Expressive Writing for Co-Occurring Depression and Alcohol Misuse

Study Overview
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Brief Summary
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***Please note that this study does not offer comprehensive treatment program for alcohol abuse or depression. Please do not contact the study staff if you are seeking psychological treatment. Further, this study is only enrolling people who are clients at Career and Recovery Resources, Inc., in Houston. The hypothesis is that writing about feelings and thoughts will help people who are in group treatment feel less depressed and abuse alcohol less.

Detailed Description
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Expressive writing applied to a variety of populations (e.g., HIV, cancer, PTSD, depression) has been associated with health improvements, reductions in symptoms of emotional distress, and one preliminary study found reductions in alcohol misuse among college students. Data suggest that expressive writing is a technique to facilitate emotional processing that can influence a number of clinical outcomes by facilitating cognitive restructuring (Hunt, 1998; Pennebaker, 2004). In addition to examining cognitive content change following expressive writing, we believe the effects of emotional writing on mood and drinking may involve two additional processes that have been found significant for both depression and alcohol misuse, namely experiential avoidance and ruminative thinking. We hypothesize that expressive writing will lead to less drinking and enhanced mood by reducing: (1) negative thought content, (2) experiential avoidance of unpleasant private events (e.g., negative thoughts, feelings, bodily sensations), and (3) ruminative thinking.

Official Title
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Expressive Writing for Co-Occurring Depression and Alcohol Misuse

Conditions
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Depression, Alcohol, Drinking

Intervention / Treatment
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* Behavioral: Expressive writing (in addition to group therapy as usual).


Participation Criteria
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Eligibility Criteria
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***Please note that this study does not offer comprehensive treatment program for alcohol abuse or depression. Please do not contact the study staff if you are seeking psychological treatment. Further, this study is only enrolling people who are clients at Career and Recovery Resources, Inc., in Houston. Inclusion Criteria: Enrolled in group therapy program at Career and Recovery Resources, Inc. Must be at least 18. Willing and able to participate in the study through the one month follow up. Able to provide the contact information of at least two people who can generally locate their whereabouts. Speak English fluently. Exclusion Criteria: Inability to read, write, speak English. History of bipolar or psychotic disorders. Severe medical, cognitive and /or psychiatric impairment that precludes cooperation with study protocol. Substance withdrawal symptoms requiring medical attention. Currently receiving other individual psychosocial therapy outside of C&R for substance abuse or other psychiatric conditions with the exception of AA, NA or CA. Impending incarceration or other factor that would create inability or unwillingness to participate in the 6 week long study period (e.g., halfway house or other aftercare program restrictions).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Expressive Writing<br>In addition to attending group therapy as usual, participants write about their feelings about an issue of their choosing three times during a two week period for at least 20 minutes each time. | Behavioral: Expressive writing (in addition to group therapy as usual).<br>* Participants in the expressive writing condition write about their feelings about an issue of their choosing three times, for at least 20 minutes each time, during a two week period.<br>|
| Active Comparator: Treatment as Usual<br>Participants attend group therapy as usual only. | Behavioral: Expressive writing (in addition to group therapy as usual).<br>* Participants in the expressive writing condition write about their feelings about an issue of their choosing three times, for at least 20 minutes each time, during a two week period.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Depression Inventory, Second Edition |  | Baseline, Post-writing (2 weeks post-baseline), and One Month Follow-Up (Six weeks post-baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Alcoholic Drinks Consumed |  | 30 days pre-baseline compared to 30 days post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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expressive writing, ruminating, ruminative thinking, experiential avoidance, depression, alcohol, drinking, emotional processing