Wendy Watson, Authors' Note: Address all correspondence to Dr. Janice M. Bell, 12224 Okanagan Centre Rd. West, Okanagan Centre, British Columbia, Canada V4V 2H5; e-mail: jmbell@ucalgary.ca; Web site: www.janicembell.com. 7 and Janice Bell (Wright et al., 1996; Wright & Watson, 1988), Lorraine Wright and Maureen Leahey (1994, 2000, 2005, 2009), and Family Systems Nursing graduates who completed one or more practicums in the FNU (Harper-Jaques & Masters, 1994; Marshall & Harper-Jaques, 2008; Wright & Simpson, 1991). The history and use of therapeutic letters in the advanced nursing practice of the FNU will be described in this article, examples of a variety of therapeutic letters written in the FNU will be offered, and a case exemplar from the research of Moules (2000, 2002) will be used to illustrate the usefulness of this family nursing intervention with families suffering in their experience of serious illness. The Use of Therapeutic Letters in Clinical Work The literature on therapeutic letters is primarily clinically based and descriptive. The term and the specific practice of therapeutic letters are generally attributed to the domain of narrative therapy and specifically to the work of David Epston and the late Michael White (Epston, 1989; White, 1995; White & Epston, 1990). Epston first experienced using letters in 1977 in a psychiatric outpatient clinic. Epston (1994) offered that the purposes of letters include offering summaries of clinical work that privilege clients' stories over medical documentation, creating opportunities for future reflection and discussion, allowing for salvaging of “bad” sessions, acknowledging of clinician “mistakes,” allowing for clarification of confu- sion and transparency of thinking, creating more possibilities for both client and clinician reflection, and as vehicles to communicate difficult ideas that might be more easily heard and absorbed when read privately. Wojcik and Iverson (1989) wrote of letters as a means to provide empha- sis and punctuation; to create a sense of drama; to provoke; to appease families and decrease clinicians' defensiveness by allowing opportunity for explanation; to offer hypotheses, interpretation, or the ability to strategize for solutions; and finally to terminate with clients. Although the authors speculated on the “power of the printed word” (p. 77), they admitted to a lack of understanding of the source of the power. Shilts and Ray (1991) referred to their use of letters as a strategic inter- vention with a specific intent “to engage clients in therapy, promote coop- eration, and find solutions to their presenting problems” (p. 98). Other strategic uses of letters include attempts to change the rules of family sys- tems (Elkaim, 1985); to engage nonattending spouses (Wilcoxen & Fenell, 1983); to increase the effect of therapy and serve as a record (Wood & Uhl, 8 1988); as a means to offer information prior to an initial session (Coles, 1995); as a vehicle to offer other mediums such as cartoons, which might invoke questions and dilemmas that represent a client's own (Kennedy, 1995); as a way to provide teaching, information, and normalizing to clients who have experienced sexual abuse (Harper-Jaques & Masters, 1994); or as a means for the clinician to organize treatment and maintain a sense of control (Lown & Britton, 1991). Clinical Scholarship of the Family Nursing Unit, 1982-2007 Advanced nursing practice in the FNU is focused on illness suffering and family healing. The FNU was established in 1982 by Dr. Lorraine Wright as a research and education unit for the purpose of creating and dis- seminating practice knowledge with families suffering with serious illness (Bell, 2008; Flowers, St. John, & Bell, 2008; Gottlieb, 2007; Wright et al., 1990; Wright, Watson, & Duhamel, 1985). Wright first coined the term Family Systems Nursing and later published an article with Leahey in 1990 that offered distinctions between family nursing and Family Systems Nursing, with the latter emphasizing the family system as the unit of assess- ment and intervention. Over time, an evolved understanding of Family Systems Nursing asserts that it is an advanced practice with attention to the reciprocity and interaction between multiple systems levels: illnesses, indi- vidual family members, family systems, and larger health care and societal systems. The ability to think “relationally” or “systemically” and assess multiple systems levels, while intervening at the systems level that offers the greatest leverage for health and healing, is one of the hallmarks of Family Systems Nursing. A preference for collaborative, strengths-based relationships with families and a belief in the legitimacy of multiple reali- ties (Maturana & Varela, 1992) also characterize this nursing practice. Clinical scholarship in the FNU (Bell, 2003) resulted in the development of two advanced nursing practice models known as the Illness Beliefs Model (Wright & Bell, in press; Wright et al., 1996) and the Trinity Model (Wright, 2005). The clinical practice of the FNU is also foundationally grounded in two models for generalist family nursing practice—the Calgary Family Assessment Model and the Calgary Family Intervention Model (Wright & Leahey, 2005, 2009). Out of many domains of family function- ing, this approach to clinical practice pulls to the foreground an emphasis on beliefs, recognizing that family members as well as health care professionals 9 have beliefs that facilitate and those that constrain in the ways they influence lives, relationships, behavior, and illness suffering. Beliefs that are con- straining can be explored, challenged, and altered; those that are facilitating can be acknowledged, reinforced, and amplified (Wright & Bell, in press; Wright et al., 1996). The Trinity Model conceptualizes the intertwining of beliefs, illness suffering, and spirituality (Wright, 2005) and offers inter- ventions for witnessing and acknowledging illness suffering and inviting spiritual conversations that may soften illness suffering. Clinical sessions in the FNU were observed from behind a one-way mir- ror by a clinical team, composed of faculty members and graduate nursing students, at master's and doctoral levels. The clinical team participated in the interviews by telephoning to the interview room with ideas and ques- tions, as well as in presession and postsession discussions. The belief of the clinical team in the benefit of “multiple minds” combined with the belief that “we are all in this together—in our desire to learn from and be helpful to families” created a synergistic collaboration for both the clinician con- ducting the session with the family and the team observing from behind the one-way mirror (Flowers et al., 2008). The structure of clinical work was based on the five-part session first suggested by the Milan family therapy team (Tomm, 1984). The interpretation of this five-part session in the FNU consisted of a presession conversation between the clinical team members; the clinical therapeutic conversation with the family and clinician; an intersession, in the form of offering a “reflecting team” (Andersen, 1991), where the family observed the team members discuss their observations and reflections amongst themselves; a concluding discussion with the fam- ily; and a postsession clinical team discussion. The clinicians for the family were faculty members, doctoral students, or 2nd-year master's students; and all sessions received live supervision by a faculty member. All clinical sessions, as well as the clinical team's presession and postsession, were videotaped after consents were obtained from family members and stu- dents. On average, families received an average of four to five sessions. After celebrating 25 years of clinical scholarship and learning from families, the FNU was closed in December 2007 (Bell, 2008). This advanced practice knowledge continues to live on through the offering of Family Systems Nursing specialization at the University of Calgary and the University of Montreal; through ongoing research and case studies from the archived clinical database of the FNU; and through the clinical practice, research, and teaching of faculty members of the FNU and more than 100 master's and doctoral graduates in Family Systems Nursing as well as hun- dreds of international nurses who have participated in the annual Family Nursing Unit Externship workshops. 