profile pic

Adolescent Psychiatry

Author(s): Yuko Taniguchi, Mason Schlief, Jered Bright, Sue Simon and Jarrod M. Leffler*

DOI: 10.2174/2210676612666211222104647

DownloadDownload PDF Flyer Cite As
Implementation of an Expressive Writing Intervention for Adolescents During Inpatient Psychiatric Hospitalization

Page: [23 - 37] Pages: 15

  • * (Excluding Mailing and Handling)

Explore Articles
About Journal
For Authors
For Editors
For Reviewers

Abstract

Background: Given the high rates of mental health concerns and communication difficulties for adolescents, a treatment intervention to allow for effective expression may be therapeutic. One of the leading writing practices is Pennebaker’s Expressive Writing (EW) intervention. EW involves individuals writing about their feelings and thoughts regarding negative life experiences. Benefits of EW include a reduction of psychological symptoms and doctor visits, and better adjustment.

Objective: The objective of this study is to examine the role of using EW and creative writing as a group intervention for youth admitted to an inpatient psychiatric hospital (IPH).

Methods: The current study evaluated participant engagement in a 3-day EW activity facilitated by nurses and graduate students on the IPH unit under the supervision of the IPH unit nurse manager and course instructor. Participants included 23 youth between 12- and 18-years-old.

Results: Of the 23 participants, 49.69% discussed vivid descriptions of illness, 24.5% discussed negative emotions, 20.25% included casual explanation, 5.52% discussed polarized view, and 16.56% discussed their desires, wishes, and goals. The response rate of clinician’s review of the EW content included 58% of clinician’s coding was on the patient’s current state, 24% was on causal explanations, and 18% was on treatment options.

Conclusion: The current EW intervention facilitated by nursing staff and graduate students in an IPH was found to be engaged by participants and provide an additional therapeutic resource to participants. EW may foster patient communication with staff about their functioning, mental health concerns, and treatment needs.

Keywords: Adolescents, inpatient treatment, implementation, milieu therapy, psychiatric care, group therapy.

