title: Expressive writing for high-risk drug dependent patients in a primary care clinic: a pilot study.
abstract: BACKGROUND
  Previous research has shown that expressive writing is beneficial in terms of both physical and emotional health outcomes. This study aimed to investigate the effectiveness and acceptability of a brief expressive writing intervention for high-risk drug dependent patients in a primary care clinic, and to determine the relationship between linguistic features of writing and health outcomes.
  
  
  METHODS
  Participants completed four 15-minute expressive writing tasks over a week, in which they described their thoughts and feelings about a recent stressful event. Self-report measures of physical (SF-12) and psychological health (DASS-21) were administered at baseline and at a two-week follow-up. Fifty-three participants were recruited and 14 (26%) completed all measures.
  
  
  RESULTS
  No statistically significant benefits in physical or psychological health were found, although all outcomes changed in the direction of improvement. The intervention was well-received and was rated as beneficial by participants. The use of more positive emotion words in writing was associated with improvements in depression and stress, and flexibility in first person pronoun use was associated with improvements in anxiety. Increasing use of cognitive process words was associated with worsening depressive mood.
  
  
  CONCLUSIONS
  Although no significant benefits in physical and psychological health were found, improvements in psychological wellbeing were associated with certain writing styles and expressive writing was deemed acceptable by high-risk drug dependent patients. Given the difficulties in implementing psychosocial interventions in this population, further research using a larger sample is warranted.
authors.affiliation: School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia. k.baikie@unsw.edu.au
authors.forename: Karen A
authors.initials: KA
authors.lastname: Baikie
authors.forename: Kay
authors.initials: K
authors.lastname: Wilhelm
authors.forename: Beverley
authors.initials: B
authors.lastname: Johnson
authors.forename: Mary
authors.initials: M
authors.lastname: Boskovic
authors.forename: Lucinda
authors.initials: L
authors.lastname: Wedgwood
authors.forename: Adam
authors.initials: A
authors.lastname: Finch
authors.forename: Gail
authors.initials: G
authors.lastname: Huon