10 The incorporation of therapeutic letters in clinical practice has existed in the FNU for more than 22 years (Wright et al., 1996; Wright & Simpson, 1991; Wright & Watson, 1988). The FNU clinical team of graduate nursing students and faculty members employed the influence of letters to create opportunities for more collaborative and transparent therapeutic relation- ships with client families. Letters provided opportunity to offer “commen- dations” or acknowledgments of individual and family strengths, describe what the family taught the nurse clinician, emphasize and punctuate in-session ideas, offer new ideas and questions, distinguish and amplify change, chal- lenge “constraining beliefs” and solidify “facilitating beliefs,” admit a thera- peutic error, and actively challenge the clinician's own ideas and beliefs (Wright et al., 1996). A Conversation of History: Letters in the Family Nursing Unit In fact, history does not belong to us, we belong to it. (Gadamer, 1989, p. 276) A unique advantage and opportunity occurred in the research of Moules (2000) by having Dr. Lorraine Wright, founder of the FNU and director of the FNU (1982-2002), as a research participant. This allowed for a portion of the interview to focus on the evolution and practice of letter writing in the unique context of the FNU, as well as the extraordinary opportunity to interview an accomplished and sophisticated clinician, who at the point of Moules's doctoral thesis had more than 15 years of clinical experience in writing therapeutic letters to families. In situating the context for letter writ- ing in the FNU, it is important to remind ourselves that we are historical, that how letters evolved in the FNU is important to how they are practiced now. “LMW” refers to Dr. Lorraine Wright; and “NJM” refers to Dr. Nancy Moules, who conducted this research interview. LMW: I think the first time we ever published [Wright & Watson, 1988] about the use of therapeutic letters was in 1988, so it would have been a couple of years before that. I remember that family very well because of the letters. Because that was really the most dramatic thing about the work with this family. We wrote letters separately, one to the daughter and one to the mother and they were just—she just came in holding this letter, like this, waving it like this . . . 11 NJM: And when you first started, was it something that you had read about in other literature in other family therapy literature, is it something you had heard about at all in other people's practices, or was it something that you just sort of stumbled onto? LMW: At that time it was just something we stumbled onto. But it was later after that that I became aware of David Epston, much later . . . NJM: Oh, so you didn't use the word therapeutic letters? LMW: No. You know I can't remember just how we came and . . . because it certainly wasn't something that was a routine part of our practice, like it is now. What I remember is we used to use the letter and what we did with this particular family to offer a split opinion instead of just offering it in the ses- sion, we would offer them a split opinion in a letter. NJM: Why did you choose that particular way to do that instead of offering it in session? LMW: Well, because we thought it would have more impact—that they could think about it, especially for families where there was really entrenched beliefs. NJM: At that time did you use letters with things other than split opinions? LMW: Yes, we did on occasion. I've never gone back and done any kind of historical review about therapeutic letters in the FNU, but then it was later that we began to became aware of David Epston and Michael White's work and especially David Epston, his use of them every single session. And they were using them in a bit of different way. NJM: What's your personal belief around what kind of contribution do you think they make in the clinical work? LMW: Well, when I look at our clinical work and when I hear back from fami- lies, verbally, or their reactions you know from session to session, or what they say to us on the outcome study, I'd have to say that the three interven- tions that really seem to stand out, that they seem to most readily comment on are; if I had an order, it would reflecting teams and therapeutic letters are tied for number one, and I'd say the use of commendations. NJM: But those [commendations] are woven into both of those. LMW: And they're woven in; they're embedded within those interventions, but those are the things that I hear family members commenting on the most and then after that what they comment on the most is the kinds of questions that we ask. NJM: Which is another thing, like commendations, it's more of a microanalysis of what happens in the letters and the reflecting teams, isn't it? LMW: I was thinking in the terms of therapeutic letters, I mean what is always so interesting to me is with any of those three ideas is that all of those inter- ventions are ways of challenging constraining beliefs, in a way that makes it more palatable to the families instead of just confronting someone, or taking them on directly or what not. It's like it lifts it into another medium. 12 NJM: Well you've written in the Beliefs book [Wright et al., 1996] and also, you read the anecdotal type of reports about how families and clinicians report the value of a therapeutic letter. I'm not sure I find this particular measure- ment a really useful one for me, but I've been asking it of everybody along, in terms of a therapeutic letter being equivalent in value to 3 to 10 clinical sessions. My guess is that it's such an individual answer, it really depends on each family, but if you could just slip into generalizing around it, in your opinion, what would you say one therapeutic letter is worth? LMW: I don't know that I could go so far as to say it's worth 10; but I'd cer- tainly say, that it has the potential, that every therapeutic letter is equal to one therapeutic conversation, to one clinical interview. NJM: So it doubles the interview? LMW: Depends on . . . there's the skill and the expertise of the person writing the letter, the clinician who's writing them. Some just really recap the ses- sion, which sometimes, in and of itself, that's useful too, for family members to really have that historical perspective, 'cause it's impossible to really remember all the things. And to me it's another way of getting at what per- turbed them in the session, because that question of what stood out for them, I think can be answered more clearly when the session's really recapped, for them again in writing. It's like they've had two opportunities to think about the session, what they reflected on in that moment, and what they reflect on again after they've left, because to me that's one of the most significant things about the letters. It's another invitation to another reflection—about their lives, about the session, about the problems they are concerned about. NJM: Would you say that that's the biggest thing that therapeutic letters do is offer that invitation then? LMW: To another reflection? Yes. To another reflection to invite them to chal- lenge their own beliefs that may be troubling, that they're suffering around. To see it in writing takes on a whole different flavor and a whole different meaning. NJM: Can you speculate why? LMW: I think anything you read is more penetrating than the spoken word. NJM: And how do you think you came to that belief? LMW: I guess from my personal experiences with words on paper, as opposed to words verbally. There's always exception to the rule. . . . I think it's more lasting somehow when it's written. That it stays with you longer . . . the beauty of being able to go back to the written word. That you can't always capture, and sometimes you're trying to remember, now how did that person say that to me, and what was it that they said exactly, but if you have a letter, it's that wonderful thing of being able to go back to the way it was actually said, rather than the way you think it was said, or the way you think you remembered it. And I think in lots of relationships that's what gets us into a lot of trouble with each other is what we retain. I mean that's usually what 13 people argue over “you said; no I didn't; I said, no you didn't, you said.” And we go around and round about that, about what we think our memory of the words that were spoken that were very meaningful to us or that were hurtful to us, or that were disappointing, and we try to recapture a conversation . . . with the written word you can go back. We do give such value to the written word in our society, way more than the oral tradition, in our particular culture anyway. NJM: But it's interesting to me about, just because you put something into writ- ing though, doesn't protect it from being misinterpreted, does it? LMW: Oh no, it doesn't protect it from that but there's something about the ability to keep going back and back to it in the way it was sent. 