Allison, J.M. (1994). Narrative and time: A phenomenological reconsideration. Text Perform. Q., 14, 108-125.
[http://dx.doi.org/10.1080/10462939409366076.]
Pennebaker, J., Kiecolt-Glaser, J., Glaser, R. 2013 Diagnostic and statistical manual of mental disorders. J. Consult. Clin. Psy.
Baikie, K.A., Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Adv. Psychiatr. Treat., 11, 338-346.
[http://dx.doi.org/10.1192/apt.11.5.338.]
Balkin, R.S. (2006). A reexamination of trends in acute care psychiatric hospitalization for adolescents: Ethnicity, payment, and length of stay. J. Prof. Couns. Pract. Theory Res., 34, 49-59.
[http://dx.doi.org/10.1080/15566382.2006.12033823.]
Bird, A., Reese, E. (2006). Emotional reminiscing and the development of an autobiographical self. Dev. Psychol., 42(4), 613-626.
[http://dx.doi.org/10.1037/0012-1649.42.4.613. ] [PMID: 16802895]
Blader, J.C., Carlson, G.A. (2007). Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996-2004. Biol. Psychiatry, 62(2), 107-114.
[http://dx.doi.org/10.1016/j.biopsych.2006.11.006. ] [PMID: 17306773]
Blazin, L.J., Cecchini, C., Habashy, C., Kaye, E.C., Baker, J.N. (2018). Communicating effectively in pediatric cancer care: Translating evidence into practice. Children (basel), 5(3), 40.
[http://dx.doi.org/10.3390/children5030040] [PMID: 29534479]
Blizzard, A.M., Weiss, C.L., Wideman, R., Stephan, S.H. (2016). Caregiver perspectives during the post inpatient hospital transition: A mixed methods approach. Child Youth Care Forum, 45, 759-780.
[http://dx.doi.org/10.1007/s10566-016-9358-x.]
Clarke, G., Lewinshon, P., Hops, H. (1990). Leader’s manual for adolescent groups: Adolescent coping with depression course.. Portland, OR: Kaiser Permanente Center for Health Research.
Davidson, L., Strauss, J.S. (1992). Sense of self in recovery from severe mental illness. Br. J. Med. Psychol., 65(Pt 2), 131-145.
[http://dx.doi.org/10.1111/j.2044-8341.1992.tb01693.x. ] [PMID: 1633118]
Drost, L.M., Schippers, G.M. (2015). Online support for children of parents suffering from mental illness: a case study. Clin. Child Psychol. Psychiatry, 20(1), 53-67.
[http://dx.doi.org/10.1177/1359104513496260. ] [PMID: 23904177]
Fisher, W. (1987). Human communication as narration: Toward a philosophy of reason, value, and action.. Columbia: University of South Carolina Press.
Fivush, R., Marin, K., Crawford, M., Reynolds, M., Brewin, C.R. (2007). Children’s narratives and wellbeing. Cogn. Emotion, 21, 1414-1435.
[http://dx.doi.org/10.1080/02699930601109531.]
Fisher, W. (1987). Human communication as narration: Toward a philosophy of reason, value, and action.. Columbia: University of South Carolina Press.
Fonteyn, M.E., Vettese, M., Lancaster, D.R., Bauer-Wu, S. (2008). Developing a codebook to guide content analysis of expressive writing transcripts. Appl. Nurs. Res., 21(3), 165-168.
[http://dx.doi.org/10.1016/j.apnr.2006.08.005. ] [PMID: 18684411]
Frattaroli, J. (2006). Experimental disclosure and its moderators: a meta-analysis. Psychol. Bull., 132(6), 823-865.
[http://dx.doi.org/10.1037/0033-2909.132.6.823. ] [PMID: 17073523]
Fristad, M.A., Goldberg Arnold, J.S., Leffler, J.M. (2011). Psychotherapy for children with bipolar and depressive disorders.. New York: Guilford Press.
Young, A.S., Fristad, M.A. (2015). Family-based interventions for childhood mood disorders. Child Adolesc. Psychiatr. Clin. N. Am., 24(3), 517-534.
[http://dx.doi.org/10.1016/j.chc.2015.02.008. ] [PMID: 26092737]
Gee, J.P. (2014). An introduction to discourse analysis: Theory and method. (4th ed.). London, New York: Routledge.
[http://dx.doi.org/10.4324/9781315819679]
Hunt, C. (1998). Therapeutic dimensions of autobiography in creative writing.. London, Philadelphia: Jessica Kingsley.
Jonassen, D.H., Hernandez-Serrano, J. (2002). Case-based reasoning and instructional design: Using stories to support problem solving. Educ. Technol. Res. Dev., 50(2), 65-77.
[http://dx.doi.org/10.1007/BF02504994.]
King, L.A. (2002). Gain without pain? Expressive writing and self-regulation.The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being. (pp. 119-134). Washington, DC: American Psychological Association.
[http://dx.doi.org/10.1037/10451-006]
Lakoff, G., Johnson, M. (1980). Metaphors we live by.. Chicago: University of Chicago Press.
Lewinsohn, P., Rohde, P., Hops, H., Clarke, G. (1991). Leader’s manual for parent groups: Adolescent coping with depression course. Eugene, OR: Castalia Publishing Company.
Lieblich, A., Tuval-Mashiach, R., Zilber, T. (1998). Narrative research: Reading, analysis and interpretation Applied Social Research Methods Series, 47 London
Marcus, P. (2017). Getting write into therapy. J. Am. Acad. Child Adolesc. Psychiatry, 56(5), 367-368.
Miklowitz, D.J., Biuckians, A., Richards, J.A. (2006). Early-onset bipolar disorder: A family treatment perspective. Dev. Psychopathol., 18, 1247-1265.
Pennebaker, J.W., Beall, S.K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. J. Abnorm. Psychol., 95(3), 274-281.
[http://dx.doi.org/10.1037/0021-843X.95.3.274. ] [PMID: 3745650]
