Expressive writing as therapeutic writing for self-efficacy in chronic illness and trauma-related stress: a systematic review

Expressive writing is a brief, low-burden language-based practice, but its effect on self-efficacy remains unclear. This systematic review examined expressive writing and closely related written emotional disclosure interventions for self-efficacy and adjacent efficacy outcomes in adults facing chronic illness or trauma-related stress. Self-efficacy was defined as self-reported perceived capability to manage illness-, trauma-, or adversity-related demands, rather than observed coping competence. PubMed, Scopus, Web of Science Core Collection, and APA PsycINFO were searched in April 2026 under a locked eligibility framework. The findings were synthesised narratively because quantitative pooling was not methodologically defensible. Searches identified 486 records; after deduplication, 278 records were screened, 15 full-text reports were assessed, and eight studies were included. Evidence was mixed. Some studies suggested benefits for condition-specific or adjacent efficacy constructs, but findings varied across outcomes, comparators, and follow-up points. Current evidence does not support a broad claim that expressive writing reliably improves self-efficacy.