Chapter 14 – Emotion Regulation

Impact of Expressive Writing in a Therapeutic Context

A recent study (Graf et al., 2008) applied the writing paradigm to therapeutic treatment for individuals suffering from depression and anxiety. In this study, students receiving treatment were randomly assigned to a writing or control group. Participants wrote for 20 minutes each week for a period of two weeks. Their therapists were blind to their clients’ assigned condition. Below are the instructions each group received about writing.
 

Emotional disclosure group: ‘‘During each of the two weekly writing sessions, we want you to write about the most stressful and upsetting experiences of your entire life for 20 minutes. You can write on different topics each week or the same topic for the 2 weeks. This might be an experience from your childhood or something that is currently weighing on your mind. The important thing is that you write about your deepest thoughts and feelings about an emotional issue. You may or may not want to discuss your writing or the themes of your writing with your therapist. This is your choice. Your writing will be kept completely confidential. Don’t worry about spelling, sentence structure, or grammar’’ (quoted form Graf et al., 2008, p. 393; instructions adapted from Pennebaker et al., 1998).

 

Writing control group: ‘‘During each of the two weekly writing sessions, we want you to write about your plans for the rest of today for 20 minutes. You may or may not want to discuss your writing or the themes of your writing with your therapist. This is your choice. Your writing will be kept completely confidential. Don’t worry about spelling, sentence structure, or grammar’’ (quoted form Graf et al., 2008, p. 393; instructions adapted from Pennebaker et al., 1998).

 
Over the two-week period, expressive writing participants showed a greater reduction in self-reported depression, anxiety, and stress (see Figures 4-6). Clients in the expressive writing reported greater satisfaction with therapy compared to control clients. Further, therapists reported that they discussed the writing more with clients in the intervention than control group and that their intervention clients achieved greater insight than control clients (remember, the therapists were blind to the conditions!).

Figure 4
Influence of Writing Type on Self-Reported Depression Over Time
A line graph showing depression levels during control writing, and expressive writing.

Adapted from “Written Emotional Disclosure: A Controlled Study of The Benefits of Expressive Writing Homework in Outpatient Psychotherapy,” by M.C. Graf, B.A. Gaudiano, and P.A. Geller, 2008, Psychotherapy Research18(4), p. 394 (https://doi.org/10.1080/10503300701691664) Copyright 2008 by Routledge.

 

Figure 5

Influence of Writing Type on Self-Reported Anxiety Over Time

A line graph showing anxiety levels during control writing, and expressive writing.

Adapted from “Written Emotional Disclosure: A Controlled Study of The Benefits of Expressive Writing Homework in Outpatient Psychotherapy,” by M.C. Graf, B.A. Gaudiano, and P.A. Geller, 2008, Psychotherapy Research18(4), p. 394 (https://doi.org/10.1080/10503300701691664) Copyright 2008 by Routledge.

 

Figure 6

Influence of Writing Type on Self-Reported Stress Over Time

A line graph showing Stress levels during control writing, and expressive writing.

Adapted from “Written Emotional Disclosure: A Controlled Study of The Benefits of Expressive Writing Homework in Outpatient Psychotherapy,” by M.C. Graf, B.A. Gaudiano, and P.A. Geller, 2008, Psychotherapy Research18(4), p. 394 (https://doi.org/10.1080/10503300701691664) Copyright 2008 by Routledge.

 

For those of you interested in how expressive writing could be used in a therapeutic setting visit Pennebaker’s article here

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