Expressive Writing for Grief: A Meta-Analysis of Randomized Controlled Trials

Purpose: This systematic review and meta-analysis assessed expressive writing (EW) interventions for grief reduction in bereaved individuals, focusing on the impact of key parameters: structure, session number, duration, and therapist feedback. Method: The review adheres to the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines to ensure rigor. Randomized controlled trials (RCTs) were retrieved from their inception to July 16, 2025. 13 RCTs were included based on the inclusion and exclusion criteria. Results: The results showed that EW had a small effect size on grief (Hedges’ g = 0.388) and depression (Hedges’ g = 0.308). Subgroup analyses revealed moderate effects for higher session numbers (Hedges’ g = 0.583) and the presence of therapist feedback (Hedges’ g = 0.679). Discussion: This meta-analysis showed writing interventions effectively reduce grief, though effect sizes were small. EW interventions containing more session numbers and with therapist feedback are especially effective.