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Jeanice Hansen, LCSW, OSW-C

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“Dear Deborah”: Gratitude letters are a beneficial intervention for cancer patients… and a great practice for Oncology Social Workers

March 8, 2023

By Kerry Irish, LCSW, OSW-C, FAOSW
The Dempsey Centers for Quality Cancer Care

Dear Deborah;

I write this knowing that words will never capture the depth and breadth of your impact and influence on me, both as a clinician and as a human being. I’m not sure who first suggested that I reach out to you when I joined the cancer center at XXX back in 2000. I was not a brand-new oncology social worker, but it was my first time working as a sole OSW, and I was missing the support and guidance that I’d enjoyed as the sixth and least experienced member of an oncology social work team at my former cancer center. As a psychologist, you were primarily serving as a faculty member at our hospital’s family medicine residency program, but you had maintained a small counseling practice, specializing in working with those impacted by cancer. I was thrilled when I called to ask if you might meet with me once in a while to provide some consultation with difficult cases, and you immediately said, “yes.” (I had no idea at the time how busy you were and how much responsibility you held, which makes your generosity even more inspiring!)

From the first time I met you, in your small, comfortably messy office in the residency building, your warmth and humor immediately put me at ease. Books were spilling out of your bookcase and onto every surface, and as I perused the titles, I knew I was in the right place! I left with an armful after that first meeting and enjoyed exchanging recommendations with you ever after. I can recall the first case I presented to you, R., a tiny woman with an aggressive cancer, a crabby exterior and a giant, warm heart. With R. and every other case that I brought to you in the years since, you listened intently and never failed to offer wise counsel that was grounded in both evidence and compassion. You also never failed to bolster my professional self-confidence, which was shaky on its best days and nearly nonexistent the rest of the time in those early years. While you were highly accomplished in your dual fields of health psychology and family medicine, you demonstrated a genuine grounded humility and an insatiable curiosity to learn more.

The impact of your guidance, kindness and friendship on my professional and personal life continues to unfold, and I often find myself thinking, “What would Deborah say?” in challenging situations. I remember your mischievous, sparkling eyes and ready laugh as we bonded over a shared fondness for salty language, Myers Briggs typology, and existential psychotherapy. I could go on and on (and I will) but will close here for now as I must turn back to my article. Please know that your mentorship and friendship will live on forever in my heart, Deborah.

***

A growing body of evidence demonstrates the positive impact of gratitude interventions with cancer patients (and pretty much all other humans!). Gratitude interventions have resulted in:

Reduction of distress
Improved resilience
Reduced death anxiety
Reduced fear of recurrence
Post traumatic growth
Higher psychological functioning and
Overall improvement in wellbeing

Of the gratitude interventions, of which there are many, “The Gratitude Letter” is one that I’ve found most impactful for my patients and for myself.

The basic format for the gratitude letter exercise is this:

Select an important person (someone living today) from your past (or present) who has made a positive impact on your life and to whom you have never fully expressed your thanks.

Write a testimonial of thanks that outlines the specific impact this person has had on your life.

Plan a visit with the recipient (virtual or in person). Let them know you’d like to see them and that you have something special to share, but don’t reveal the exact purpose of the meeting. Instead, when you meet, let the person know that you are grateful to them and would like to read a letter expressing your gratitude; ask that they refrain from interrupting until you’re done. Take your time reading the letter. While you read, pay attention to their reaction as well as your own. After you have read the letter, be receptive to the recipient’s reaction and discuss your feelings together. Remember to give (or mail) the letter to the person when you leave.

Research has shown that this act is correlated with a significant boost in positive emotions, lasting up to two months after doing a gratitude visit. In fact, this ranked highest among five different positive psychology interventions for boosting happiness. And evidence suggests that while there are benefits simply to writing the letter, significantly greater benefits result from delivering and reading it in person.

Last year at our AOSW conference, my colleague Kailie Sullivan and I presented a Clinical Practice Institute on gratitude, during which participants were invited to write gratitude letters to a colleague in attendance at the conference and encouraged to read these to the person while there. We were both very touched to hear back from multiple attendees about how impactful this act was, both for them and for the recipient. In that spirit, I would invite you to write a letter to one of your professional colleagues, mentors, or professors, and if you are intending to come to AOSW’s 39th annual conference in New Orleans this June, to bring it with you and share it face to face there.

In closing, I want to thank AOSW’s wise editorial and Communications team for inviting reflection on this theme of gratitude and express my appreciation for this community of colleagues and friends for the many ways in which you teach, inspire and support me every day.

About the Author

Kerry Irish, LCSW, OSW-C

The Dempsey Centers for Quality Cancer Care
kirish.cccps@gmail.com

Kerry Irish, LCSW, OSW-C, FAOSW, has worked in oncology and hospice-care settings since 1995 in both direct clinical practice and senior leadership roles. She currently works as a remote Oncology Counselor with the Dempsey Centers for Quality Canc...
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