A client requested a letter in support of her case for breaking her lease. She claims her current living situation has affected her mental health and she needs to move What do you think?
Well, I suppose, what I think depends very much on what you think.
That said, here’s how I see it:
There are several different answers to this question. I’ll give them in no particular order.
1) A lawyer I know (who is quite conservative) advises against ever sending such letters, and, when doing so, sticking strictly to FACTS, and avoiding opinions. (As in, “I have diagnosed this person with Generalized Anxiety Disorder.” That’s a fact. Whereas, “I think her living situation has affected her mental health,” is an opinion.) His explanation is, basically, if you offer your opinion, you’re opening yourself up to potential litigation.
2) What’s the clinical meaning of this request? What’s the transference? Who are you/what is your patient asking you to do, to be? <— This is, to me, the most useful approach to such requests. I’ve been asked to write a number of letters. I wrote one, in my second year of LMSW practice. All the rest have disappeared once we started talking about them. Most recently, a patient asked me to write an emotional support animal letter. I asked them what they thought of such letters. They said, “I think they’re bullshit!” And I said, “Well then, why don’t you ask a bullshit therapist to give you one!” They can be had for $50 online if you Google. That’s what they ended up doing.
3) I can imagine – though I haven’t yet been in this situation – being in a situation where a patient was asking for a letter to bring about a reality that I genuinely believe is justified by their mental health, and by the issues we’ve been discussing in session. It’s hard for me to imagine that, but I can. In that circumstance, I think I would want to spend a fair amount of time exploring the clinical significance of the request before granting it, but then, most likely, would grant it.
I’m not overly impressed with the lawyer’s conservative stance. I think lawsuits happen, and while it’s true that writing such a letter infinitely increases your chance of being sued (if, for example, something terrible happens to the patient as a direct result of their not living in the apartment in which they currently are living, subsequent to your having written the letter), I’m not sure that it meaningfully increases your chance of being sued.
I don’t have direct advice for you, I suppose, other than to do what feels right. You are certainly entitled to write anything you like, and to sign any letter you wish.
AI postscript: I used both Midjourney and Dall-E (via ChatGPT) to generate possible images to accompany this post. My first prompt – “A hand writing with a fountain pen” – resulted in four Midjourney and two Dall-E images of white hands writing (with various numbers of fingers). My second prompt, “A Black woman’s hand writing a letter with a fountain pen” produced several better images, one of which accompanies this post.