'Cause I find verbally, you can keep going back and back to what you thought was said, what you thought the message was, what you thought you heard, but the beauty here is I can't change that. NJM: Both the beauty and the risk, the danger. LMW: Yes, very much, 'cause we can always modify. I mean we're always say- ing to each other, “Well gee if I did say that I didn't quite mean it that way.” You can't do that in a letter. You can't deny you said it. NJM: Or if I did I didn't mean it. LMW: Well, you can do that in a letter, well “Did I say that? Well, I didn't really mean to word it that way.” But it stays, it's there, it can't be removed in the same way. Types of Therapeutic Letters Written in the Family Nursing Unit With the exception of the “closing letter,” which denoted the end of the clinical work with the family, not all families received therapeutic letters during their clinical work at the FNU, or after every clinical session. Generally, it was decided in the clinical team's postsession discussion to send a family a letter, a decision at times initiated by the clinician, a team member, or the faculty supervisor. This decision seems to be related to some indication that the family might find a letter useful, the perception that the family might benefit from clarification of the session (see Table 1 for an example of a between-session therapeutic letter), the intention to invite nonattending family members (see Table 2 for an example of a thera- peutic letter to an absent family member), the admission of a therapeutic “error” (see Table 3 for an example of a letter admitting a therapeutic error), the intention to summarize the multiple ideas offered in the reflecting team, or creating an opportunity to offer further ideas that developed during the postsession discussion. At the termination of the clinical work, all families 14 received a “closing letter,” which follows a more structured format, describ- ing to the family what the team learned from them over the course of the clinical work and what the team believed they offered the family (see Tables 4 and 5 for examples of a closing therapeutic letter). With the fam- ily's permission, a copy of the closing letter was usually sent to the referral source. Typically, an FNU therapeutic letter would include the following ele- ments: distinguishing individual and family strengths through the offering of commendations (Bohn, Wright, & Moules, 2003; Houger Limacher & Wright, 2003, 2006; Wright & Bell, in press; Wright et al., 1996; Wright & Leahey, 2005, 2009), highlighting significant conversational events, offer- ing reflections of the clinician and the clinical team, posing additional ques- tions offered either as outcomes of these reflections or with the intent to challenge “constraining beliefs” and invite family members to a new reflec- tion, and celebrating therapeutic change and distinguishing new “facilitat- ing beliefs” (Wright et al., 1996). Rather than the letter simply being a summary of the session, the challenge was to offer something “different” in the letter—some “news of difference” (Bateson, 1979). The news of differ- ence needed to be carefully calibrated—not too slight a difference so that it went unnoticed, but not too large a difference or too many different ideas so that the family members could reflect without feeling like they were, in the words of one overwhelmed father, “drinking water from a fire hose”! The ideas and suggestions also needed to be offered tentatively and specu- latively to honor the ideas of objectivity (in parentheses) and the legitimacy of multiple realities (Maturana & Varela, 1992). Following the research by Moules (2000), the clinical team became more mindful to also acknowl- edge illness suffering and hear the “cries of the wounded” (James, cited in Amundson, 2001, p. 186). Because of the nature of the educational context of the FNU, graduate student clinicians or graduate observers of the clinical sessions most often wrote letters as a means to develop conceptual and perceptual skills in Family Systems Nursing (Wright et al., 1996). A faculty supervisor always reviewed and edited the letter before it was sent to the family. The educa- tional context of the FNU raises the issue of teaching students how to write therapeutic letters, while still maintaining a responsibility to the family. The FNU was a clinical setting, but it was primarily an educational one, and there was a responsibility to immerse the students in learning the clinical practice, a part of which was giving them experience in writing therapeutic letters. With experience, we, as faculty supervisors, learned to find a balance 15 Table 1 Example of a Family Nursing Unit (FNU) Between-Session Therapeutic Letter 16 between teaching and creating the opportunity for learning and needing a certain amount of vigilance and surveillance. What goes out of the FNU, with the signature of the clinician and faculty supervisor and director, is laden with the ethics of responsibility, professionalism, and personal com- mitment. The therapeutic letters that left the FNU were the end result of acts of balancing between learning, teaching, commitment, and integrity. A Case Example of Therapeutic Letters in the Family Nursing Unit The first four letters from the FNU in Moules's research (2000, 2002) were received by Doreen and Charlie. This couple was referred to the FNU by their home care worker, because of concerns regarding Doreen's “uncon- trolled” epilepsy and Charlie's bowel disease, diabetes, cardiac disease, and depression. Doreen made the initial contact and came to the first session on her own. Her concerns were her own health, the health of her husband, her dependence on him, and the influence of all these issues on their relationships with each other and their children. Doreen and Charlie both had a long his- tory of involvement in the health care system and in the mental health system and had been seen for marital therapy several times and for extensive periods in the past. At the FNU, they were seen for four sessions over a period of 3 months and received four therapeutic letters (Letter 2 to Doreen and Charlie is offered as an example of a between-session therapeutic letter in Figure 1). 17 Table 2 Example of a Family Nursing Unit (FNU) Therapeutic Letter to an Absent Family Member The research interview occurred 2 years and 3 months after the closing of their clinical work in the FNU and the receipt of their last therapeutic letter. Rose Schroeder, RN, BN, a master's student in Family Systems Nursing in the FNU in her 2nd year of study, wrote the letters. She had previous experi- ence as a staff nurse in mental health, a nurse clinician, and a nurse educator. Supervision for the clinical work and in the writing of the therapeutic 18 Table 3 Example of a Family Nursing Unit (FNU) Letter Admitting a Therapeutic Error 19 letters was provided by Janice Bell, RN, PhD, an FNU faculty member. Ms. Schroeder will be referred to as “RS” and Dr. Nancy Moules as “NJM.” Significance of the Letters to Doreen, Charlie, and Rose: Withstanding the Test of Time In the final clinical session with Doreen and Charlie, RS asked questions designed to evaluate her own practice as well as gain some understanding of the experience of the family regarding the clinical work. In the process of this evaluative discussion, Charlie suggested that the letters were very significant. 