Writing therapy using new technologies—the art of blogging

Pages 41-45 | Published online: 04 Mar 2009

Using a blog as a form of journaling is becoming increasingly common. With email we are familiar with the phenomenon of responding rapidly and emotionally. In the blogging world, the same phenomenon may take place. While this type of immediate cathartic release may be similar to placing words on the pages of a journal, the aftermath that follows the use of blogging as journaling may be experienced much differently. The authors discuss the line between a self-help experience, a cathartic and possibly therapeutic intervention, and concern for the person who may be revealing too much. The therapist can prepare the client for feelings of empowerment, relief, and even exhilaration. They can also prepare for the risks, such as feelings of vulnerability, exposure, and possibly being re-traumatized. That the therapist may also want to establish boundaries within the therapeutic relationship about a client’s blog is also discussed.

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Unravelling the written word: Expressive Writing, narratives and Counselling Psychology

http://openaccess.city.ac.uk/13840/1/Pavlides%2C%20R.%20%28redacted%29.pdf

 

There is a growing body of evidence supporting the use of Pennebaker’s ‘Expressive Writing’ paradigm as an adjunct to psychological therapy or as a self-help therapeutic intervention. Research, thus far, has predominantly focused on measuring, explaining and analysing the effects of ‘Expressive Writing’ as a therapeutic intervention through randomised controlled trials, paying little attention to the subjective experience of the individuals and the types of narratives people write. This doctoral research approaches ‘Expressive Writing’ from a narrative perspective, which argues that individuals construct their sense of self and create meaning of their own lives through the use of narratives. The aim of this thesis is to explore how people construct their sense of self through ‘Expressive Writing’. Following an adapted version of Pennebaker’s ‘Expressive Writing’ guidelines, six participants were asked to spend 50 to 60 minutes writing about an emotional life-changing event and then share their stories, and their experience of writing about their stories, in an hour-long interview. The study used qualitative methods of inquiry, namely narrative analyses to explore the process of the construction of sense of self in both the written and oral narratives. The emerged findings point to the natural tendency of people to write in a narrative form using culturally available narratives and highlight the dialogical nature of the intervention. Findings are discussed in terms of implications for Counselling Psychology practice, their contribution to theory, and suggestions for future research. Overall, this thesis suggests that Expressive Writing could be a valuable addition to Counselling Psychology practice, when used in line with the ethos and values of Counselling Psychology.

Focused expressive writing as self-help for stress and trauma.

J Clin Psychol. 2003 Feb;59(2):227-35.

Abstract

In the therapy process, the process of disclosing about stressful or traumatic events is often considered essential. One such manner is through focused expressive writing (FEW) about stressful or traumatic experiences. FEW is related to improvements in health and well-being, across a wide array of outcomes and participant characteristics. As FEW requires limited involvement of other individuals, is relatively low cost, and portable, it has tremendous potential as self-help. In particular, FEW may be an effective means to reach populations unwilling or unable to engage in psychotherapy. A case illustration of FEW is presented. Evidence and future directions for FEW as self-help are reviewed.

https://www.ncbi.nlm.nih.gov/pubmed/12552631

Focused expressive writing as self-help for stress and trauma.

J Clin Psychol. 2003 Feb;59(2):227-35.

Smyth J1, Helm R.

In the therapy process, the process of disclosing about stressful or traumatic events is often considered essential. One such manner is through focused expressive writing (FEW) about stressful or traumatic experiences. FEW is related to improvements in health and well-being, across a wide array of outcomes and participant characteristics. As FEW requires limited involvement of other individuals, is relatively low cost, and portable, it has tremendous potential as self-help. In particular, FEW may be an effective means to reach populations unwilling or unable to engage in psychotherapy. A case illustration of FEW is presented. Evidence and future directions for FEW as self-help are reviewed.

https://www.ncbi.nlm.nih.gov/pubmed/12552631

A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder.

Behav Res Ther. 2009 Jan;47(1):6-12. doi: 10.1016/j.brat.2008.10.006. Epub 2008 Oct 17.

Bugg A1, Turpin G, Mason S, Scholes C.

The study investigated the effects of writing and self-help information on severity of psychological symptoms in traumatic injury patients at risk for developing post-traumatic stress disorder (PTSD). Patients attending Accident and Emergency (A & E), were screened for Acute Stress Disorder and randomised to an information control group (n=36) or a writing and information group (n=31). Participants in both groups received an information booklet one-month post-injury. Participants in the writing group also wrote about emotional aspects of their trauma during three 20-min sessions, five to six weeks post-injury. Psychological assessments were completed within one month and at three and six months post-injury. There were significant improvements on measures of anxiety, depression and PTSD over time. Differences between groups on these measures were not statistically significant. However, subjective ratings of the usefulness of writing were high. In conclusion, the results do not currently support the use of writing as a targeted early intervention technique for traumatic injury patients at risk of developing PTSD.

https://www.ncbi.nlm.nih.gov/pubmed/19012880

Writing for Health: Rationale and Protocol for a Randomized Controlled Trial of Internet-Based Benefit-Finding Writing for Adults With Type 1 or Type 2 Diabetes.

JMIR Res Protoc. 2017 Mar 14;6(3):e42. doi: 10.2196/resprot.7151.

Crawford J1,2, Wilhelm K1,2,3, Robins L1,3, Proudfoot J2,4.

Diabetes mellitus is Australia’s fastest growing chronic disease, and has high comorbidity with depression. Both subthreshold depression and diabetes distress are common amongst people with type 1 or type 2 diabetes, and are associated with poorer diabetes self-care. A need exists for low-intensity self-help interventions for large numbers of people with diabetes and diabetes distress or subthreshold depression, as part of a stepped-care approach to meeting the psychological needs of people with diabetes. Benefit-finding writing is a very brief intervention that involves writing about any positive thoughts and feelings about a stressful experience, such as an illness. Benefit-finding writing has been associated with increases in positive affect and positive growth, and has demonstrated promising results in trials amongst other clinical populations. However, benefit-finding writing has not yet been examined in people with diabetes.

OBJECTIVE:

The aim of this randomized controlled trial (RCT) is to evaluate the efficacy of an Internet-based benefit-finding writing (iBFW) intervention for adults with type 1 or type 2 diabetes (compared to a control writing condition) for reducing diabetes distress and increasing benefit-finding in diabetes, and also improving a range of secondary outcomes.

METHODS:

A two-arm RCT will be conducted, using the online program Writing for Health. Adults with type 1 or type 2 diabetes living in Australia will be recruited using diabetes-related publications and websites, and through advertisements in diabetes services and general practitioners’ offices. Potential participants will be referred to the study-specific website for participant information and screening. All data will be collected online. Participants will be randomized to either iBFW about diabetes, or a control writing condition of writing about use-of-time. Both conditions involve three daily sessions (once per day for three consecutive days) of 15-minute online writing exercises. Outcome measures will be administered online at baseline, one-month, and three-month follow-ups.

RESULTS:

This trial is currently underway. The primary outcomes will be diabetes distress and benefit-finding in diabetes. Secondary outcomes will be depression, anxiety, diabetes self-care, perceived health, and health care utilization. We aim to recruit 104 participants. All stages of the study will be conducted online using the Writing for Health program. Group differences will be analyzed on an intention-to-treat basis using mixed models repeated measures. Linguistic analyses of the writing exercise scripts, and examinations of the immediate emotional responses to the writing exercises, will also be undertaken.

CONCLUSIONS:

This RCT will be the first study to examine iBFW for adults with type 1 or type 2 diabetes. If iBFW is found to be efficacious in reducing diabetes distress and improving diabetes self-care and other outcomes, iBFW may offer the potential to be a low-cost, easily accessible self-help intervention to improve the wellbeing of adults with diabetes.

TRIAL REGISTRATION:

Australia and New Zealand Clinical Trials Registry (ACTRN12615000241538).

https://www.ncbi.nlm.nih.gov/pubmed/28292741

 

When self-help materials help: Examining the effects of self-discrepancy and modes of delivery of positive self-statements

The Journal of Positive Psychology

Dedicated to furthering research and promoting good practice

Volume 11, 2016 – Issue 2

Pages 163-172

https://doi.org/10.1080/17439760.2015.1037862

& Vivian Miu-Chi Lun

Self-help materials inculcating individuals with positive self-statements are popular in recent years, although the effectiveness of such self-statements on improving individuals’ psychological well-being has not yet been confirmed. Using a control-group pre-test/post-test design, we examined how positive self-statements may or may not benefit individuals’ mood. Individual characteristics and modes of delivery were found to moderate mood changes resulting from positive self-statements. Specifically, we found that participants experienced negative mood change after reading positive self-statements, if they have low level of need satisfaction. However, we also found that participants experienced a mood boost after listening to positive self-statements, and this effect was unrelated to self-esteem or need satisfaction. These findings suggest that self-help materials with a focus on positive self-statements should be used with caution.