Program Profile: School-Based Expressive Writing Intervention for At-Risk Urban Adolescents

This was a school-based intervention targeting at-risk, seventh-grade students. The intervention included either a standard expressive-writing condition or an enhanced expressive-writing condition. The program is rated Ineffective. There were no statistically significant differences between the standard writing treatment condition, the enhanced writing treatment condition, and the control condition on self- and teacher-reported measures of aggression and teacher-reported emotion regulation.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals

The School-Based Expressive Writing Intervention was a preventative intervention targeting at-risk, seventh-grade students at an urban public school. The overall goal of the intervention was to use expressive writing as a means to reduce aggressive behaviors and improve emotion regulation.

Target Population

The intervention was implemented in an urban public school system (comprising three schools) that was predominately African American, and whose students typically lived in high-crime, impoverished neighborhoods.

Program Components

The intervention was offered during fifth period by project staff. The intervention included either a standard expressive- writing condition or an enhanced expressive-writing condition. The enhanced condition was developed to be culturally relevant and engaging to the youth.

In the standard expressive-writing condition (a total of eight sessions), students wrote for up to 20 minutes per session. They were asked to write about their thoughts and feelings related to violence they had seen or experienced. Project staff instructed students not to worry about spelling or grammar; instead, they were asked to focus on and write about their deepest feelings. Students who had not experienced violence were asked to write about something that was bothering them.

Similar to the standard condition (also a total of eight sessions), students in the enhanced expressive-writing condition wrote for up to 20 minutes per session. However, students in the enhanced condition were given the option to write stories, skits, songs, or poetry about violence rather than (or in addition to) a simple narrative account of their feelings toward violence. In four of the eight sessions, students were also given the opportunity to share their work with the classroom. Students were also instructed not to worry about spelling or grammar, but to focus on relating their deepest feelings.

In both conditions, the project staff read aloud samples to the students to ensure they understood the instructions. Students were told that only the project staff would see their writings, unless the writings indicated that the students were being harmed, or were harming others or themselves. In that case, these writings would be reported to the authorities to ensure necessary help was provided. At the end of each writing session, project staff collected the student writings.

Program Theory

Overall, it is believed that expressive writing improves an individual’s psychological and behavioral response to stressors because it facilitates emotion regulation. By encouraging participants to write about stressful experiences and their associated emotions, individuals can learn to regulate their emotions by directing their attention to different aspects of the experience, while also developing alternative ways to respond (Kliewer 2011).

Study

To investigate the impact of the expressive-writing intervention (standard and enhanced), Kilewer and colleagues (2011) used a cluster-randomized design. The intervention targeted seventh-grade classrooms in the three public middle schools within a southeastern public school system. This recruitment resulted in 17 seventh-grade classrooms and a total of 344 students.

The final sample included 258 students (86 students were excluded due to being ineligible, refusing, or not consenting to participate in the study). The majority of students were African American (91 percent), and a little over half were girls (55 percent). Approximately half of the sample lived in a single-parent (mother) home, and 18 percent lived with both biological parents.

The 17 seventh-grade classrooms were randomized to either a standard expressive-writing condition (six classrooms), an enhanced expressive-writing condition (six classrooms), or a control condition (five classrooms). Rather than writing about their thoughts and feelings toward violence in a narrative account (standard condition) or through poetry, skits, stories or songs (enhanced condition), students in the control condition were asked to write about non-emotional topics such as how they spent their day.

The intervention was implemented over a 5-week period during the spring semester of 2006. Data was collected at baseline, and at 2 and 6 months after the intervention ended. Data was collected through student self-report and teacher- report measures. Students rated their aggression on a 7-item Physical Aggression subscale of the Problem Behavior Frequency Scales. This measure asked students to answer how frequently they engaged in aggressive behavior in the past 30 days. The scale ranged from 1 (never) through 6 (20 times or more); items included “hit or slapped another kid” and “threatened someone with a weapon”.

Teachers rated student behavior on the 20-item Aggressive Behavior subscale of the Teacher Report Form of the Achenbach System of Empirically Based Assessment. The scale ranged from 0 (not true) to 2 (very or often true). Items on the scale included “physically attacks people” and “threatens people”. Additionally, teachers rated students’ emotional lability using the 16-item subscale from the Emotion Regulation Checklist, which accesses students’ emotions during social interactions. The scale ranges from 1 (rarely) to 4 (almost always), on items such as “prone to angry outbursts/tantrums easily” and “exhibits wide mood swings”. The two teacher-report scales were averaged to create a composite score due to the high correlation between aggression and emotional lability.

Intervention effects on student self-report and teacher-report outcomes were examined using a mixed-model approach. For each outcome, scores on the two follow-up waves were modeled as a function of the pretest score on that outcome measure, and intervention condition (standard versus enhanced). No subgroup analysis was conducted.

Project staff received a 2-day training in the intervention protocol, classroom management, and in Child Protective Services–reporting laws. To ensure that the intervention was implemented according to protocol, process monitors evaluated project staff using a standard observation form (Kliewer et al. 2011).

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Pennebaker, J.W., and S.K. Beall. 1986. “Confronting a Traumatic Event: Toward an Understanding of Inhibition and Disease.” Journal of Abnormal Psychology 95:274–81.