20 Table 4 Example of a Family Nursing Unit (FNU) Closing Therapeutic Letter 21 RS: What do you think helped the most by coming here? Charlie: Like I've remarked about the comments that are said afterwards [the letters] and how it's picked . . . your picking out the positives and relaying that back to us, maybe you know even if it's a negative, then hearing it that way, that's sort of what I'm picking up, and it's really encouraging. Doreen: Ya, I was going to say something along the same line. Just reading the letters, it gives you a positive attitude towards yourself where you pick up anything that you know you feel good about—you've obviously picked up from listening to what we're saying and things like that and it gives you a 22 Table 5 Example of a Family Nursing Unit (FNU) Closing Therapeutic Letter 23 Table 5 (continued) 24 better feeling about yourself as to where you can move, put more, okay I've got to go, strive towards that. . . . Myself, I found, especially after hearing back you know from you some of the positive aspects that you wrote up on the letters. RS: So, the letters . . . Doreen: Sure gave me an awful lot more strength to turn around and not be as- more strength to deal with . . . give me that much more strength and there- fore, it gave me that ability to understand that I could do it and then when I read it, it gave me . . . RS: So did you go back and read the letters? Doreen: Oh, ya, I've gone back and read them a few times. RS: Wow! Doreen: 'Cause it gives me just that much more strength—you can do it. RS: Sounds like the letters are kinda helpful as a reminder sometimes. Charlie: Oh, very much so. In the research interview, 2 years and 3 months later, Moules (NJM) asked the family how they would value the letters in terms of worthiness and how they might equate the value of the letters to the value of clinical sessions: Charlie: I would say, uhm, anywhere from three to five sessions, like some- where in that area there; it uh, you know it could be more, like it wouldn't be any less, that's for sure. I found it very invaluable, like it just you know it's just like you know what price do you put on a person's life? That's the way you look at that too. It's in the eye of the beholder. To me it was like, it did a lot for me, it just built me up, it gave me some more self-esteem. 25 Doreen: Like I say, to myself, it made me feel much stronger in dealing with my own personal feeling about myself. In the research interview with the nurse clinician, RS reflected on the impact the letters had on her as a clinician working with the family. RS: I mean certainly the philosophy of the FNU and the work, clinical work, the actual sessions, I mean we try to pull out unique outcomes, try and pull out positives within the family, try and look at strengths, and develop strengths, um, those kinds of things. But, and certainly I write them down in charting, but kind of in writing a letter to the family, um, I have to pay meticulous attention to those details, to those strengths. I think just their whole experi- ence of the letters was very positive, so as a clinician, the letters became more meaningful to me as well. NJM: Do you think that the work you did with this family would have been as good if you hadn't written the letters? RS: No. No. NJM: What would you say that these letters had been worth to this family in terms of if you could equate it to a number of sessions? RS: For this family I would say that the letters probably would be equivalent to them continuing in therapy for the last [laughs] if I would have continued to see them ongoing once a month from then until now. NJM: So we're talking almost 3 years? [Laughter] RS: I think so [still laughing]. Well, I don't know if I can equate it that way. I would say a lot of sessions, maybe 5 to 10, but I think that the value of the letters has been in the time, in how they have withstood the test of time. I don't think Charlie would have came had we not had the letter, so I think that probably I mean it was invaluable, that first letter, because if there was just Doreen at the session, I don't think their marriage would have lasted. So I think that it was invaluable in that way, so I don't know that you could equate it to sessions, 'cause I could have a thousand sessions with Doreen alone, and I don't think I would have gotten very far. NJM: Would you have guessed, you know first impression, that this was a fam- ily where letters might be useful? RS: When I first met Doreen . . . I didn't necessarily think she would be the type that would just sit down and read a letter . . . like I wouldn't have guessed that she would have spent the time to really go over it and keep it and keep going over it. In the reflecting team during the fourth clinical session, RS offered the suggestion that the reason the family has been able to handle illnesses bet- ter than many is because of their commitment. Dr. Janice Bell responded, 26 The other piece of it that is connected to, maybe even fuels or increases the commitment, is this new awareness that when they feel supported, they're able to give more support. I heard Charlie talk about that as a new kind of understanding—that when he feels supported, affirmed, when he feels loved, when he feels cared about, that he's able to show, you know, that it's easier to show that caring back and Doreen said similarly, that . . . there is some sort of similar theme for her . . . like she said “When I read the letters, I gained strength, I rely on him less, that enables me to support him more” . . . sort of balancing out that supportiveness between them. I was quite taken with that. This comment gives us a glimpse into why these letters might have been a fit for this family, a family we might not have anticipated being one who would value them. The therapeutic letters helped them feel supported, gave them strength in a way that nurtured and fueled their capacities to offer support. The letters have “withstood the test of time,” still continuing to invite reflection, conversation, and a sense or measure of time to hold up against change. Postscript: Doreen and Charlie Approximately 6 months after the completion of clinical work, the FNU routinely conducts an outcome study, designed to evaluate the clinical work. The family indicated a high degree of satisfaction with the clinical work and the subsequent changes they have experienced with themselves, particularly as a couple in a marital relationship. Charlie responded when asked, “What did you find most helpful about the family sessions?” You know you're struggling, but you don't see the good things you're doing. Therapeutic letters give you a real boost. As a closing comment to the influence of these letters on this family, transcripts from the research interviews follow. RS asked in the research interview if the family had received any subsequent clinical work: I was just curious if I mean I've always kind of wondered about this family because they have had so many issues in the past, have had therapy numerous times of various sorts, I'm just wondering because it was only four sessions plus four letters whether they felt it still had impact on the, or whether . . . 'cause four sessions isn't very long for a family dealing with these kind of problems . . . that I would say that if this is a difference that has been long- standing that would mostly be attributed to the letters. Certainly the sessions would have had an impact, but I think that a lot of the credit would have to go to the letters. 27 Summary In this article, we speak to the use and significance of therapeutic letters within the context and legacy of the clinical scholarship of the FNU. Whereas we have described the content and process of writing therapeutic letters to families, we have not discussed the numerous letters received from families—many of which were invited by the clinician and clinical team as a way to mark and celebrate therapeutic change and invite the fam- ily to offer advice and suggestions to other families about how they were able to shift from constraining to facilitating beliefs about their lives, rela- tionships, and illnesses in ways that softened their illness suffering (an example of a letter from George and Linda [the family mentioned in Figure 5], who want to publicly share their letter about their healing journey, is avail- able at www.janicembell.com; see NIFT Day). Relational practice with families emphasizes the healing aspects of rela- tionship between family members, between the family and the health care provider(s), and the relationship of the family to their illness suffering. Therapeutic letters happen in reciprocity and relationship; they are written with care and received with heart. They have the potential to heal, to invite reflection and change, and to make a difference in suffering. This relation- ship of family and health care provider that is extended through the medium of the written word is a sacred relationship, and the words within it must be carefully chosen, delicately presented, and intentionally positioned. As an intervention, therapeutic letters evoke us—subtly, boldly, and ethically—to preserve the integrity of relationships in nursing through the enduring tradi- tion of the written word. References Amundson, J.K. (2001). Why narrative therapy need not fear science and "other" things. Journal of Family Therapy, 23(2), 175-189. Andersen, T. (Ed.). (1991). The reflecting team: Dialogues and dialogues about the dialogues. New York: Norton. Bateson, G. (1979). Mind and nature: A necessary unity. New York: Dutton. Bell, J.M. (2003). Clinical scholarship in family nursing [Editorial] . Journal of Family Nursing, 9(2), 127-129. Bell, J.M. (2008). The Family Nursing Unit, University of Calgary: Reflections on 25 years of clinical scholarship (1982-2007) and closure announcement [Editorial]. Journal of Family Nursing, 14(3), 275-288. Bell, J.M., & Wright, L.M. (2007). La recherche sur la pratique des soins infirmiers à la famille [Research on family interventions]. In F. Duhamel (Ed.), La santé et la famille: Une approche systémique en soins infirmiers [Families and health: A systemic approach in nursing care] (2nd ed., pp. 87-105). Montreal, Canada: Gaëtan Morin editeur, Chenelière Éducation. 