We conducted a randomized clinical trial of a 3-session written self-disclosure intervention for patients with cystic fibrosis (CF). Patients (n = 39) who were at least 15 years of age and diagnosed with CF participated in the intervention. Participants in the intervention arm were asked to write in the health care setting about an important emotionally distressing issue of personal significance for a 20-min period of time and two additional 20-min writing episodes at the patient's home, which were prompted by telephone calls. Patients in the control condition received standard care alone. Findings revealed that the intervention resulted in a reduction of the number of days patients spent in the hospital over a 3-month period. The intervention did not have an impact on physiological (Forced Expiratory Volume and Body Mass Index or subjective markers of health status. These findings extend those of Pennebaker's (cf., J. Smyth, 1998) demonstrating an effect of the written-self-disclosure intervention on health care utilization. These preliminary findings are promising and justify further investigation of the modified intervention in other chronic illness populations.
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American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Cystic Fibrosis Foundation. (2001). CF foundation patient registry annual report. Bethsda, MD: Author.
Godding, V., Kruth, M., & Jamart, J. (1997). Joint consultation for high-risk asthmatic children and their families, with pediatrician and child psychiatrist as co-therapists: Model and evaluation. Family Process, 36(3), 265-280.
Harber, K., & Pennebaker, J. (1992). Overcoming traumatic memories. In S. Christianson (Ed.), The handbook of emotion and memory (pp. 359-387).
Klapow, J. C., Schmidt, S. M., Taylor, L. A., Roller, P., Li, Q.,Calhoun, J. W., et al.. (2001). Symptom management in older primary care patients: Feasibility of an experimental, written self-disclosure protocol. Annals of Internal Medicine, 134, 905-911.
Kolbe, J. (1999). Asthma education, action plans, psychosocial issues and adherence. Canadian Respiratory Journal, 6(3), 273-280.
McQuaid, E., & Nassau, J. (1999). Empirically supported treatments of disease-related symptoms in pediatric psychology: Asthma, diabetes, and cancer. Journal of Pediatric Psychology, 24(4), 305-328.
Payne, A., & Blanchard, E. (1995). A controlled comparison of cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome. Journal of Consulting and Clinical Psychology, 63(5), 779-786.
Pennebaker, J. (1988). Confiding traumatic experiences and health. In S. Fisher & J. Reason (Eds.), Handbook of life stress, cognition, and health (pp. 669-682). New York: Wiley.
Pennebaker, J. (1989). Stream of consciousness and stress: Levels of thinking. In J. Uleman & J. Scargh (Eds.), Unintended thought (pp. 327-350). New York: Guilford Press.
Pennebaker, J. (1991). Self-expressive writing: Implications for health, education, and welfare. In F. Belanoff, P. Elbow, & S. Fontaine (Eds.), Nothing begins with N: New investigations of freewriting (pp. 157-170). Edwardsville, IL: Southern Illinois University Press.
Pennebaker, J. (1993). Putting stress into words: Health, linguistic, and therapeutic implications. Behavior Research Therapy, 49, 1427-1433.
Pennebaker, J. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162-166.
Pennebaker, J., & Francis, M. (1996). Cognitive, emotional, and language processes in disclosure. Cognition and Emotion, 10, 601-626.
Pennebaker, J., Kiecolt-Glaser, J., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Personality and Social Psychology, 56, 239-245.
Pennebaker, J., & Seagal, J. (1999). Forming a story: The health benefits of narrative. Journal of Clinical Psychology, 55, 1243-1254.
Smyth, J. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174-184.
Smyth, J. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma and rheumatoid arthritis. JAMA, 281, 1304-1309.
Spirito, A. (1999). Special series on empirically supported treatments in pediatric psychology: Introduction. Journal of Pediatric Psychology, 24, 87-90.
Spitzer, R., Kronke, K., Williams, W., and the Patient Health Questionnaire Primary Care Study Group (1999). Validation and utility of the PRIME-MD. Journal of the American Medical Association, 282, 1737-1744.
Spitzer, R., Williams, J., Kroenke, D., Linzer, M., deGruy, F., Hahn, S., et al. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. JAMA, 272, 1749-1755.
Ware, J., Snow, K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey: Manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center.
Ware, J., & Hays, R. (1988). Methods for measuring patient satisfaction with specific medical encounters. Medical Care, 26, 393-402.
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Taylor, L.A., Wallander, J.L., Anderson, D. et al. Improving Health Care Utilization, Improving Chronic Disease Utilization, Health Status, and Adjustment in Adolescents and Young Adults with Cystic Fibrosis: A Preliminary Report. Journal of Clinical Psychology in Medical Settings 10, 9–16 (2003). https://doi.org/10.1023/A:1022897512137