Employment counseling and life stressors: coping through expressive writing

Job loss can be one of life's most traumatic experiences, especially if the unemployment is extended. In addition to more common interventions used by employment counselors and others dedicated to assisting clients in the search for work, it can be helpful to assist clients in expressing their negative feelings through writing. Expressive writing is a powerful technique used successfully to confront traumatic life events. Beneficial effects of expressive writing include understanding why feelings occur. Factors that favorably influence expressive writing and specific procedures for implementation in the employment counseling context are discussed.     

Benefits of expressive writing and expressive talking about life goals

This study employed a 2 (writing vs. talking) × 2 (life goals vs. daily schedule) fully crossed, factorial design to examine whether health benefits might accrue for talking and/or writing about life goals. Participants assigned the life goals topic had fewer illness-related health center visits, regardless of mode of expression, compared to participants assigned the non-emotional topic. Counter to expectation, optimism did not moderate the effect of topic on illness-related health center visits. Participants in talking groups rated post-intervention mood as less negative than those in writing groups and participants rated talking about life goals as more difficult than writing about life goals.     

Structured writing about current stressors: The benefits of developing plans

To investigate the health outcomes of structured writing about everyday stressors, 64 undergraduates selected a stressful event with which they were currently dealing, and wrote about it at home on three occasions in 1 week. Two forms of writing were manipulated: expressive writing?–?exploring one's thoughts and feelings about the stressor; and planful writing?–?developing plans to deal with the problem. Appraisals of control and efficacy were investigated as mediators. Expressive writing yielded no health benefits and did not affect appraisals, but planful writing did. Whereas non-planners' levels of negative affect (NA) remained stable across writing days, planners initially experienced higher NA, but their NA decreased significantly across writing days. Planful writers, relative to non-planners, felt less control over their emotions and less confidence in resolving their problem, but it was non-planners who experienced an increase in stress-related symptoms following writing. Appraisals did not mediate the physical health outcomes.     

The health benefits of writing about intensely positive experiences

In a variation on Pennebaker’s writing paradigm, a sample of 90 undergraduates were randomly assigned to write about either an intensely positive experience (IPE) (n=48) or a control topic (n=42) for 20 min each day for three consecutive days. Mood measures were taken before and after writing. Three months later, measures of health center visits for illness were obtained. Writing about IPEs was associated with enhanced positive mood. Writing about IPEs was also associated with significantly fewer health center visits for illness, compared to controls. Results are interpreted as challenging previously considered mechanisms of the positive benefits of writing.     

Women's experiences of the therapeutic value of writing about pregnancy sickness

Background

There is evidence of the beneficial effects of writing therapy in relation to a range of disorders. This is the first study to evaluate those effects in the field of pregnancy sickness.

Aim

To analyse the experiences of women using writing therapy to address issues associated with pregnancy sickness.

Method

Ten women with an age range of 32–48 years participated in this research study. All had been hospitalised at least once with severe pregnancy sickness symptoms in the form of hyperemesis gravidarum. Participants were invited to write reflectively about their former pregnancy sickness, at home, and then take part in a qualitative, semi‐structured telephone interview of approximately one hour to talk about how they experienced this writing process.

Findings

Thematic analysis identified several themes relating to the beneficial effects and uses of writing therapy and women's relational need to be heard and supported.

Discussion

This study supports previous findings about the beneficial effects of writing therapy and contributes new knowledge to the field of pregnancy sickness vis‐à‐vis the importance of emotional expression, emotional care and emotional recovery. The findings have important implications for healthcare professional practice.     

Benefits of expressive writing in lowering rumination and depressive symptoms

Depression-vulnerable college students (with both elevated prior depressive symptoms and low current depressive symptoms) wrote on 3 consecutive days in either an expressive writing or a control condition. As predicted, participants scoring above the median on the suppression scale of the Emotion Regulation Questionnaire (Gross & John, 2003) showed significantly lower depression symptoms at the 6-month assessment when they wrote in the expressive writing versus the control condition. Additional analyses revealed that treatment benefits were mediated by changes in the Brooding but not the Reflection scale of the Ruminative Response Scale (Nolen-Hoeksema & Morrow, 1991). A "booster" writing session predicted to enhance treatment benefits failed to have a significant effect.     

The durability of beneficial health effects associated with expressive writing

Abstract

This study examined the durability of benefits associated with expressive writing. Sixty-eight college undergraduates completed measures of physical and psychological health at the beginning of their first year and were then randomized to either an expressive writing or a control writing condition. Changes in physical health, psychological health (i.e., depression, stress, and anxiety), and academic performance were assessed two, four, and six months later. Findings indicated that participants assigned to the expressive writing condition reported less depression symptom severity at the two-month follow-up assessment relative to participants assigned to the control condition. However, these symptom reductions were not observed at any of the subsequent follow-up assessments. No significant changes were reported for physical health complaints, stress symptoms, anxiety symptoms, or academic performance. These findings suggest that, among first-year college students, expressive writing may provide some short-term relief for certain symptoms.     

The health benefits of writing about positive experiences: The role of broadened cognition

This study tested the potential to elicit a broadened attentional focus through writing about a positive life experience and to derive health benefits from such writing. Participants (n = 38) wrote for 20 min each day for 3 consecutive days about either a positive life experience or a control topic. Writing about positive experiences led to improved physical health (measured 4–6 weeks after writing) compared to control and higher levels of global cognitive focus after writing mediated this effect. Notably, while the positive writing condition was more broadened than control, positive affect was not responsible for this difference. Implications for disclosive writing and the broaden and build model are discussed.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?相似文献   

Experimental manipulations of perspective taking and perspective switching in expressive writing

Previous studies suggest that those who naturally vary their pronoun use over the course of expressive writing subsequently report the greatest improvements in physical and mental health. To explore possible perspective taking or perspective switching effects, two studies manipulated writing perspectives about emotional events from either a first-person, second-person, or third-person perspective. In Study 1, 55 students were randomly assigned to one of the three writing perspectives and were asked to write from the same perspective for three 5-minute writing sessions. In Study 2, 129 students wrote for three 5-minute sessions, one from each perspective in a counterbalanced order. The results showed that writing from a first-person perspective conferred more perceived benefits and was associated with using more cognitive mechanism words, whether engaged in perspective taking or perspective switching.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.     

Experimental manipulations of perspective taking and perspective switching in expressive writing

Previous studies suggest that those who naturally vary their pronoun use over the course of expressive writing subsequently report the greatest improvements in physical and mental health. To explore possible perspective taking or perspective switching effects, two studies manipulated writing perspectives about emotional events from either a first-person, second-person, or third-person perspective. In Study 1, 55 students were randomly assigned to one of the three writing perspectives and were asked to write from the same perspective for three 5-minute writing sessions. In Study 2, 129 students wrote for three 5-minute sessions, one from each perspective in a counterbalanced order. The results showed that writing from a first-person perspective conferred more perceived benefits and was associated with using more cognitive mechanism words, whether engaged in perspective taking or perspective switching.     

Effects of positive versus negative expressive writing exercises on adolescent academic achievement

A robust body of research has documented how expressive writing about difficult or traumatic experiences can be beneficial across a range of domains. Relatively little research, on the other hand, has documented the impact of expressive writing activities on positive events. In this randomized controlled trial, adolescents (N = 350) beginning ninth grade in three schools serving mostly low-income students of color participated in a 45-min writing workshop. They were prompted to write about either a negative or positive life event, then edit their writing to include themes thought to insulate them from the possible threats to identity that can come with the transition to high school. We find evidence that positive expressive writing activities are more academically beneficial than expressive writing about negative events. Compared with students who wrote about a failure and subsequent resilience, students who detailed how they attained an important success showed a more positive trajectory for absences (β = −.417; p = .008) and detentions (β = −.962; p = .034), and those who wrote about a generally happy life event showed a better trajectory for grade point average (β = .622; p = .043). Exploratory analyses also show that, regardless of condition, including themes of the “self as competent” and “savoring” good experiences was associated with improved academic outcomes. Including themes of “resilience” was not, across conditions, associated with improved outcomes unless students at the same time included “self as competent” themes.     

How benefits of expressive writing vary as a function of writing instructions,ethnicity and ambivalence over emotional expression

Written emotional disclosure has been reported to confer a variety of benefits on physical and psychological well-being. However, variable findings suggest that outcomes may vary systematically as a function of specific parameters of the experimental design. This study aims to investigate the unique and combined effects of disclosure instructions focusing on emotional expression and instructions facilitating cognitive reappraisal and to examine how ambivalence over emotional expression and ethnicity moderate the effects of these writing instructions. Seventy-one Asian and 59 Caucasian undergraduates (N = 130) with at least minimal physical or depressive symptoms were randomly assigned to one of the four writing conditions: emotional disclosure (ED), cognitive reappraisal (COG), the combination of ED and COG, or a control condition. Self-reported physical symptoms, positive affect (PA) and negative affect were assessed at baseline and three follow-ups spanning 4 months. Mixed linear models revealed that COG writing reduced physical symptoms, ED buffered a decrease in PA over time, and the combination of ED and COG (i.e. self-regulation; SR) was most effective. Asians and highly ambivalent participants benefited most from expressive writing. Findings contribute to the development of a SR moderator model and carry implications for designing expressive disclosure studies, particularly for ethnic minorities.     

