Skip to main content Accessibility help

Visible ink: A flexible and individually tailored writing intervention for cancer patients

  • Geoffrey W. Corner (a1), Sabrina M. Jhanwar (a1), Judith Kelman (a2), Hayley Pessin (a1), Emma Stein (a1) and William Breitbart (a1)...



Subjective reports on the effectiveness of and satisfaction with writing interventions in medical populations have indicated that they can have a profound impact on patients. Further, past research on these programs has demonstrated that they can lead to a number of different positive outcomes depending on the personal characteristics of the participating patients and the type of writing with which they are tasked. For this reason, a flexible and individually tailored writing intervention may be particularly effective for patients, molding its approach to their desires and backgrounds. This paper examines Visible Ink, a writing program for cancer patients at Memorial Sloan-Kettering Cancer Center (MSKCC) that follows this model.


At Visible Ink's First Fall Writing Festival in November 2012, an optional survey was provided to all program participants in attendance, capturing both quantitative and qualitative information on patient experiences in the program. Twenty-nine surveys were completed.


The program appears to have a variety of positive effects, including fostering personal growth and providing a positive distraction. Respondents reported that they write in a number of different genres on topics both related and not related to their illnesses, which supports the flexible model of the program. All respondents indicated that they would recommend the program to others, and satisfaction with the program's general approach (i.e., individualized work with a writing coach) was unanimous. A few areas for potential improvement were also identified, most of which involved expanding the services and events offered by the program.

Significance of results:

Despite the limitations of this survey (e.g., small sample size and low response rate), its results support the promise of the Visible Ink model and demonstrate participants' satisfaction with the program. Future research can more thoroughly examine Visible Ink's effectiveness, and additional resources could enable the program to expand.


Corresponding author

Address correspondence and reprint requests to: Geoffrey W. Corner, Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 641 Lexington Avenue, 7th Floor, New York, NY 10022. E-mail:


