Expressive writing as a practice against work stress: A literature review

Figures & data

Figure 1. Representation of the literature selection process based on the PRISMA method (cf. Moher et al., 2009).

Table 1. Tabular comparison of the internal validity threats of the studies analyzed in the review.

Article listing by researcher	Comparison of internal validity threats
	Maturation	Selection	Mortality	History
Ashley et al. (2013)	low threat	very low threat	threat	–
Barclay and Saldanha (2016)	low threat	low threat	low threat	–
Barclay and Skarlicki (2009)	low threat	low threat	very low threat	–
Cosentino et al. (2019)	low threat	threat	very low threat	threat
Cosentino et al. (2021)	low threat	very low threat	very low threat	–
Kirk et al. (2011)	increased threat	low threat	low threat	–
Michailidis Cropley (2019)	increased threat	very low threat	increased threat	–
Procaccia et al. (2021)	low threat	very low threat	very low threat	–
Round et al. (2022)	low threat	very low threat	threat	–
Saldanha and Barclay (2021)	low threat	low threat	increased threat	–
Tarquini et al. (2016)	threat	threat	very low threat	intense threat
Tonarelli et al. (2017)	low threat	very low threat	very low threat	–
Tonarelli et al. (2018)	low threat	threat	very low threat	threat

Table 2. Tabular comparison of the studies analyzed in the review.

Article listing by researcher	Research subject	Design	Sample characteristics	Key dependent variable	Independent variable	Key findings
Ashley et al. (2013)	Evaluation of written emotional disclosure interventions on the self-reported health and job satisfaction of school teachers	Randomized control trial	Participants were recruited through advertisements in schools in the UK,5.33 years of work experience, 43.62 average age, 85.71 % females (N = 77)	Psychological health, Physical health, Job satisfaction	Vriations of expressive writing protocol	No significant difference could be found between experimental groups and the control group with respect to the dependent variables Physical health, however, improved in all writing conditions (experimental and control); this improvement was still evident six months after the intervention
Barclay and Saldanha (2016)	Evaluation of the relationship between expressive writing and forgiveness after an injustice at work	Randomized control trial	Participants were recruited on a North American university campus,5.33 years of work experience, 20.85 average age, 67.7 % females (N = 96)	Overall Injustice Perceived Resolution Forgiveness	Experiences with injustice in the workplace and variations of the expressive writing protocol	Expressive writing was associated with higher levels in perceived resolution meditated by positive emotions and perceived injustice Perceived resolution also mediated the relationship between expressive writing and forgiveness
Barclay and Skarlicki (2009)	Evaluation of the effectiveness of expressive writing after an injustice at work	Randomized control trial	Participants were recruited on a North American university campus,5 years average of work experience, 23 average age, 75 % females (n = 100)	Physical Symptoms Psychological Well-being Anger Retaliation Intentions Perceived Resolution	Experiences with organizational injustice	Expressive writing was associated with higher psychological well-being, fewer intentions to retaliate, and higher levels of personal resolution
Cosentino et al. (2019)	Evaluation of the expressive writing protocol in palliative care	Pretest–Posttest Control Group Design (no randomization)	Palliative care staff from Northern Italy, 34.8 %; were between 26-35 years old, 68.2 % females (N = 66)	Compassion Satisfaction, Group Cohesion, Organizational Commitment	Expressive writing protocol	The analysis did not show significant differences between the experimental group and control group
Cosentino et al. (2021)	Evaluation of the expressive writing protocol in palliative care	Randomized control trial	Palliative care staff from Northern Italy, 44.74 average age, 78 % females (N = 50)	Compassion Satisfaction, Organizational Commitment, Resilience, Compassion Fatigue Perceived Stress	Expressive writing protocol	Expressive writing was associated with higher continuance Commitment, lower sleep disturbances, less anger, less intrusiveness, less hyperarousal
Kirk et al. (2011)	Evaluation of expressive writing protocol in terms of self-efficacy, emotional intelligence, positive affect and workplace incivilities	Randomized control trial	Various personnel from New South Wales and Queensland Australia, 3.1 years average work experience, 35.1 average age, 67.35 % females (N = 49)	Emotional Self-efficacy Emotional Intelligence Positive Affect Negative Affect Incivility Victimization Incivility Perpetration	Experiences incivility in the workplace, expressive writing protocol	Expressive writing was associated with increase in self-efficacy for participants with lower pretest scores, increase in emotional intelligence, positive affect, and decrease in workplace incivility perpetration
Michailidis and Cropley (2019)	Evaluation of the influence of expressive writing on workplace embitterment	Randomized control trial	Various personnel from the UK, 45 % have worked in their current role 1-3 years, average age 34.22, 50 % females (N = 44)	Embitterment, Work-related Rumination, Sleep Quality	Expressive writing protocol	No significant differences were found between the control and experimental group. In both groups, embitterment and affective rumination decreased, detachment increased, and sleep quality improved
Procaccia et al. (2021)	Evaluation of the influence of expressive writing on psychological adjustment of healthcare workers during the Covid Pandemic	Randomized control trial	Palliative care staff from Italy, 46.42 average age, 74.54% % females (N = 55)	Perceived social support, Resilience Depression PTSD	Expressive writing Protocol	Expressive writing was associated with a decrease in PTSD, depression and global psychopathology In addition, the effect of expressive writing was found to depend on demographic variables
Round et al. (2022)	Examining the influence of an expressive writing protocol that encourages positive reflection on events on teachers and non-teachers	Randomized control trial	Teachers and non-teachers from the UK 38.1 average age, 81.28% % females (N = 66)	State anxiety Burnout Job satisfaction Perceived stress Trait anxiety Physical health	An expressive writing protocol that encourages intensive reflection on a particularly positive experience	State anxiety and job satisfaction were positively influenced by the experimental condition of positive expressive writing There was no difference between teachers and non-teachers
Saldanha and Barclay (2021)	Validate a new expressive writing intervention that promotes meaning-finding to help deal with workplace unfairness	Randomized control trial	Participants were recruited on a North American university campus, 3.34 years of work experience, 20.32 average age, 43.4 % females (N = 131)	Willingness to reconcile Positive relationships with others Resilience Situation Resolution	Experiences with unfairness in the workplace and variations of the expressive writing protocoll	The meaning-finding protocol is associated with higher resilience than traditional expressive writing Resilience has a mediating effect on the relationship between expressive writing and willingness to reconcile, positive relationships with others, and life satisfaction.
Tarquini et al. (2016)	Evaluate the impact of expressive writing on occupational burnout.	Non equivalent Control Group Design	Italian administrators from Siena and Chianciano Terme, 49.94 average age, 51.43 % females (N = 35)	Exhaustion, Cynicism, Professional Ineffectiveness Alexithymia Difficulty Identifying Feelings Difficulty Describing Feelings Self-acceptanc Positive Relations With Others Externally-oriented Thinking Environmental Mastery Personal Growth Dimension	Expressive writing protocol	Expressive writing was associated with a decrease of all three burnout dimensions, alexithymia, and an increase in environmental mastery, self-acceptance and positive relations with others
Tonarelli et al. (2017)	Evaluate the impact of an expressive writing protocol on coping strategies, emotions and relationships, and on work satisfaction of health care professionals	Randomized control trial	Healthcare staff from Bologna, 45.47 average age, 97 % females (N = 66)	Coping Strategies, Working Satisfaction Relational Communication Satisfaction	Expressive writing protocol	In the follow-up measurement, a rebound effect was found in the avoidant coping style
Tonarelli et al. (2018)	Review of findings previously obtained in 2017 on the relationship between expressive writing and coping with occupational stress in the field of palliative care	Pretest–Posttest Control Group Design (no randomization)	Palliative care staff from Italy 46.15 average age, 88,5% female (N = 27)	Avoidance Transcendent Positive aptitude Social support Problem orientation Emotional exhaustion Depersonalization Personal fulfillment Explicit recognition Work-family balance Work family Colleagues Social interaction Professional opportunities Praises and recognitions Responsibilities control	Expressive writing protocol	The experimental group showed lower avoidant coping strategies and improved work-colleague relationships.

