Expressive Writing as Brief Psychotherapy

AIM: To analyse the effect of expressive writing in three selected cases. METHODS: Case studies presented from three psychiatric patients in a hospital-based outpatient clinic in Surabaya, Indonesia, between May 2017 and July 2018. Clinical changes have been observed and reported. Three patients were selected based on the possibility of whether they were able to or not to participate in similar cognitive therapy. These three cases were considered to represent a diagnosis for the psychotic and non-psychotic spectrum. The first case was a male with suicidal depression, the second was a woman with Suicidal Depression, and the third was schizophrenic woman elderly with auditory hallucinations. Expressive writing was formulated from literature studies and then implemented in these patients. Clinical changes were observed both associated with a reduction in symptoms as well as new symptoms. These non-directive measures allowed the author to observe the therapeutic effects and side effects of the intervention given. RESULTS: Three cases were analysed. Targets were determined by patients themselves without author’s intervention. Each patient underwent 10 sessions in minimum and 32 sessions in maximum, from once per week to once per two weeks, and was stopped after it was considered reaching or approaching the desired target, or if unwanted side effects appeared. Main changes were “father hunger” symptom decreased in the first patient, self-esteem increased in the second patient, and cope with auditory hallucination in the third patient. Few adverse events also have been recorded such as masturbation as an obsession ritual of the first patient, possibly provoked double-identity symptom in the second patient and mental fatigue in the elderly in the third patient. CONCLUSION: Over six months of implementation, expressive writing show desirable results, yet some side effects in patients still need to be aware of.