Addiction Disorders and Therapy

The effect of Expressive Writing among Illicit Drug Users: A Meta-analytic Review

*Amira M Ali
Department Of Psychiatric Nursing And Mental Health, Alexandria University, Egypt

*Corresponding Author:
Amira M Ali
Department Of Psychiatric Nursing And Mental Health, Alexandria University, Egypt
Email:mercy.ofheaven2000@gmail.com

Published on: 2019-02-11

Abstract

Purpose: This article examined the therapeutic effectiveness of expressive writing (EW) for psychological health, physical health, and recovery among illicit drug users.
Methods: This review involved an extensive search of PubMed, PsychINFO, Web of Science, CINAHL, and the grey literature for randomized trials that evaluated the effect of EW on psychological health, physical health, and recovery of illicit drug users. Nine studies were included in this review. Cohen’s d was computed, effect sizes were combined, and trials’ methodological quality was evaluated.
Results: Pooled and non-pooled results indicated no effect of EW on all the outcome measures both at posttreatment and at follow up. The range of effect sizes (ESs) was small (0.02 to 0.35), and most ESs (SMD) were below 0.20 e.g., depression (0.16, N= 218) and drug use (0.14, N= 125). Baseline levels of distress and life change moderated the effect of EW.
Conclusion: The results failed to support the therapeutic effectiveness of EW among drug users. Examined studies were deficient—had high unclear or high risk of bias and heterogeneity of procedures. Rigorous studies are needed to examine the therapeutic effectiveness of EW among drug users.

Keywords

Expressive Writing; Coping Behaviors; Cognitive Behavior Therapy; Mental Health; Physical Health; Substance- related Disorders; Recovery

Introduction

This article examines the available randomized control trials that used expressive writing in drug using samples for effects of the intervention on psychological health, physical health, and recovery. In this review “expressive writing” is defined as a self-exposure writing intervention in which participants write their deepest thoughts and feelings related to traumatic, stressful or emotional events spontaneously and continuously without paying attention to spelling or grammar—usually for 15-30 minutes on 3 to 4 consecutive days or weeks. “Psychological health” refers to the level of emotional and behavioral adjustment (the intervention effect is reflected by changes in symptoms of mental distress and dysfunction such as depression and anxiety). “Physical health” is indicated by the body’s ability to function and its general condition (e.g., sleep, pain, and nutrition). “Recovery” from illicit drug dependence is defined as processes of change that allow individuals achieve abstinence (e.g., seeking treatment, decreased frequency and quantity of drug use).