28 Binding, L., Moules, N.J., Tapp, D.M., & Rallison, L. (2007). Hermeneutic musings on learning: The dialological nature of teaching interpretively. Journal of Educational Thought, 41(2), 179-189. Bohn, U., Wright, L.M., & Moules, N.J. (2003). A family systems nursing interview following a myocardial infarction: The power of commendations. Journal of Family Nursing, 9(2), 151-165. Coles, D. (1995). A pilot use of letters to clients before the initial session. Australian and New Zealand Journal of Family Therapy , 16(4), 209-213. Elkaim, M. (1985). From general laws to singularities. Family Process, 24, 151-164. Epston, D. (1989). Collected papers. Adelaide , Australia: Dulwich Centre Publications. Epston, D. (1994). Extending the conversation. Family Therapy Networker, 18(6), 31-37, 62-63. Flowers, K., St. John, W., & Bell, J.M. (2008). The role of the clinical laboratory in teaching and learning family nursing skills. Journal of Family Nursing , 14(2), 242-267. Gadamer, H.G. (1989). Truth and method (2nd revised ed.; J. Weinsheimer & D. G. Marshall, Trans.). New York: Continuum. Gottlieb, L. (2007). A tribute to the Calgary Family Nursing Unit: Lessons that go beyond family nursing [Editorial]. Canadian Journal of Nursing Research, 39(3), 7-11. Harper-Jaques, S., & Masters, A. (1994). Written communication with survivors of sexual abuse: Use of letters in therapy. Journal of Psychosocial Nursing, 32(8), 11-16. Houger Limacher, L., & Wright, L.M. (2003). Commendations: Listening to the silent side of a family intervention. Journal of Family Nursing, 9(2), 130-135. Houger Limacher, L., & Wright, L.M. (2006). Exploring the therapeutic family intervention of commendations: Insights from research. Journal of Family Nursing, 12, 307-331. Kennedy, S. (1995). Leunig cartoons as therapeutic letters: Crafting a viable therapeutic focus for change. Australian and New Zealand Journal of Family Therapy, 16(4), 199-200. Levac, A.M., McLean, S., Wright, L.M., Bell, J.M., "Ann," & "Fred." (1998). A "Reader's Theatre" intervention to managing grief: Post-therapy reflections by a family and a clinical team. Journal of Marital and Family Therapy, 24(1), 81-94. Limacher, L.H., & Wright, L.M. (2006). Exploring the therapeutic family intervention of commendations: Insights from research. Journal of Family Nursing, 12, 307-331. Lown, N., & Britton, B. (1991). Engaging families through the letter writing technique . Journal of Systemic and Strategic Therapies, 10(2), 43-48. Marshall, A.J., & Harper-Jaques, S. (2008). Depression and family relationships: Ideas for healing. Journal of Family Nursing , 14(1), 56-73. Maturana, H., & Varela, F.J. (1992). The tree of knowledge: The biological roots of human understanding (2nd ed.). Boston: Shambhala. McLeod, D.L., & Wright, L.M. (2008). Living the as-yet unanswered: Spiritual care practices in family systems nursing. Journal of Family Nursing, 14(1), 118-141. Moules, N.J. (2000). Nursing on paper: The art and mystery of therapeutic letters in clinical work with families experiencing illness. Unpublished doctoral thesis, University of Calgary, Alberta, Canada. Moules, N.J. (2002). Nursing on paper: Therapeutic letters in nursing practice. Nursing Inquiry, 9(2), 104-113. Moules, N.J. (2003). Therapy on paper: Therapeutic letters and the tone of relationship. Journal of Systemic Therapies, 22(1), 33-49. 29 Moules, N.J. (2009b). Therapeutic letters in nursing: Examining the character and influence of the written word in clinical work with families experiencing illness. Journal of Family Nursing, 15(1), (this issue). Moules, N.J., & Simonson, K. (2009). Following in behind: An interview with the Reverend Bob Glasgow on his practice with grief work. Illness, Crisis, & Loss , 17(1), 51-69. Moules, N.J., Simonson, K., Fleiszer, A., Prins, M., & Glasgow, B. (2007). The soul of sorrow work: Grief and therapeutic interventions with families. Journal of Family Nursing, 13(1), 117-141. Moules, N.J., Simonson, K., Prins, M., Angus, P., & Bell, J.M. (2004). Making room for grief: Walking backwards and living forward. Nursing Inquiry, 11(2), 99-107. Moules, N.J., Thirsk, L.M., & Bell, J.M. (2006). A Christmas without memories: Beliefs about grief and mothering-A clinical case analysis. Journal of Family Nursing, 12(4), 426-441. Shilts, L.G., & Ray, W.A. (1991). Therapeutic letters: Pacing with the system. Journal of Marital and Family Therapies, 10(3-4), 92-99. Tomm, K. (1984). One perspective on the Milan systemic approach: Part II. Description of session format, interviewing style and interventions . Journal of Marital and Family Therapy, 10(3), 253-271. White, M. (1995). Therapeutic documents revisited. In M. White (Ed.), Re-authoring lives: Interviews and essays (pp. 199-213). Adelaide, Australia: Dulwich Centre Publications. White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton. Wilcoxen, A., & Fenell, D. (1983). Engaging the non-attending spouse in marital therapy through the use of therapist-initiated written communication. Journal of Marital and Family Therapy, 9, 199-203. Wojcik, J., & Iverson, E. (1989). Therapeutic letters: The power of the written word. Journal of Systemic and Strategic Therapies, 8(2-3), 77-81. Wood, C.D., & Uhl, N.E. (1988). Post-session letters: Reverberating in the family treatment systems. Journal of Strategic and Systemic Therapies , 7(3), 35-52. Wright, L.M. (2005). Spirituality, suffering, and illness: Ideas for healing. Philadelphia: F.A. Davis . Wright, L.M., & Bell, J.M. (in press). Beliefs and illness: A model for healing. Calgary, Alberta, Canada: 4th Floor Press. Wright, L.M., & Leahey, M. (1990). Trends in the nursing of families. Journal of Advanced Nursing, 15, 148-154. Wright, L.M., & Leahey, M. (1994). Nurses and families: A guide to family assessment and intervention (2nd ed.). Philadelphia: F. A. Davis. Wright, L.M., & Leahey, M. (2000). Nurses and families: A guide to family assessment and intervention (3rd ed.). Philadelphia: F.A. Davis. Wright, L.M., & Leahey, M. (2005). Nurses and families: A guide to family assessment and intervention (4th ed.). Philadelphia: F.A. Davis. Wright, L.M., & Leahey, M. (2009). Nurses and families: A guide to family assessment and intervention (5th ed.). Philadelphia: F.A. Davis Wright, L.M., & Simpson, P. (1991). A systemic belief approach to epileptic seizures: A case of being spellbound. Contemporary Family Therapy: An International Journal, 13(2), 165-180. Wright, L.M., & Watson, W.L. (1988). Systemic family therapy and family development . In C. J. Falicov (Ed.), Family transitions: Continuity and change over the life cycle (pp. 407-430). New York: Guilford. 