Clinical Psychology Review, Vol. 19, No. 1, pp. 79–96, 1999 Copyright © 1999 Elsevier Science Ltd Printed in the USA. All rights reserved 0272-7358/99/$–see front matter PII S0272-7358(98)00015-4 79 EMPIRICAL FOUNDATIONS FOR WRITING IN PREVENTION AND PSYCHOTHERAPY: MENTAL AND PHYSICAL HEALTH OUTCOMES Brian A. Esterling Duke University Medical Center Luciano L’Abate Georgia State University Edward J. Murray University of Miami James W. Pennebaker Southern Methodist University ABSTRACT. 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 re- search 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 experi- ences 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 phys- ically and mentally beneficial. This review highlights advances in written disclosure that deter- mine 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. © 1999 Elsevier Science Ltd We are indebted to William McCown and Daniel Segal for their helpful comments on a previous draft of this article. Correspondence should be addressed to Brian A. Esterling, Merit Behavioral Care Corporation, 3000 Aerial Center Parkway, Suite 120, Morrisville, NC 27560.