How does expressive writing promote recovery from trauma?

Background

After a traumatic event, it is common to experience heightened distress and a range of other uncomfortable emotions and responses. For some people, these reactions will recover naturally over a few weeks. For other people, these reactions will continue or even get worse, to the point that they can interfere with everyday life. Such persistent symptoms are known as post-traumatic stress (PTS).

Theories regarding the development and maintenance of PTS emphasise disruptions in the processing of the memory of the event, and avoidance of the memory and reminders of the event. As such, prominent treatments for PTS involve the re-processing and reconsolidation of the traumatic memory and associated thoughts, feelings and sensations. While such treatments are effective, there remains questions as to how and why this process works in producing recovery from PTS and for whom specifically. Furthermore, different treatments use different methods to produce this reconsolidation process, and there is emerging evidence of the effectiveness of expressive writing in the recovery from trauma.

Project aims

The proposed research aims to explore mechanisms of change in two brief interventions for PTS that involve sessions of structured writing about the trauma experience, with guidance from the primary researcher. Expressive writing is a broad term for a range of therapeutic writing interventions that instruct individuals to write about one or more stressful experiences they have encountered in their life. Expressive writing is considered a safe and beneficial intervention for persistent psychological symptoms arising from trauma, including subthreshold PTS symptoms and clinical PTSD populations (Sloan et al., 2011; 2018). Additionally, some longer-term treatments for PTSD, such as Cognitive Processing Therapy, commonly incorporate writing techniques as a means to facilitate re-processing of the trauma memory.

The proposed research explores mechanisms of change in producing benefits from structured writing interventions. The study will allocate participants with PTS to one of three expressive writing conditions. The conditions differ with regards to their underlying theoretical model, meaning that they intend to target different mechanisms. Thus, it is hypothesised that the three conditions will have different effects on various process and outcome variables included in the study.

Project significance

The current study will enhance our knowledge regarding the mechanisms that drive recovery from PTS in a psychological intervention. In doing so, this study will have both research and clinical implications. Identifying mechanisms will allow for the critical appraisal of existing theoretical models of PTSD and its treatment. Some aspects of theoretical models offer conflicting ideas regarding the key processes in PTSD and the present research aims to add clarification. This in turn allows for the refinement of treatments for PTSD and early intervention targets to decrease the likelihood of developing PTSD. Furthermore, the research will allow clinicians to tailor treatments depending on an individuals’ particular difficulties. Depending on our findings, we are likely to make recommendations to clinicians on what types of treatment techniques may work for individuals suffering from certain difficulties. Within the PTSD research community, this kind of research is now considered of critical importance (Kangaslampi & Peltonen, 2019) due to these implications involved.

Participants

We aim to recruit 150 adults who reside in Australia that are experiencing some continued distress following a traumatic event. As the intervention is conducted online, there is no exclusion based on location, so long as participants have access to a computer, webcam/phone facilities, and internet.

Interested participants are encouraged to contact the primary researcher Rachelle for more information: Rachelle.dawson@anu.edu.au