How to Write a Letter of Support as an Immigration Evaluation Therapist

One of the primary documents you will learn to prepare in your immigration evaluation training is a psychosocial evaluation. Psychological evaluations will be a cornerstone of the services you offer. However, if you have clients who you regularly see for therapy, there may come a time when they ask you to write a letter of support.

I have prepared many letters of support for my ongoing clients over the years. The insights I have been able to offer based on my ongoing relationship with these clients have proven vital to some of their cases, so it’s important to prepare such letters with this potential impact in mind!

How will a letter of support help my client?

As an immigration evaluation therapist, your letters of support can help your clients in several ways:

• You can indicate how a client’s diagnosis would likely be affected if a family member were required to leave the U.S.
• You could speak to your client’s prognosis if they were to relocate to a country in which they would no longer have access to therapy.

As an example, imagine you are treating a child for ADHD whose father is in removal proceedings. Your letter of support might comment on how the father’s absence would affect the child’s behavior and prognosis (e.g., increased emotional distress and trouble focusing).

What should I include in a letter of support?

When writing a letter of support, open with a paragraph stating who you are providing the letter on behalf of (i.e., your client). After this, introduce yourself and your credentials. Then give a summary of your client’s treatment to date by stating when and for how long your client has been undertaking therapy with you.

You would then detail a client’s presenting symptoms, followed by your diagnoses (if applicable).  Remember to include the relevant DSM and ICD codes beside each diagnosis (e.g., 309.81/F43.10 – Post-Traumatic Stress Disorder).

After this, what you write will vary depending on the specific purpose of the letter. It may be relevant to detail the type of therapy your client is undertaking and with what frequency (e.g., group therapy once a week). You may then comment on their response to treatment and any functional improvements they have made to support their case. For instance, you may state that since commencing therapy, your client has developed skills to better manage a mental illness and has thus become able to maintain stable employment for the first time in several years

Other times, you may be supporting a case that someone in your client’s life is a crucial source of social and emotional support, in which case, your client will experience adverse consequences were this support person to be removed. Whatever the goal, be sure to tailor this part according to the purpose of the letter

Lastly, end the letter with your contact details, inviting the reader to follow up should they need further information. By the time you are done, your letter should be about 1-2 pages.

What are the differences between a letter of support and an evaluation?

There are several key differences between a letter of support and an immigration evaluation. For starters, a letter of support is typically only one to two pages long. In contrast, an immigration evaluation will span several pages and is structured more like a report. Also, note that you should only provide letters of support to clients with whom you have an ongoing therapeutic relationship.

Many of the details that you would include in an immigration evaluation are not necessary to include in a letter of support. Letters of support also do not include the results of psychometric evaluations, academic references, or dedicated summary and conclusions sections.

Instead, letters of support should serve as a succinct, to-the-point description focused on present diagnoses and treatments, and any anticipated consequences should your client’s current circumstances (e.g., networks of support, living circumstances) change in the near future.

For more information on how to conduct immigration evaluations, be sure to sign up for my free guides and video series so you can use your clinical skills to keep immigrant families together.