Programmed writing and therapy with symbiotically enmeshed patients.

Am J Psychother. 1995 Spring;49(2):225-36.

Jordan KB1, L’Abate L.

This paper illustrates how programmed writing lessons to be completed as homework assignments can be used in conjunction with traditional verbal psychotherapy. Each patient was involved in a symbolically enmeshed relationship. Special benefits for patients from the combination of programmed writing lessong with traditional psychotherapy were: (1) increased couple communication; (2) possibly more rapid change; (3) possibly shorter-term therapy; (4) increased forgotten trauma discovery; (5) and increased explicit and specific instructions. Patients were informed from the outset that the use of programmed writing lessons would or might: (1) help the therapist get a better idea of what was going on in regard to the development, values, rules, etc. of their symbiotic relationships; (2) decrease the time spent in therapy, and (3) encourage self-realization through self-directed assignments between sessions. For psychotherapists there are advantages of: (1) putting the responsibility for change on the shoulders of patients rather than on themselves; (2) using programs of theoretical and therapeutic approaches that may not be well known to the therapist; (3) reducing the frequency of sessions and administering written homework assignments when the therapist is on vacation; and (4) increasing the number of patients that can be seen for unit of therapist’s time.

The use of writing in psychotherapy.

Am J Psychother. 1991 Jan;45(1):87-98.

L’Abate L.

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.