1. the healing potential of writing, stories & poems

2. key points  the evidence base for therapeutic writing  practical writing exercise  how does therapeutic writing work; implications  reflection & questions

3. therapeutic writing: evidence base  there’s a considerable amount of research out there – for example I have about 50 articles on writing & health in my own database  the research goes back at least 20 years, e.g: Pennebaker JW, & O'Heeron RC. Confiding in others and illness rate among spouses … J Abnorm Psychol 1984;93:473-6  a careful literature search in the mid ’90’s found 13 research studies that could be included in a meta-analysis: Smyth JM. Written emotional expression: effect sizes, outcome types … J Consult Clin Psychol 1998;66:174-84  there have been several further research studies involving clinical populations since this meta-analysis

4. therapeutic writing: meta-analysis  the therapeutic writing intervention produced significant improvements in 4 health areas – reported physical health, psychological wellbeing, physiological functioning, and general functioning – but not health behaviours  writing produced immediate (pre- to post-writing) increases in distress, which wasn’t related to health outcomes  effect sizes produced by writing were similar to those produced by other psychological, behavioural, or educational health interventions  most of the studies involved healthy, student populations the Smythe meta-analysis came to several interesting conclusions:

5. therapeutic writing: evidence base  Petrie KJ, Pennebaker JW et al Disclosure of trauma & immune response J Consult Clin Psychol 1995;63:787-92  Spera SP et al Expressive writing and coping with job loss Academy of Management J 1994; 37(2): 722-733  Kelley JE, Lumley MA, et al Health effects of emotional disclosure in rheumatoid arthritis patients Health Psychology 1997;16(4):331-40.  Smyth JM et al Effects of writing about stressful experiences on … asthma or rheumatoid arthritis JAMA 1999; 281(14): 1304-9  Hannay D, & Bolton G. Therapeutic writing in primary care: a feasibility study Prim Care Psych 1999;5(4):157-160.

6. therapeutic writing: evidence base  Smyth JM, Gould O, et al. The role of narrative in medicine: a multi-theoretical perspective. Adv Mind-Body Med 2000;16:186-93  Klapow JC, Schmidt SM, et al. Symptom management in older primary care patients: feasibility of an experimental, written self- disclosure protocol. Ann Intern Med 2001;134(9 Pt 2):905-11.  Gidron Y, Duncan E, et al. Effects of guided written disclosure of stressful experiences on clinic visits and symptoms in frequent clinic attenders. Fam Pract 2002;19(2):161-6.  Hockemeyer J, & Smyth J. Evaluating the feasibility and efficacy of a self-administered manual-based stress management intervention for individuals with asthma: results from a controlled study. Behav Med 2002;27(4):161-72.  Smyth J, & Helm R. Focused expressive writing as self-help for stress and trauma. J Clin Psychol 2003;59(2):227-35. … but please avoid missionary zeal!! …