30 Wright, L.M., Watson, W.L., & Bell, J.M. (1990). The Family Nursing Unit: A unique integration of research, education and clinical practice. In J. M. Bell, W. L. Watson, & L. M. Wright (Eds.), The cutting edge of family nursing (pp. 95-112). Calgary, Canada: Family Nursing Unit Publications. Wright, L.M., Watson, W.L., & Bell, J.M. (1996). Beliefs: The heart of healing in families and illness. New York: Basic Books. Wright, L.M., Watson, W.L., & Duhamel, F. (1985). The Family Nursing Unit: Clinical preparation at the masters' level. The Canadian Nurse, 81, 26-29. Janice M. Bell, RN, PhD, is a nurse educator and registered psychologist who joined the Family Nursing Unit, University of Calgary, in 1986 and served as the director of the Family Nursing Unit from 2002 to 2007. Her scholarly expertise focuses on illness suffering and fam- ily healing with a focus on therapeu]tic conversations with families, family interventions in health care, and family intervention research. The focus of her career is on building capacity in nurses and other health care professionals to care for families experiencing illness. Her Web site is www.janicembell.com. Recent publications include “The Family Nursing Unit, University of Calgary: Reflections on 25 Years of Clinical Scholarship (1982-2007) and Closure Announcement [Editorial]” in Journal of Family Nursing (2008), “The Role of the Clinical Laboratory in Teaching and Learning Family Nursing Skills” in Journal of Family Nursing (2008, with K. Flowers and W. St. John), and Beliefs and Illness: A Model for Healing (in press, with L. M. Wright). Nancy J. Moules, RN, PhD, is an associate professor, Faculty of Nursing, University of Calgary. Her clinical, teaching, and research interests include hermeneutics, family nursing, Family Systems Nursing, grief, therapeutic conversations, and pediatric oncology. Recent publications include “Hermeneutic Musings on Learning: The Dialological Nature of Teaching Interpretively” in Journal of Educational Thought (2007, with L. Binding, D. M. Tapp, and L. Rallison), “The Soul of Sorrow Work: Grief and Therapeutic Interventions With Families” in Journal of Family Nursing (2007, with K. Simonson, A. Fleizer, M. Prins, and B. Glasgow), and “Following in Behind: An Interview With the Reverend Bob Glasgow on His Practice With Grief Work” in Illness, Crisis, & Loss (2009, with K. Simonson). Lorraine M. Wright, RN, PhD, is a professor emeritus of nursing, University of Calgary. She is also an author, international lecturer, and marriage and family therapist. Her clinical practice, lectures, and research focus on (a) illness beliefs of couples, families, and health care professionals; (b) spirituality, suffering, and illness; and (c) marriage and family interven- tions. Her Web site is www.lorrainewright.com. Recent publications include “Exploring the Therapeutic Family Intervention of Commendations: Insights From Research” in Journal of Family Nursing, 12, (2006, with L. H. Limacher), “ àLiving the as-yet Unanswered:' Spiritual Care Practices in Family Systems Nursing” in Journal of Family Nursing (2008, with D. L. McLeod), and Nurses and Families: A Guide to Family Assessment and Intervention (5th ed., 2009, with M. Leahey).</meta-value></custom-meta></custom-meta-wrap></article-meta></front><back><ref-list><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Amundson, J.K.</surname></name> (<year>2001</year>). <article-title>Why narrative therapy need not fear science and "other" things</article-title>. <source>Journal of Family Therapy</source>, <volume>23</volume>(<issue>2</issue>), <fpage>175</fpage>-<lpage>189</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Andersen, T.</surname></name> (Ed.). (<year>1991</year>). <source>The reflecting team: Dialogues and dialogues about the dialogues</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Norton</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Bateson, G.</surname></name> (<year>1979</year>). <source>Mind and nature: A necessary unity</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Dutton</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Bell, J.M.</surname></name> (<year>2003</year>). <article-title>Clinical scholarship in family nursing [Editorial]</article-title> . <source>Journal of Family Nursing</source>, <volume>9</volume>(<issue>2</issue>), <fpage>127</fpage>-<lpage>129</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Bell, J.M.</surname></name> (<year>2008</year>). <article-title>The Family Nursing Unit, University of Calgary: Reflections on 25 years of clinical scholarship (1982-2007) and closure announcement [Editorial]</article-title>. <source>Journal of Family Nursing</source>, <volume>14</volume>(<issue>3</issue>), <fpage>275</fpage>-<lpage>288</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Bell, J.M.</surname></name>, & <name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2007</year>). <source>La recherche sur la pratique des soins infirmiers à la famille [Research on family interventions]</source>. In <name name-style="western"><surname>F. Duhamel</surname></name> (Ed.), <source>La santé et la famille: Une approche systémique en soins infirmiers [Families and health: A systemic approach in nursing care]</source> (<edition>2</edition>nd ed., pp. <fpage>87</fpage>-<lpage>105</lpage>). <publisher-loc>Montreal</publisher-loc>, Canada: <publisher-name>Gaëtan Morin editeur, Chenelière Éducation</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Binding, L.</surname></name>, <name name-style="western"><surname>Moules, N.J.</surname></name>, <name name-style="western"><surname>Tapp, D.M.</surname></name>, & <name name-style="western"><surname>Rallison, L.</surname></name> (<year>2007</year>). <article-title>Hermeneutic musings on learning: The dialological nature of teaching interpretively</article-title>. <source>Journal of Educational Thought</source>, <volume>41</volume>(<issue>2</issue>), <fpage>179</fpage>-<lpage>189</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Bohn, U.</surname></name>, <name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Moules, N.J.</surname></name> (<year>2003</year>). <article-title>A family systems nursing interview following a myocardial infarction: The power of commendations</article-title>. <source>Journal of Family Nursing</source>, <volume>9</volume>(<issue>2</issue>), <fpage>151</fpage>-<lpage>165</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Coles, D.</surname></name> (<year>1995</year>). <article-title>A pilot use of letters to clients before the initial session</article-title>. <source>Australian and New Zealand Journal of Family Therapy</source> , <volume>16</volume>(<issue>4</issue>), <fpage>209</fpage>-<lpage>213</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Elkaim, M.</surname></name> (<year>1985</year>). <article-title>From general laws to singularities</article-title>. <source>Family Process</source>, <volume>24</volume>, <fpage>151</fpage>-<lpage>164</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Epston, D.</surname></name> (<year>1989</year>). <source>Collected papers</source>. <publisher-loc>Adelaide</publisher-loc> , Australia: <publisher-name>Dulwich Centre Publications</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Epston, D.</surname></name> (<year>1994</year>). <article-title>Extending the conversation</article-title>. <source>Family Therapy Networker</source>, <volume>18</volume>(<issue>6</issue>), <fpage>31</fpage>-<lpage>37</lpage>, 62-63.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Flowers, K.</surname></name>, <name name-style="western"><surname>St. John, W.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (<year>2008</year>). <article-title>The role of the clinical laboratory in teaching and learning family nursing skills</article-title>. <source>Journal of Family Nursing</source> , <volume>14</volume>(<issue>2</issue>), <fpage>242</fpage>-<lpage>267</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Gadamer, H.G.</surname></name> (<year>1989</year>). <source>Truth and method</source> (<edition>2</edition>nd revised ed.; <name name-style="western"><surname>J. Weinsheimer</surname></name> & <name name-style="western"><surname>D. G. Marshall</surname></name>, Trans.). <publisher-loc>New York</publisher-loc>: <publisher-name>Continuum</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Gottlieb, L.</surname></name> (<year>2007</year>). <article-title>A tribute to the Calgary Family Nursing Unit: Lessons that go beyond family nursing [Editorial]</article-title>. <source>Canadian Journal of Nursing Research</source>, <volume>39</volume>(<issue>3</issue>), <fpage>7</fpage>-<lpage>11</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Harper-Jaques, S.</surname></name>, & <name name-style="western"><surname>Masters, A.</surname></name> (<year>1994</year>). <article-title>Written communication with survivors of sexual abuse: Use of letters in therapy</article-title>. <source>Journal of Psychosocial Nursing</source>, <volume>32</volume>(<issue>8</issue>), <fpage>11</fpage>-<lpage>16</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Houger Limacher, L.</surname></name>, & <name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2003</year>). <article-title>Commendations: Listening to the silent side of a family intervention</article-title>. <source>Journal of Family Nursing</source>, <volume>9</volume>(<issue>2</issue>), <fpage>130</fpage>-<lpage>135</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Houger Limacher, L.</surname></name>, & <name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2006</year>). <article-title>Exploring the therapeutic family intervention of commendations: Insights from research</article-title>. <source>Journal of Family Nursing</source>, <volume>12</volume>, <fpage>307</fpage>-<lpage>331</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Kennedy, S.</surname></name> (<year>1995</year>). <article-title>Leunig cartoons as therapeutic letters: Crafting a viable therapeutic focus for change</article-title>. <source>Australian and New Zealand Journal of Family Therapy</source>, <volume>16</volume>(<issue>4</issue>), <fpage>199</fpage>-<lpage>200</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Levac, A.M.</surname></name>, <name name-style="western"><surname>McLean, S.</surname></name>, <name name-style="western"><surname>Wright, L.M.</surname></name>, <name name-style="western"><surname>Bell, J.M.</surname></name>, "<name name-style="western"><surname>Ann</surname></name>," & "<name name-style="western"><surname>Fred.</surname></name>" (<year>1998</year>). A <article-title>"Reader's Theatre" intervention to managing grief: Post-therapy reflections by a family and a clinical team</article-title>. <source>Journal of Marital and Family Therapy</source>, <volume>24</volume>(<issue>1</issue>), <fpage>81</fpage>-<lpage>94</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Limacher, L.H.</surname></name>, & <name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2006</year>). <article-title>Exploring the therapeutic family intervention of commendations: Insights from research</article-title>. <source>Journal of Family Nursing</source>, <volume>12</volume>, <fpage>307</fpage>-<lpage>331</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Lown, N.</surname></name>, & <name name-style="western"><surname>Britton, B.</surname></name> (<year>1991</year>). <article-title>Engaging families through the letter writing technique</article-title> . <source>Journal of Systemic and Strategic Therapies</source>, <volume>10</volume>(<issue>2</issue>), <fpage>43</fpage>-<lpage>48</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Marshall, A.J.</surname></name>, & <name name-style="western"><surname>Harper-Jaques, S.</surname></name> (<year>2008</year>). <article-title>Depression and family relationships: Ideas for healing</article-title>. <source>Journal of Family Nursing</source> , <volume>14</volume>(<issue>1</issue>), <fpage>56</fpage>-<lpage>73</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Maturana, H.</surname></name>, & <name name-style="western"><surname>Varela, F.J.</surname></name> (<year>1992</year>). <source>The tree of knowledge: The biological roots of human understanding</source> (<edition>2</edition>nd ed.). <publisher-loc>Boston</publisher-loc>: <publisher-name>Shambhala</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>McLeod, D.L.</surname></name>, & <name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2008</year>). <article-title>Living the as-yet unanswered: Spiritual care practices in family systems nursing</article-title>. <source>Journal of Family Nursing</source>, <volume>14</volume>(<issue>1</issue>), <fpage>118</fpage>-<lpage>141</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name> (<year>2000</year>). <source>Nursing on paper: The art and mystery of therapeutic letters in clinical work with families experiencing illness</source>. Unpublished doctoral thesis, <publisher-name>University of Calgary</publisher-name>, <publisher-loc>Alberta</publisher-loc>, Canada.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name> (<year>2002</year>). <article-title>Nursing on paper: Therapeutic letters in nursing practice</article-title>. <source>Nursing Inquiry</source>, <volume>9</volume>(<issue>2</issue>), <fpage>104</fpage>-<lpage>113</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name> (<year>2003</year>). <article-title>Therapy on paper: Therapeutic letters and the tone of relationship</article-title>. <source>Journal of Systemic Therapies</source>, <volume>22</volume>(<issue>1</issue>), <fpage>33</fpage>-<lpage>49</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name> (<year>2009</year>b). <article-title>Therapeutic letters in nursing: Examining the character and influence of the written word in clinical work with families experiencing illness</article-title>. <source>Journal of Family Nursing</source>, <volume>15</volume>(<issue>1</issue>), (this issue).</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name>, & <name name-style="western"><surname>Simonson, K.</surname></name> (2009). <article-title>Following in behind: An interview with the Reverend Bob Glasgow on his practice with grief work</article-title>. <source>Illness, Crisis, & Loss</source> , <volume>17</volume>(<issue>1</issue>), <fpage>51</fpage>-<lpage>69</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name>, <name name-style="western"><surname>Simonson, K.</surname></name>, <name name-style="western"><surname>Fleiszer, A.</surname></name>, <name name-style="western"><surname>Prins, M.</surname></name>, & <name name-style="western"><surname>Glasgow, B.</surname></name> (<year>2007</year>). <article-title>The soul of sorrow work: Grief and therapeutic interventions with families</article-title>. <source>Journal of Family Nursing</source>, <volume>13</volume>(<issue>1</issue>), <fpage>117</fpage>-<lpage>141</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name>, <name name-style="western"><surname>Simonson, K.</surname></name>, <name name-style="western"><surname>Prins, M.</surname></name>, <name name-style="western"><surname>Angus, P.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (<year>2004</year>). <article-title>Making room for grief: Walking backwards and living forward</article-title>. <source>Nursing Inquiry</source>, <volume>11</volume>(<issue>2</issue>), <fpage>99</fpage>-<lpage>107</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Moules, N.J.</surname></name>, <name name-style="western"><surname>Thirsk, L.M.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (<year>2006</year>). <article-title>A Christmas without memories: Beliefs about grief and mothering-A clinical case analysis</article-title>. <source>Journal of Family Nursing</source>, <volume>12</volume>(<issue>4</issue>), <fpage>426</fpage>-<lpage>441</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Shilts, L.G.</surname></name>, & <name name-style="western"><surname>Ray, W.A.</surname></name> (<year>1991</year>). <article-title>Therapeutic letters: Pacing with the system</article-title>. <source>Journal of Marital and Family Therapies</source>, <volume>10</volume>(<issue>3</issue>-<issue>4</issue>), <fpage>92</fpage>-<lpage>99</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Tomm, K.</surname></name> (<year>1984</year>). <article-title>One perspective on the Milan systemic approach: Part II. Description of session format, interviewing style and interventions</article-title> . <source>Journal of Marital and Family Therapy</source>, <volume>10</volume>(<issue>3</issue>), <fpage>253</fpage>-<lpage>271</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>White, M.</surname></name> (<year>1995</year>). <source>Therapeutic documents revisited</source>. In <name name-style="western"><surname>M. White</surname></name> (Ed.), <source>Re-authoring lives: Interviews and essays</source> (pp. <fpage>199</fpage>-<lpage>213</lpage>). <publisher-loc>Adelaide</publisher-loc>, Australia: <publisher-name>Dulwich Centre Publications</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>White, M.</surname></name>, & <name name-style="western"><surname>Epston, D.</surname></name> (<year>1990</year>). <source>Narrative means to therapeutic ends</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Norton</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wilcoxen, A.</surname></name>, & <name name-style="western"><surname>Fenell, D.</surname></name> (<year>1983</year>). <article-title>Engaging the non-attending spouse in marital therapy through the use of therapist-initiated written communication</article-title>. <source>Journal of Marital and Family Therapy</source>, <volume>9</volume>, <fpage>199</fpage>-<lpage>203</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wojcik, J.</surname></name>, & <name name-style="western"><surname>Iverson, E.</surname></name> (<year>1989</year>). <article-title>Therapeutic letters: The power of the written word</article-title>. <source>Journal of Systemic and Strategic Therapies</source>, <volume>8</volume>(<issue>2</issue>-<issue>3</issue>), <fpage>77</fpage>-<lpage>81</lpage>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wood, C.D.</surname></name>, & <name name-style="western"><surname>Uhl, N.E.</surname></name> (<year>1988</year>). <article-title>Post-session letters: Reverberating in the family treatment systems</article-title>. <source>Journal of Strategic and Systemic Therapies</source> , <volume>7</volume>(<issue>3</issue>), <fpage>35</fpage>-<lpage>52</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name> (<year>2005</year>). <source>Spirituality, suffering, and illness: Ideas for healing</source>. <publisher-loc>Philadelphia</publisher-loc>: <publisher-name>F.A. Davis</publisher-name> .</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (in press). <source>Beliefs and illness: A model for healing</source>. <publisher-loc>Calgary, Alberta</publisher-loc>, Canada: 4th Floor Press.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Leahey, M.</surname></name> (<year>1990</year>). <article-title>Trends in the nursing of families</article-title>. <source>Journal of Advanced Nursing</source>, <volume>15</volume>, <fpage>148</fpage>-<lpage>154</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Leahey, M.</surname></name> (<year>1994</year>). <source>Nurses and families: A guide to family assessment and intervention</source> (<edition>2</edition>nd ed.). <publisher-loc>Philadelphia</publisher-loc>: <publisher-name>F. A. Davis</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Leahey, M.</surname></name> (<year>2000</year>). <source>Nurses and families: A guide to family assessment and intervention</source> (<edition>3</edition>rd ed.). <publisher-loc>Philadelphia</publisher-loc>: <publisher-name>F.A. Davis</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Leahey, M.</surname></name> (<year>2005</year>). <source>Nurses and families: A guide to family assessment and intervention</source> (<edition>4</edition>th ed.). <publisher-loc>Philadelphia</publisher-loc>: <publisher-name>F.A. Davis</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Leahey, M.</surname></name> (<year>2009</year>). <source>Nurses and families: A guide to family assessment and intervention</source> (<edition>5</edition>th ed.). <publisher-loc>Philadelphia</publisher-loc>: <publisher-name>F.A. Davis</publisher-name></citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Simpson, P.</surname></name> (<year>1991</year>). <article-title>A systemic belief approach to epileptic seizures: A case of being spellbound</article-title>. <source>Contemporary Family Therapy: An International Journal</source>, <volume>13</volume>(<issue>2</issue>), <fpage>165</fpage>-<lpage>180</lpage>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, & <name name-style="western"><surname>Watson, W.L.</surname></name> (<year>1988</year>). <source>Systemic family therapy and family development</source> . In <name name-style="western"><surname>C. J. Falicov</surname></name> (Ed.), <source>Family transitions: Continuity and change over the life cycle</source> (pp. <fpage>407</fpage>-<lpage>430</lpage>). <publisher-loc>New York</publisher-loc>: <publisher-name>Guilford</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, <name name-style="western"><surname>Watson, W.L.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (<year>1990</year>). <source>The Family Nursing Unit: A unique integration of research, education and clinical practice</source>. In <name name-style="western"><surname>J. M. Bell</surname></name>, <name name-style="western"><surname>W. L. Watson</surname></name>, & <name name-style="western"><surname>L. M. Wright</surname></name> (Eds.), <source>The cutting edge of family nursing</source> (pp. <fpage>95</fpage>-<lpage>112</lpage>). <publisher-loc>Calgary</publisher-loc>, Canada: <publisher-name>Family Nursing Unit Publications</publisher-name>.</citation></ref><ref><citation citation-type="book" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, <name name-style="western"><surname>Watson, W.L.</surname></name>, & <name name-style="western"><surname>Bell, J.M.</surname></name> (<year>1996</year>). <source>Beliefs: The heart of healing in families and illness</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Basic Books</publisher-name>.</citation></ref><ref><citation citation-type="journal" xlink:type="simple"><name name-style="western"><surname>Wright, L.M.</surname></name>, <name name-style="western"><surname>Watson, W.L.</surname></name>, & <name name-style="western"><surname>Duhamel, F.</surname></name> (<year>1985</year>). <article-title>The Family Nursing Unit: Clinical preparation at the masters' level</article-title>. <source>The Canadian Nurse</source>, <volume>81</volume>, <fpage>26</fpage>-<lpage>29</lpage>.</citation></ref></ref-list></back></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Therapeutic Letters and the Family Nursing Unit</title><subTitle>A Legacy of Advanced Nursing Practice</subTitle></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Therapeutic Letters and the Family Nursing Unit</title><subTitle>A Legacy of Advanced Nursing Practice</subTitle></titleInfo><name type="personal"><namePart type="given">Janice M.</namePart><namePart type="family">Bell</namePart><affiliation></affiliation><affiliation>E-mail: jmbell@ucalgary.ca</affiliation><affiliation>University of Calgary, Alberta, Canada, jmbell@ucalgary.ca</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nancy J.</namePart><namePart type="family">Moules</namePart><affiliation>University of Calgary, Alberta, Canada</affiliation><affiliation>University of Calgary, Alberta, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lorraine M.</namePart><namePart type="family">Wright</namePart><affiliation>University of Calgary, Alberta, Canada</affiliation><affiliation>University of Calgary, Alberta, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other"></genre><originInfo><publisher>SAGE Publications</publisher><place><placeTerm type="text">Sage CA: Los Angeles, CA</placeTerm></place><dateIssued encoding="w3cdtf">2009-02</dateIssued><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">This article focuses on the history of the use of therapeutic letters in the clinical scholarship of the Family Nursing Unit at the University of Calgary and offers examples of a variety of therapeutic letters written to families experiencing illness suffering. A case study from the research of Moules (2000, 2002) is offered to further illustrate the usefulness of therapeutic letters as a family nursing intervention.</abstract><subject><genre>keywords</genre><topic>therapeutic letters</topic><topic>Family Nursing Unit</topic><topic>Family Systems Nursing</topic><topic>family nursing intervention</topic><topic>illness suffering</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Family Nursing</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1074-8407</identifier><identifier type="eISSN">1552-549X</identifier><identifier type="PublisherID">JFN</identifier><identifier type="PublisherID-hwp">spjfn</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>15</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>6</start><end>30</end></extent></part></relatedItem><identifier type="istex">E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A</identifier><identifier type="DOI">10.1177/1074840709331865</identifier><identifier type="ArticleID">10.1177_1074840709331865</identifier><recordInfo><recordContentSource>SAGE</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Psychologie/explor/TherFamFrancoV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000B73 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 000B73 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Psychologie
|area= TherFamFrancoV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:E0F3A168B0D6699066DBC3DA54AF09F8101A8A6A
|texte= Therapeutic Letters and the Family Nursing Unit
}}
| This area was generated with Dilib version V0.6.29. |  |