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 undergraduate students 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 severity at the two-month follow-up assessment relative to participates 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.”

Implications

For Practice

This article complements, but more importantly questions, conclusions of recent innovative studies on expressive writing and mental health. Since the mid-1990s, a significant number of research studies have been published demonstrating the efficacy of expressive writing as a tool for improving mental health and well-being. Much of this work follows and responds to the work of James Pennebaker, whose 1996 study on expressive writing and trauma established what has come to be called the Pennebaker Protocol. Pennebaker’s research suggested that some benefit may be derived from expressive writing. Subsequent studies have generally followed Pennebaker’s highly controlled methodology, and many have suggested a variety of benefits to expressive writing. This article, however, points to the possible limitations of expressive writing. Most notably, while the research demonstrated that expressive writing provided short-term relief from depression symptomology, it was unable to demonstrate any “durable” (i.e., long-lasting) effects of expressive writing among test subjects, in this case college freshmen. The article ultimately suggests that the hope for lasting healing effects from expressive writing may be very limited and that any claims about the benefit of expressive writing need to be more fully examined.

For Policy

The Department of Veterans Affairs (VA) is currently conducting a research project aimed at understanding whether or not expressive writing can benefit veterans with post-traumatic stress disorder (PTSD). As the VA develops programs and treatment processes to help veterans and family members understand and live with trauma, some of which fall in to the category of non-traditional treatments (e.g., art therapy, play therapy, etc.), a clear understanding of not only short-term but long-term benefits is necessary. VA programs that help veterans with depression, in particular, can benefit from longitudinal studies that track ongoing effects of new treatment methodologies. Significant funding and incentives for veterans to participate in long-term studies is necessary and need to be addressed by policy makers. Further, if expressive writing provides even a viable form of short-term relief from depression, implementation of programs will require ongoing education of both caregivers and clients.

For Future Research

While the study that is the subject of this brief does not directly control for veteran status, it nonetheless points to the need for a deeper and more nuanced understanding of the value of writing in mitigating the impact of trauma and disruptions to mental health. The study focuses on college freshmen, a group not inherently comparable to veterans. Recent research has looked at the veteran population and found that written exposure treatment reduced PTSD symptoms (see Sloan, Marx, Bovin, Feinstein, and Gallagher 2012). Further research that focuses solely on the effects of writing on veterans’ trauma, like that currently underway at the VA, will provide more actionable data. Further, more research on the durability of expressive writing needs to be conducted. The majority of expressive writing research has not examined durability, suggesting a significant gap in our understanding of how writing may or may not provide relief from anxiety, stress, and depression. Without a clearer vision of the long-term effects, whether positive, neutral, or even negative, the practice of expressive writing as a tool for healing should be studied more extensively.

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