Figure 2. Graphical representation of the positive effects of expressive writing depending on the study design and intervention protocol.

Table 3. Tabular comparison of intervention protocols used for expressive writing.

Article listing by researcher	Variables of the expressive writing implementation protocol
				Instructions
	Number of sessions	Duration (minutes)	Time between sessions	Experimental group	Control group
Ashley et al. (2013)	3	20	Consecutive	Writing about thoughts and feelings (EG1) / Writing about thoughts and feelings about one single event (EG2) / Writing about thoughts and feelings about a stressful work-related topic (EG 3)	Writing about time management
Barclay and Saldanha (2016)	4	20	Consecutive	Writing about thoughts and feelings about an experience of injustice in the workplace (EG1) / Writing about thoughts and feelings about an experience of injustice in the workplace and forgiveness (EG 2 + EG 3)	Writing about time management, bedroom, daily routine, experimental room
Barclay and Skarlicki (2009)	5	20	Consecutive	Writing about thoughts and feelings about an experience of injustice in the workplace	Writing about time management, bedroom, daily routine, experimental room
Cosentino et al. (2019)	2	15	Time span of 1 – 3 Days	Writing about thoughts and feelings about traumatic, stressful and emotionally significant event in personal life	Write in an objective way about an event that has occurred without dwelling on emotions, thoughts and feelings
Cosentino et al. (2021)	3	15	Time span of 15 Days	Writing about thoughts and feelings about traumatic, stressful and emotionally significant event in personal life	Use of a comparison tool to describe an event as objectively as possible
Kirk et al., (2011)	3	20	Consecutive	Writing about thoughts and feelings about the workday or a significant event at work	Writing about daily routine
Michailidis &Cropley (2019)	3	20	Consecutive	Writing about deepest thoughts and feelings about work	Writing about daily routine
Procaccia et al. (2021)	3	20	Consecutive	Writing about thoughts and feelings about an emotional events	Write in an objective way about an event that has occurred without dwelling on emotions, thoughts and feelings
Round et al. (2022)	3	20	Consecutive	Writing about thoughts and feelings surrounding intensely positive previous experiences	Writing about plans for the rest of the day, shoes they were wearing and their bedroom
Saldanha and Barclay (2021)	4	20	Consecutive	Writing about emotions and thoughts about an experience of injustice in the workplace (EG1) / Writing about thoughts and feelings about an experience of injustice in the workplace and the benefits/positive aspects (EG 2 + EG 3)	Writing about time management, bedroom, daily routine, experimental room
Tarquini et al. (2016)	3	20	Time Span Of 15 Days	Writing about deepest thoughts and feelings about relocation and relating these with their personal situation	–
Tonarelli et al. (2017)	3	20	Consecutive	Writing about thoughts and feelings about traumatic, stressful and emotionally significant event in personal life	Writing about time Management
Tonarelli et al. (2018)	3	20	Consecutive	Writing about thoughts and feelings about traumatic, stressful and emotionally significant event in personal life	Writing about time Management

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