de Moor, C., Sterner, J., Hall, M., Warneke, C., Gilani, Z., Amato, R., & Cohen, L. (2002). A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a phase II trial of vaccine therapy for metastatic renal cell carcinoma. Health Psychology, 21(6), 615–619.

An expressive writing intervention involved four writing sessions. Patients were randomized to an expressive writing (EW) group in which they were instructed to write their deepest thoughts and feelings about their cancer or to a neutral writing (NW) group in which they were instructed to write about a different health behavior at each session. Writing instructions were developed from the Pennebaker and Beall model. Repeated measures at baseline, end of intervention, and 4, 6, 8, and 10 weeks later.

• N = 42 (EW = 21, NW = 21)
• AVERAGE AGE: 56.4 years
• MALES: 85%
• KEY DISEASE CHARACTERISTICS: Patients had newly diagnosed stage IV metastatic renal cell carcinoma and were participating in a phase II vaccine trial. Of the participants, 76% had metastases and 76% had no lung involvement.
• OTHER KEY SAMPLE CHARACTERISTICS: Patients were four to six weeks post-operation.

It is implied that the setting is outpatient, in which patients are participating in a phase II clinical trial using vaccine therapy.

• PHASE OF CARE: Active treatment

• Pilot study
• Randomized controlled trial  

• Profile of Mood States (POMS)

There was 86% and 81% adherence with each group. No differences in the POMS fatigue subscale were found; the POMS vigor subscale was significantly higher in the EW group.

• Sample size was small.
• Generalizability is questionable due to the nature of illness.
• Follow-up scores were averaged over multiple measures.
• Space for the writing to occur is required prior to the injection.