The proposed research is a feasibility study of a brief expressive writing intervention added to treatment as usual in a community substance abuse treatment center for clients with depressed mood who have been court-referred for alcohol treatment. Evidence-based interventions have been developed for both depression and alcohol misuse, but few well-integrated interventions with proposed common mechanisms underlying both disorders have been developed or validated. Further, community substance abuse treatment centers would benefit substantially from easily adoptable interventions that target both alcohol and psychiatric problems such as depression. Expressive writing applied to a variety of populations (e.g., HIV, cancer, PTSD, depression) has been associated with health and emotional benefits. This study will utilize a two group, randomized controlled pilot study design to: (1) assess feasibility of integrating a writing intervention into treatment as usual in a community treatment center; (2) evaluate its promise for impacting depressed mood and problematic drinking, and; (3) gather data pertaining to potentially mediating constructs. Eligible participants will be those who score 12 or more on the BDI-II and who score 8 or more on the AUDIT and who are not currently dependent on or abusing other drugs. A total of 80 participants will be enrolled and half will be randomly assigned to receive the writing intervention in addition to their treatment as usual, and the other half will receive treatment as usual. The writing intervention will follow the classic procedures developed by Pennebaker (Pennebaker et al., 1988) and participants will write for at least 20 minutes, three times within a one-week period, about their """"""""deepest emotions and thoughts about the most upsetting experience"""""""" in their lives. Although the theoretical mechanisms of this intervention are not fully understood, we propose to investigate two psychological processes that may be particularly important for both depression and alcohol misuse, namely experiential avoidance and ruminative thinking. We also plan to develop a system for coding ruminative thinking and experiential avoidance in the writing samples based on word counts and independent ratings. Assessment will be conducted at intake and one month follow-up. If successful, this feasibility trial will provide the foundation from which to develop a large-scale randomized controlled trial of expressive writing for dually-diagnosed populations in community settings. ? ? ?
