Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work.
As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis.
Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention.
The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process.
Published online 2013 Dec 23. doi: 10.1080/10615806.2013.868887
Jonathan A. Beyer, Mark A. Lumley, Deborah A. Latsch, Lindsay M.S. Oberleitner, Jennifer N. Carty, and Alison M. Radcliffe
Standard written emotional disclosure (WED) about stress, which is private and unguided, yields small health benefits. The effect of providing individualized guidance to writers may enhance WED, but has not been tested. This trial of computer-based WED compared two novel therapist-guided forms of WED—advance guidance (before sessions) or real-time guidance (during sessions, through instant messaging)—to both standard WED and control writing; it also tested Big 5 personality traits as moderators of guided WED. Young adult participants (n = 163) with unresolved stressful experiences were randomized to conditions, had three, 30-min computer-based writing sessions, and were reassessed 6 weeks later. Contrary to hypotheses, real-time guidance WED had poorer outcomes than the other conditions on several measures, and advance guidance WED also showed some poorer outcomes. Moderator analyses revealed that participants with low baseline agreeableness, low extraversion, or high conscientiousness had relatively poor responses to guidance. We conclude that providing guidance for WED, especially in real-time, may interfere with emotional processing of unresolved stress, particularly for people whose personalities have poor fit with this interactive form of WED.
Am J Psychother. 1991 Jan;45(1):87-98.
The use of writing in psychotherapy is relatively new and may have meager empirical support. A rationale for the use of writing in psychotherapy is given in terms of splitting therapeutic skills into relationship and structuring skills. Writing is one application of structuring skills to increase the therapist’s influence outside of the office and into the home or workplace. There are at least four different degrees of writing possible according to structure: open, focused, guided, and programmed. Examples from the available literature are given. Even though, its impact on therapeutic outcome has yet to be fully realized beyond the experience of few clinicians. Pennebacker’s research contribution in the use of writing is highlighted to support its use in psychotherapy. He found that students who wrote on traumatic topics for 20 minutes a day for four days showed improved physiological reactions and fewer physical symptoms at three-month follow-up than students who wrote about trivial topics.