J Commun. 2011 Jun;61(3):432-464.
Despite much research on the beneficial effects of written disclosure, relatively little attention has been paid to specifying the mechanism underlying the effects. Building upon the two theoretical models (the cognitive adaptation model and the emotional exposure-habituation model), this research focused on two aspects of disclosure content—insights and emotions—and examined how women with breast cancer benefit from written disclosure in online support groups. Using survey data collected at baseline and after four months and messages posted in bulletin-board-type online groups in between, we analyzed how the content of disclosive messages predicted health outcomes. Disclosure of insights led to greater improvements in health self-efficacy, emotional well-being, and functional well-being, which was mediated by lowered breast cancer concerns. Disclosure of negative emotions did not have main effects on health outcomes; instead, it weakened the unfavorable association between concerns at baseline and functional well-being at follow-up. Our findings support both theoretical models, but in regard to different aspects of disclosure content.
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.
Psychol Bull. 2006 Nov;132(6):823-65.
Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified.