The Use of Expressive Writing in Healthcare Professionals: A Systematic Review of Quantitative Studies

Background: Healthcare professionals are exposed to high emotional demands, including repeated contact with suffering, death, moral distress, and organizational pressure. These factors are associated with psychological distress, burnout, and secondary traumatic stress. Expressive Writing (EW) has been proposed as a psychological intervention, but evidence of its effectiveness among healthcare professionals remains heterogeneous. Objectives: To examine the effects of EW on psychological health, psychophysical well-being, and professional satisfaction among healthcare professionals. Methods: A systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA 2020 guidelines. Searches were performed in PubMed, CINAHL, CENRAL, CENTRAL Scopus, Embase, and PsycINFO from database inception to January 2025. Quantitative studies involving healthcare professionals and evaluating structured expressive writing interventions were considered for inclusion, including ran- domized and non-randomized, controlled and uncontrolled designs. Studies reporting psychological, psychophysical, or work-related outcomes were eligible. Only full-text articles published in English or Italian were considered. The review protocol was registered and archived in the Open Science Framework. Methodological quality was assessed using CASP checklists, the RoB 2 tool, and the Newcastle–Ottawa Scale. Results: Seven studies published between 2017 and 2023 were included. EW interventions were associated with re- ductions in psychological distress, particularly perceived stress, depressive symptoms, and post-traumatic stress symptoms. Findings regarding burnout and compassion fatigue were mixed. Organizational and job-related outcomes, such as job satisfaction and organizational commitment, showed limited and heterogeneous improvements. No consistent effects were observed for resilience or social support. Overall, the methodological quality of the included studies was generally good. Conclusions: EW appears to be a promising, low-cost intervention for reducing psychological distress among healthcare professionals. However, heterogeneity in study designs, intervention protocols, and outcome measures limits the strength of the evidence. Further high-quality, controlled studies using standardized EW protocols are needed.