Abstract / Summary
This study aimed to evaluate the effectiveness of expressive writing interventions on the psychosocial health outcomes of family caregivers and to synthesize the available evidence. It was conducted in accordance with the PRISMA 2020 guidelines. Studies published up to May 2025 were searched in PubMed, Web of Science, CENTRAL, SCOPUS, and MEDLINE. The methodological quality of included studies was assessed using the Cochrane Collaboration Risk of Bias Tool 2.0, and standardized mean differences were calculated for depression, anxiety, stress, and caregiver burden. A total of 13 studies met the inclusion criteria and were included in the meta-analysis. The included interventions varied considerably in writing content, session number, writing duration, intervention intervals, and comparator conditions. Most studies were judged to have a high overall risk of bias. Most interventions were short-term, and the observed benefits were not maintained over the long term. The available evidence provides limited support for the broad effectiveness of expressive writing among family caregivers. A small short-term effect was observed for anxiety (SMD = -0.22; p = 0.041). However, no significant effects were found for depression (SMD = -0.17; p = 0.084), stress (SMD = -0.21; p = 0.167), or caregiver burden (SMD = -0.02; p = 0.905). The observed anxiety effect should be interpreted as preliminary evidence rather than definitive evidence of efficacy. Further research is needed to clarify the effects of expressive writing on psychosocial outcomes in family caregivers.