Hide All
Arden-Close, E., Gidron, Y., Bayne, L., et al. (2013). Written emotional disclosure for women with ovarian cancer and their partners: Randomised controlled trial. Psycho-Oncology. Advance online publication.
Atkinson, R., Hare, T., Merriman, M., et al. (2009). Therapeutic benefits of expressive writing in an electronic format. Nursing Administration Quarterly, 33(3), 212215.
Baikie, K.A. (2008). Who does expressive writing work for? Examination of alexithymia, splitting, and repressive coping style as moderators of the expressive writing paradigm. British Journal of Health Psychology, 13, 6166.
Barclay, L.J. & Skarlicki, D.P. (2009). Healing the wounds of organizational injustice: Examining the benefits of expressive writing. Journal of Applied Psychology, 94(2), 511523.
Bruera, E., Willey, J., Cohen, M., et al. (2008). Expressive writing in patients receiving palliative care: A feasibility study. Journal of Palliative Medicine, 11(1), 1519.
Bugg, A., Turpin, G., Mason, S., et al. (2009). A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder. Behaviour Research and Therapy, 47(1), 612.
Chiu, Y.C. & Hsieh, Y.L. (2012). Communication with fellow cancer patients: Writing to be remembered, gain strength, and find survivors. Journal of Health Psychology. doi: 10.1177/1359105312465915.
Craft, M.A., Davis, G.C. & Paulson, R.M. (2013). Expressive writing in early breast cancer survivors. Journal of Advanced Nursing, 69(2), 305315.
Creswell, J.D., Lam, S., Stanton, A.L., et al. (2007). Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing? Personality & Social Psychology Bulletin, 33(2), 238250.
Danoff-Burg, S., Mosher, C.E., Seawell, A.H., et al. (2010). Does narrative writing instruction enhance the benefits of expressive writing? Anxiety, Stress, and Coping, 23(3), 341352.
de Moor, C., Sterner, J., Hall, M., et al. (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), 615619.
de Moor, J.S., Moyé, L., Low, M.D., et al. (2008). Expressive writing as a presurgical stress management intervention for breast cancer patients. Journal of the Society for Integrative Oncology, 6(2), 5966.
Elford, H., Wilson, F., McKee, K.J., et al. (2005). Psychosocial benefits of solitary reminiscence writing: An exploratory study. Aging & Mental Health, 9(4), 305314.
Fernández, I. & Páez, D. (2008). The benefits of expressive writing after the Madrid terrorist attack: Implications for emotional activation and positive affect. British Journal of Health Psychology, 13, 3134.
Gellaitry, G., Peters, K., Bloomfield, D., et al. (2010). Narrowing the gap: The effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer. Psycho-Oncology, 19(1), 7784.
Gortner, E., Rude, S. & Pennebaker, J.W. (2006). Benefits of expressive writing in lowering rumination and depressive symptoms. Behavior Therapy, 37(3), 292303.
Graf, M.C., Gaudiano, B.A. & Geller, P.A. (2008). Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research, 18(4), 389399.
Jensen-Johansen, M.B., Christensen, S., Valdimarsdottir, H., et al. (2012). Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors: Results from a nationwide randomized clinical trial. Psycho-Oncology. Psycho-Oncology, 22(7), 14921500.
Kidd, L.I., Zauszniewski, J.A. & Morris, D.L. (2011). Benefits of a poetry writing intervention for family caregivers of elders with dementia. Issues in Mental Health Nursing, 32(9), 598604.
Laccetti, M. (2007). Expressive writing in women with advanced breast cancer. Oncology Nursing Forum, 34(5), 10191024.
Low, C.A., Stanton, A.L., Bower, J.E., et al. (2010). A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychology, 29(4), 460466.
Lu, Q., Zheng, D., Young, L., Kagawa-Singer, M., et al. (2012). A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors. Health Psychology, 31(5), 548551.
Lyubomirsky, S., Sousa, L. & Dickerhoof, R. (2006). The costs and benefits of writing, talking, and thinking about life's triumphs and defeats. Journal of Personality and Social Psychology, 90(4), 692708.
Manzoni, G.M., Castelnuovo, G. & Molinari, E. (2011). The WRITTEN-HEART study (expressive writing for heart healing): Rationale and design of a randomized controlled clinical trial of expressive writing in coronary patients referred to residential cardiac rehabilitation. Health and Quality of Life Outcomes, 9, 51.
Mosher, C.E., DuHamel, K.N., Lam, J., et al. (2012). Randomised trial of expressive writing for distressed metastatic breast cancer patients. Psychology & Health, 27(1), 88100.
Oppenheim, D., Pittolo, V., Gericot, C., et al. (2008). A writing workshop for children with cancer. Archives of Disease in Childhood, 93(8), 708709.
Rickett, C., Greive, C. & Gordon, J. (2011). Something to hang my life on: The health benefits of writing poetry for people with serious illnesses. Australasian Psychiatry, 19(3), 265268.
Seih, Y.T., Lin, Y.C., Huang, C.L., et al. (2008). The benefits of psychological displacement in diary writing when using different pronouns. British Journal of Health Psychology, 13, 3941.
Sloan, D.M., Marx, B.P. & Epstein, E.M. (2005). Further examination of the exposure model underlying the efficacy of written emotional disclosure. Journal of Consulting and Clinical Psychology, 73(3), 549554.
Smyth, J.M., Stone, A.A., Hurewitz, A., et al. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. The Journal of the American Medical Association, 281(14), 13041309.
Spiegel, D. (1999). Healing words: Emotional expression and disease outcome. The Journal of the American Medical Association, 281(14), 13281329.
Tabolli, S., Naldi, L., Pagliarello, C., et al. (2012). Evaluation of the impact of writing exercises interventions on quality of life in patients with psoriasis undergoing systemic treatments. British Journal of Dermatology, 167(6), 12541264.
Tamagawa, R., Moss-Morris, R., Martin, A., et al. (2012). Dispositional emotion coping styles and physiological responses to expressive writing. British Journal of Health Psychology, 18(3), 574592.


Visible ink: A flexible and individually tailored writing intervention for cancer patients

  • Geoffrey W. Corner (a1), Sabrina M. Jhanwar (a1), Judith Kelman (a2), Hayley Pessin (a1), Emma Stein (a1) and William Breitbart (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed