Using letter writing to augment the therapeutic relationship is familiar to counsellors and psychotherapists, but many mental health nurses have been reluctant to employ this practice. Therapeutic letter writing is not usually included in the mainstream nursing curriculum or as part of routine care, and nurses can feel ill-equipped to undertake it.

Letters concerning service users are copied to them as standard practice to aid transparency in communicating about their care. This presents an opportunity to revisit the potential of writing to enhance care and the therapeutic dialogue. This article includes a brief review of therapeutic letter writing, and examines its uses, advantages and contraindications. Examples of letters with therapeutic intent are included.