Writing Therapy for Posttraumatic Stress: A Meta-Analysis

Abstract

Background: Face-to-face psychological treatments have difficulty meeting today’s growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administered through the Internet. We therefore conducted a meta-analysis to investigate the efficacy of writing therapies for PTS and comorbid depressive symptoms. Methods: The literature was searched using several structured and unstructured strategies, including key word searches of the PubMed, Web of Science, PsycINFO, and PILOTS databases. Six studies met eligibility criteria and were included in the analyses. These studies included a total of 633 participants, of which 304 were assigned to writing therapy. Results: Across 5 direct comparisons of writing therapy to waiting-list control, writing therapy resulted in significant and substantial short-term reductions in PTS and comorbid depressive symptoms. There was no difference in efficacy between writing therapy and trauma-focused cognitive behavioral therapy, but we caution that this finding was based on only 2 direct comparisons. Conclusions: Writing therapy is an evidence-based treatment for PTS, and constitutes a useful treatment alternative for patients who do not respond to other evidence-based treatments. Internet adaptations of writing therapy for PTS may be especially useful for reaching trauma survivors in need of evidence-based mental health care who live in remote areas or who prefer to retain their anonymity.

Concreteness and Specificity in Clinical Psychology

“…Van Emmerik et al (2013), therefore, conducted a meta-analysis to investigate the efficacy of writing therapies for PTS and comorbid depressive symptoms. The literature was searched using several structured and unstructured strategies, including keyword searches of the PubMed, Web of Science, PsycINFO, and PILOTS databases.…”

No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder

“…This method comes close to the therapist-supported writing therapy, an approach that has been used in the treatment of various other disorders with good results (including posttraumatic stress disorder [24,25,26], complicated grief [27,28], social phobia [29,30,31], panic disorder [32,33], generalized anxiety disorder [34,35], depression [36,37] and burnout [38]). However, therapist-supported writing therapy goes beyond a self-help approach with therapist contact.…”

Schreibtherapie nach traumatischen Belastungen: Therapieansätze und Wirkmechanismen

“…Auch nachfolgende Studien, die diesen Ansatz aufnahmen, konnten diese Ergebnisse replizieren [ 14 , 16 -18 ] . In einer ersten Metaanalyse (K = 6) zur Schreibtherapie bei PTBS [ 19 ] …”

“…Mögli-cherweise ist dabei die spezifi sche Darbietungsform des Therapierationals (ob mündlich oder schriftlich) von untergeordneter Relevanz und die Wirksamkeit primär auf die inhaltliche Ausgestaltung zurückzuführen. Die Befunde der Metaanalyse von Emmerik et al[ 19 ] deuten darauf hin, dass schreibtherapeutische Interventionen vergleichbar wirksam sind wie konventionelle Therapieansätze. Ob dies allerdings auf identischen Wirkfaktoren beruht, ist nicht ausreichend geklärt.…”