The Impact of Written Emotional Disclosure on Cancer Caregivers’ Perceptions of Burden, Stress, and Depression: A Randomized Controlled Trial

The Impact of Written Emotional Disclosure on Cancer Caregivers’ Perceptions of Burden, Stress, and Depression: A Randomized Controlled Trial

Expressive Writing for Resilience in Adult Pediatric Oncology Survivors and Their Caregivers (2018-2019)

Randomized controlled expressive writing pilot in individuals with Parkinson’s disease and their caregivers

Caring for Caregivers (C4C): study protocol for a pilot feasibility randomised control trial of Positive Written Disclosure for older adult caregivers of people with psychosis.

Pilot Feasibility Stud. 2017 Nov 21;3:63. doi: 10.1186/s40814-017-0206-z. eCollection 2017.

Hazell CM1, Jones CJ2, Hayward M3, Bremner SA1, O’Connor DB4, Pinfold V5, Smith HE1,6.

The caregivers of people who experience psychosis are themselves at risk of developing physical and mental health problems. This risk is increased for older adult caregivers who also have to manage the lifestyle and health changes associated with ageing. As a consequence, older adult caregivers are in particular need of support; we propose a Written Emotional Disclosure (WED) intervention, called Positive Written Disclosure (PWD).


This is a pilot randomised controlled trial of PWD compared to a neutral writing control and a no writing condition. We aim to recruit 60 participants, 20 in each arm. This study will utilise a mixed-methods approach and collect quantitative (questionnaires) and qualitative (interviews) data. Quantitative data will be collected at baseline and 1, 3, and 6 months post baseline. Participants who complete a writing task (PWD or neutral writing control) will be invited to complete an exit interview to discuss their experiences of the intervention and study. The study is supported by a patient and public involvement group.


The results of this trial will determine whether a definitive trial is justified. If so, the quantitative and qualitative findings will be used to refine the intervention and study protocols.


ISRCTN, ISRCTN79116352. Registered on 23 January 2017.

Does expressive writing reduce stress and improve health for family caregivers of older adults?

Gerontologist. 2007 Jun;47(3):296-306.

Mackenzie CS1, Wiprzycka UJ, Hasher L, Goldstein D.

We examined whether written emotional disclosure reduces stress and improves health outcomes for family caregivers of physically frail and cognitively impaired older adults, as it has been shown to do for certain student and clinical populations.


Primary caregivers of older adults attending a day program were randomly assigned to expressive-writing (n = 14), time-management (n = 13), or history-writing (n = 13) conditions. Participants wrote for 20 minutes on four occasions over a 2-week period, and they completed self-report measures of caregiver burden and health prior to the intervention, immediately afterward, and at 1-month follow-up.


Contrary to expectations, expressive-writing and history-writing participants performed similarly across outcomes. Only caregiver participants in the time-management condition experienced significant mental and physical health improvements after writing.


The results of this study add to a growing body of research demonstrating equivocal effects of expressive writing with clinical samples, and they suggest the potential benefit of written time management for stressed caregivers.

Seeing the glass half full: optimistic expressive writing improves mental health among chronically stressed caregivers.

Br J Health Psychol. 2008 Feb;13(Pt 1):73-6.

Mackenzie CS1, Wiprzycka UJ, Hasher L, Goldstein D.

This study explored treatment mediators among caregivers of older adults who did not benefit from expressive writing in a recently published randomized clinical trial.


Twenty-seven expressive writing and time management participants completed questionnaires prior to writing, following their fourth writing session, and 1 month later. We examined the effect of group differences in linguistic markers on health improvements.


Our hypothesis concerning narrative development received no support, and expected links between function words and health were partially confirmed. Results most strongly supported the hypothesis that expressive writing benefited caregivers who used increasingly positive, optimistic, and future-focused language.