Therapy letters: formulation and end of therapy
Prompts for a therapist to draft two plain, tentative letters to a client: a formulation letter that sets out the shared understanding for the client to correct, and an end-of-therapy letter that records what changed and a plan for setbacks. Based on Kuyken, Padesky and Dudley (2009) and Roth and Pilling (2007): the two-letter layout and prompts are ours.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Therapy letters: formulation and end of therapy
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About this letter
A letter from your therapist, written to you.
Formulation letter
This letter sets out what we have understood together so far. It is a draft for you to correct.
End-of-therapy letter
This letter records what you have done and learned, and a plan for setbacks. It is a draft for you to correct.
Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.
When to use ‘Therapy letters: formulation and end of therapy’
‘Therapy letters: formulation and end of therapy’ is an interactive cognitive behavioural therapy (CBT) worksheet. As a core CBT skill it is used right across the model, with presentations including depression, anxiety, OCD, trauma and low self-esteem, rather than being tied to a single diagnosis.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 30 minutes. It moves through three short steps:
- About this letter: A letter from your therapist, written to you.
- Formulation letter: This letter sets out what we have understood together so far. It is a draft for you to correct.
- End-of-therapy letter: This letter records what you have done and learned, and a plan for setbacks. It is a draft for you to correct.
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, ‘Therapy letters: formulation and end of therapy’ works by mapping how the parts of a problem connect and keep it going (formulation). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Kuyken, W., Padesky, C.A., & Dudley, R. (2009). Collaborative case conceptualization: Working effectively with clients in cognitive-behavioral therapy. New York: Guilford Press.
- Roth, A.D., & Pilling, S. (2007). The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. London: Department of Health.
- Roth, A.D., & Pilling, S. (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36(2), 129-147. doi:10.1017/S1352465808004141
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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