Examining explanatory mechanisms of positive and expressive writing: Towards a resource-oriented perspective

This study tested the hypothesis that benefits of positive and expressive writing accrue when the intervention matches or activates the participant’s personal resources. Students were randomly assigned to keep a newly developed resource diary (RD, n = 114), which asked the participants to write about positive experiences and personal resources, or an expressive writing diary (ED, n = 114), which asked the participants to engage with negative emotional experiences, at home on three consecutive days per week for four weeks. Participants keeping the RD perceived significantly more social support and reported a significantly better mood at post-test than participants keeping the ED. Compared to a control group (n = 81) treatment effects of both writing interventions were higher for participants with lower pre-test values of well-being and brooding as well as for participants who wrote in an ‘atmosphere of activated resources.’ It is suggested that research should move away from testing deficit-compensating hypotheses towards a stronger resource orientation.     

A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema

Objective: Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL.

Design: Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions.

Main Outcome Measures: Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy–Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis.

Results: There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis.

Conclusion: These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.     

Testing the benefits of expressive writing for workplace embitterment: a randomized control trial

Clinicians working in occupational health services often recognize features of embitterment in organizations; however, research on interventions for embitterment are scarce. The present study aimed to assess the effectiveness of an expressive writing intervention on working adults who experience workplace embitterment. Employing a randomized control trial we sought to test an expressive writing intervention for its effects on reducing embitterment, work-related rumination and sleep quality and assess whether the effect of the intervention was maintained over time by following up participants after one and three months. Findings partially supported our hypothesis as results showed that participants who completed the expressive writing intervention (N = 23) did not show significantly lower levels of embitterment, affective rumination, higher levels of detachment, either improved sleep quality, compared to participants who completed the factual writing (N = 21), when baseline values were controlled for. However, when looking at the mean scores embitterment and affective rumination levels diminished, detachment levels increased and sleep quality improved throughout the course of the intervention for both groups. Given the stability of embitterment and as findings from this study indicate embitterment diminished after a writing exercise irrespective of emotional disclosure taking place or not, further research and investigation are warranted.     

The benefits of expressive writing on sleep difficulty and appearance concerns for college women

The college years represent an important developmental period in the lives of young women, who report health-related difficulties such as sleep disturbance and body/eating concerns. This study explored whether expressive writing (EW) can decrease health-relevant complaints among college women. College females (n?=?111) were randomised into an EW condition (writing about body concerns) or a control writing condition and completed three 15-min writing sessions. Results indicate that participants in the EW condition reported less sleep difficulty and less body-focused upward social comparison at 8-week follow-up, relative to control participants. For individuals who reported higher perceived stress at baseline, the EW condition resulted in less eating disturbance and less social comparison, relative to the control condition. The effect of EW on eating disturbance for those who were high in stress was partially mediated by the change in upward social comparisons focused on one's body. These findings suggest that EW about body image and appearance concerns may positively influence the trajectory of risk for, or resilience against, future complications as a result of sleep difficulty, eating disturbance and body dissatisfaction.     

Finding happiness in negative emotions: An experimental test of a novel expressive writing paradigm

Positive emotions are evoked on seeing one's favorite person. To investigate the psychological and physiological responses accompanying these positive emotions, we simultaneously recorded various parameters such as the mood state, heart rate, skin conductance level (SCL), serum levels of catecholamines, and proportions of T cells and natural killer (NK) cells among the lymphocytes while participants viewed films featuring their favorite persons. The participants reported that they felt better and invigorated; in addition, SCL and proportion of NK cells in peripheral blood increased significantly, and these physiological changes were positively correlated. These results suggest that positive emotions elicited on seeing a favorite person may lead to psychological and physiological activation and, more importantly, may promote health.

A cheerful heart is good medicine, but a crushed spirit dries up the bone (Proverbs 17 : 22; New International Version)