Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes.

The use of writing, alone or in conjunction with traditional psychotherapy, has increased substantially in recent years. The most widespread use of writing has been for single-shot ad hoc purposes or to log behavior. The purpose of this review is to summarize a decade of research demonstrating the efficacy of writing about past traumatic experiences on mental and physical health outcomes. It is widely acknowledged in our culture that putting upsetting experiences into words can be healthy. Research from several domains indicates that talking with friends, confiding to a therapist, praying, and even writing about one's thoughts and feelings can be physically and mentally beneficial. This review highlights advances in written disclosure that determine some therapeutic outcomes. In addition, we attempt to explore the mechanisms that predict improved psychological and physical health. Finally, limitations of previous studies are highlighted, and suggestions for future research and application are made.

Programmed writing and therapy with symbiotically enmeshed patients.

This paper illustrates how programmed writing lessons to be completed as homework assignments can be used in conjunction with traditional verbal psychotherapy. Each patient was involved in a symbolically enmeshed relationship. Special benefits for patients from the combination of programmed writing lessong with traditional psychotherapy were: (1) increased couple communication; (2) possibly more rapid change; (3) possibly shorter-term therapy; (4) increased forgotten trauma discovery; (5) and increased explicit and specific instructions. Patients were informed from the outset that the use of programmed writing lessons would or might: (1) help the therapist get a better idea of what was going on in regard to the development, values, rules, etc. of their symbiotic relationships; (2) decrease the time spent in therapy, and (3) encourage self-realization through self-directed assignments between sessions. For psychotherapists there are advantages of: (1) putting the responsibility for change on the shoulders of patients rather than on themselves; (2) using programs of theoretical and therapeutic approaches that may not be well known to the therapist; (3) reducing the frequency of sessions and administering written homework assignments when the therapist is on vacation; and (4) increasing the number of patients that can be seen for unit of therapist's time.

The use of writing in psychotherapy.

The use of writing in psychotherapy is relatively new and may have meager empirical support. A rationale for the use of writing in psychotherapy is given in terms of splitting therapeutic skills into relationship and structuring skills. Writing is one application of structuring skills to increase the therapist's influence outside of the office and into the home or workplace. There are at least four different degrees of writing possible according to structure: open, focused, guided, and programmed. Examples from the available literature are given. Even though, its impact on therapeutic outcome has yet to be fully realized beyond the experience of few clinicians. Pennebacker's research contribution in the use of writing is highlighted to support its use in psychotherapy. He found that students who wrote on traumatic topics for 20 minutes a day for four days showed improved physiological reactions and fewer physical symptoms at three-month follow-up than students who wrote about trivial topics.

Toward a classification of sex and sexual behavior.

This paper presents a classification of sexual behaviors bases on Foa and Foa's resource exchange theory. They postulated six classes of resources: information, services, possessions, money, love, and status. We expanded and applied this theory to sexual behavior through three modalities: 1) Doing (information and services), which relates to sex as performance; 2) Having (possessions and money), which relates to sex as product; and 3) Being (love and status), which relates to sex as presence. Implications of this framework for sexual deviations, empirical verification, diagnostic evaluation, and therapeutic interventions are discussed.

Popularity or influence? The use of citation index to identify leaders in family therapy.

Our frequency analysis of most living family therapy theorists using the Social Science Citation Index yielded a definite increase in frequencies over the last ten years and considerable differences in frequencies among various theorists.

The use of paradox with children in an inpatient treatment setting.

This paper illustrates with case examples the use of paradoxical procedures in a child inpatient treatment center. Indications and contraindications for this type of intervention are discussed.