Expressive writing as a therapeutic process for drug-dependent women.

Subst Abus. 2014;35(1):80-8. doi: 10.1080/08897077.2013.805181.

Meshberg-Cohen S1, Svikis D, McMahon TJ.

Although women with substance use disorders (SUDs) have high rates of trauma and posttraumatic stress, many addiction programs do not offer trauma-specific treatments. One promising intervention is Pennebaker’s expressive writing, which involves daily, 20-minute writing sessions to facilitate disclosure of stressful experiences.


Women (N = 149) in residential treatment completed a randomized clinical trial comparing expressive writing with control writing. Repeated-measures analysis of variance was used to document change in psychological and physical distress from baseline to 2-week and 1-month follow-ups. Analyses also examined immediate levels of negative affect following expressive writing.


Expressive writing participants showed greater reductions in posttraumatic symptom severity, depression, and anxiety scores, when compared with control writing participants at the 2-week follow-up. No group differences were found at the 1-month follow-up. Safety data were encouraging: although expressive writing participants showed increased negative affect immediately after each writing session, there were no differences in pre-writing negative affect scores between conditions the following day. By the final writing session, participants were able to write about traumatic/stressful events without having a spike in negative affect.


Results suggest that expressive writing may be a brief, safe, low-cost, adjunct to SUD treatment that warrants further study as a strategy for addressing posttraumatic distress in substance-abusing women.

Expressive writing for high-risk drug dependent patients in a primary care clinic: a pilot study.

Harm Reduct J. 2006 Nov 19;3:34.

Baikie KA1, Wilhelm K, Johnson B, Boskovic M, Wedgwood L, Finch A, Huon G.

Previous research has shown that expressive writing is beneficial in terms of both physical and emotional health outcomes. This study aimed to investigate the effectiveness and acceptability of a brief expressive writing intervention for high-risk drug dependent patients in a primary care clinic, and to determine the relationship between linguistic features of writing and health outcomes.


Participants completed four 15-minute expressive writing tasks over a week, in which they described their thoughts and feelings about a recent stressful event. Self-report measures of physical (SF-12) and psychological health (DASS-21) were administered at baseline and at a two-week follow-up. Fifty-three participants were recruited and 14 (26%) completed all measures.


No statistically significant benefits in physical or psychological health were found, although all outcomes changed in the direction of improvement. The intervention was well-received and was rated as beneficial by participants. The use of more positive emotion words in writing was associated with improvements in depression and stress, and flexibility in first person pronoun use was associated with improvements in anxiety. Increasing use of cognitive process words was associated with worsening depressive mood.


Although no significant benefits in physical and psychological health were found, improvements in psychological wellbeing were associated with certain writing styles and expressive writing was deemed acceptable by high-risk drug dependent patients. Given the difficulties in implementing psychosocial interventions in this population, further research using a larger sample is warranted.