Chasing elusive expressive writing effects: emotion-acceptance instructions and writer engagement improve outcomes.

Introduction: Pennebaker's expressive writing (EW) paradigm in which participants are encouraged to explore their "deepest thoughts and feelings" about a difficult experience in several short writing sessions has yielded impressive mental health outcomes and holds great promise as a cost-effective intervention. Yet results have been difficult to replicate and it is unclear what conditions are necessary for observing the effect. Our aim was to discover reasons for the variability in EW outcomes.