Pennebaker, J.W., Colder, M., Sharp, L.K. (1990). Accelerating the coping process. J. Pers. Soc. Psychol., 58(3), 528-537.
[http://dx.doi.org/10.1037/0022-3514.58.3.528. ] [PMID: 2324942]
Pennebaker, J. (2004). Theories, therapies, and taxpayers: On the complexities of the expressive writing paradigm. Clin. Psychol. Sci. Pract., 11, 138-142.
[http://dx.doi.org/10.1093/clipsy.bph063.]
Pennebaker, J., Evans, J. (2014). Expressive Writing Words that Heal.. Enumclaw, WA: Idyll Arbor.
Pennebaker, (2016). Opening up by writing it down: How expressive writing improves health and eases emotional pain. (3rd ed..), New York, NY: The Guilford Press.
Pennebaker, J.W., Kiecolt-Glaser, J.K., Glaser, R. (1988). Confronting traumatic experience and immunocompetence: A reply to Neale, Cox, Valdimarsdottir, and Stone. J. Consult. Clin. Psychol., 56(4), 638-639.
[http://dx.doi.org/10.1037/0022-006X.56.4.638. ] [PMID: 3198829]
Petrie, K.J., Booth, R.J., Pennebaker, J.W., Davison, K.P., Thomas, M.G. (1995). Disclosure of trauma and immune response to a hepatitis B vaccination program. J. Consult. Clin. Psychol., 63(5), 787-792.
[http://dx.doi.org/10.1037/0022-006X.63.5.787. ] [PMID: 7593871]
Proctor, E.K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Adm. Policy Ment. Health, 36(1), 24-34.
[http://dx.doi.org/10.1007/s10488-008-0197-4. ] [PMID: 19104929]
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Adm. Policy Ment. Health, 38(2), 65-76.
[http://dx.doi.org/10.1007/s10488-010-0319-7. ] [PMID: 20957426]
Reddy, M.J. (1979). The conduit metaphor: A case of frame conflict in our language about language. Metaphor and Thought. (pp. 284-310). Cambridge: Cambridge University Press.
Richards, J.M., Beal, W.E., Seagal, J.D., Pennebaker, J.W. (2000). Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates. J. Abnorm. Psychol., 109(1), 156-160.
[http://dx.doi.org/10.1037/0021-843X.109.1.156. ] [PMID: 10740948]
Rossiter, M. (1999). Understanding adult development as narrative. New Dir. Adult Contin. Educ., 1999(84), 77-85.
[http://dx.doi.org/10.1002/ace.8409.]
Sloan, D.M., Marx, B.P. (2004). A closer examination of the structured written disclosure procedure. J. Consult. Clin. Psychol., 72(2), 165-175.
[http://dx.doi.org/10.1037/0022-006X.72.2.165. ] [PMID: 15065952]
Schoutrop, M.J.A., Lange, A., Hanewald, G., Davidovich, U., Salomon, H. (2002). Structured writing and processing major stressful events: A controlled trial. Psychother. Psychosom., 71(3), 151-157.
[http://dx.doi.org/10.1159/000056282. ] [PMID: 12021557]
Sibierska, M. (2017). Storytelling without telling: The non-linguistic nature of narratives from evolutionary and narratological perspectives. Lang. Commun., 54, 47-55.
[http://dx.doi.org/10.1016/j.langcom.2016.10.005.]
Smyth, J.M., Pennebaker, J.W. (2008). Exploring the boundary conditions of expressive writing: In search of the right recipe. Br. J. Health Psychol., 13(Pt 1), 1-7.
[http://dx.doi.org/10.1348/135910707X260117. ] [PMID: 18034917]
Tharayil, P.R., Sigrid, J., Morgan, R., Freeman, K. (2012). Examining outcomes of acute psychiatric hospitalization among children. Soc. Work Ment. Health, 10(3), 205-232.
[http://dx.doi.org/10.1080/15332985.2011.628602. ] [PMID: 23946699]
Travagin, G., Margola, D., Revenson, T.A. (2015). How effective are expressive writing interventions for adolescents? A meta-analytic review. Clin. Psychol. Rev., 36, 42-55.
[http://dx.doi.org/10.1016/j.cpr.2015.01.003. ] [PMID: 25656314]
Twenge, J. (2017). IGen: Why today’s super-connected kids are growing up less rebellious, more tolerant, less happy-and completely unprepared for adulthood (and what this means for the rest of us).. New York: Atria Books.
Tyson, E., Baffour, T. (2004). Arts-based strengths: A solution-focused intervention with adolescents in an acute-care psychiatric setting. Arts Psychother., 31, 213-227.
[http://dx.doi.org/10.1016/j.aip.2004.06.004.]
Tyson, E., Baffour, T. (2010). Gender comparisons of self-identified strengths and coping strategies: A study of adolescents in an acute psychiatric facility. Child Adolesc. Social Work J., 27, 161-175.
[http://dx.doi.org/10.1007/s10560-010-0196-7.]
Welch, M., James, R.C. (2007). An investigation on the impact of a guided reflection technique in service-learning courses to prepare special educators. Teach. Educ. Spec. Educ., 30(4), 276-285.
[http://dx.doi.org/10.1177/088840640703000407.]
West, A.E., Henry, D.B., Pavuluri, M.N. (2007). Maintenance model of integrated psychosocial treatment in pediatric bipolar disorder: A pilot feasibility study. J. Am. Acad. Child Adolesc. Psychiatry, 46(2), 205-212.
[http://dx.doi.org/10.1097/01.chi.0000246068.85577.d7. ] [PMID: 17242624]
World Health Organization. (2019). Adolescent mental health.Available from.https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Wymer, B., Ohrt, J.H., Morey, D., Swisher, S. (2020). Integrating expressive arts techniques into trauma-focused treatment with children. J. Ment. Health Couns., 42, 124-139.
[http://dx.doi.org/10.17744/mehc.42.2.03.]