Adolesc Psychiatry. 1983;11:92-103.
The concept of the diary as a transitional object adds a new perspective to the theory and treatment of adolescents. The findings of this pilot study suggest that the diary mirrors, soothes , helps inhibit frightening impulses, and helps integrate inner and outer realities. These functional aspects of the diary become internalized into the evolving psychic structure just as the analogous functions of the therapist in the context of a positive transference are internalized. The use of the adolescent diary in psychotherapy enhances and enriches the meaning of the treatment alliance and promotes the progress of the “second separation-individuation.” The therapist’s sensitive and creative understanding of the diary- diarist relationship can lead to improved treatment strategies for adolescent patients. Further empirical research on the phenomenon of adolescent diary writing may deepen our clinical and theoretical understanding of this challenging population.
Clin Psychol Rev. 2015 Mar;36:42-55. doi: 10.1016/j.cpr.2015.01.003. Epub 2015 Jan 15.
This meta-analysis evaluated the effects of the expressive writing intervention (EW; Pennebaker & Beall, 1986) among adolescents. Twenty-one independent studies that assessed the efficacy of expressive writing on youth samples aged 10-18 ears were collected and analyzed. Results indicated an overall mean g-effect size that was positive in direction but relatively small (0.127), as well as significant g-effect sizes ranging from 0.107 to 0.246 for the outcome domains of Emotional Distress, Problem Behavior, Social Adjustment, and School Participation. Few significant effects were found within specific outcome domains for putative moderator variables that included characteristics of the participants, intervention instructions, or research design. Studies involving adolescents with high levels of emotional problems at baseline reported larger effects on school performance. Studies that implemented a higher dosage intervention (i.e., greater number and, to some extent, greater spacing of sessions) reported larger effects on somatic complaints. Overall, the findings suggest that expressive writing tends to produce small yet significant improvements on adolescents’ well-being. The findings highlight the importance of modifying the traditional expressive writing protocol to enhance its efficacy and reduce potential detrimental effects. At this stage of research the evidence on expressive writing as a viable intervention for adolescents is promising but not decisive.
The role of emotional expression was explored in the writings of adolescent children of parents with cancer. Participants ages 12-18 (n=40) were assigned randomly to write in 3 sessions about their thoughts and feelings regarding their parents’ cancer (experimental condition) or their time management (fact control condition). Physical health (i.e., doctor visits, school absences, physical symptoms) and psychological health variables (i.e., internalizing and externalizing behavior, depression, anxiety, positive emotion, negative emotion, post traumatic growth) were assessed as a function of writing condition and participants’ temporal orientation (i.e., the time period on which a person bases the majority of his or her perceptions of reality). Results from analysis of covariance indicated experimental condition was related to decreases in negative affect, self reported depression symptoms, parent-reported anxiety symptoms, and parent- reported internalizing problems in the adolescent participants and increases in post traumatic growth reported by the adolescent participants. Past temporal orientation was related to increased conduct problems reported by parents, increased physical symptoms, and decreased school absences. Conduct problems scores reported by parent were related to increased positive affect, increased anxiety, and decreased illness-related doctor visits. Adolescent Atypicality scores were related to increased parent-reported anxiety in the child, physical symptoms, and school absences. Problem solving coping was related to decreased anxiety, and behavioral avoidance coping was related to increased depression as reported by parent and increased internalizing problems as reported by parent. Given the significant results for the experimental condition, the findings are discussed in light of future possible research on the use of emotional expressive writing in adolescents as well as use of emotional writing tasks as interventions for adolescent children of cancer patients.