Using Reflective Writing as a Nursing Intervention: Review of the Literature

Over twenty years ago in a groundbreaking study, participants who engaged in an expressive writing intervention about emotionally-laden experiences showed positive changes in health outcomes when compared with those in a neutral writing control group. The effects lasted several weeks after the writing intervention concluded. Since then, a number of studies have indicated that written disclosure about stressful experiences improves measures of physical and mental health in clinical and non-clinical populations. For instance, expressive writing has been linked to: fewer physician visits, increases in T-helper cell growth, drops in blood pressure and heart rate, and improvements in mood. Additionally, writing about stressful events appears to increase meaning making and lead to fewer intrusive thoughts.

While these studies have been primarily in the fields of psychology and medicine, nursing has begun to investigate expressive writing as a low-cost effective intervention. The purpose of this presentation is to review the literature on the effects of an expressive writing intervention on measures of physical and mental health outcomes. The presentation describes implications for evidence based practice including guidelines for practitioners who want to study the effects of a minimally-structured writing intervention in select populations.