Web-Based Writing Intervention for Body Image–Related Distress in Women With Breast Cancer


Key Points

  • The intervention was associated with reduced body image distress and improved body appreciation at 1 week.
  • Benefits persisted at 1 and 3 months. 

In an Australian trial reported in the Journal of Clinical Oncology, Sherman et al found that use of a structured online writing exercise (My Changed Body) was associated with reduced body image distress and improved body appreciation among breast cancer survivors.

Study Details

My Changed Body is a Web-based psychological intervention in which patients use therapeutic expressive writing to describe their thoughts and emotions. Responses are elicited to specific prompts focused on self-compassion that may enable patients to perceive their breast cancer experience in a caring and supportive manner.

In the trial, 304 women with stage I to III breast cancer who had experienced at least 1 negative event related to bodily changes were randomized to the My Changed Body intervention (n = 149) or an expressive writing control group (n = 155), with each exercise consisting of a single 30-minute online writing activity. The primary outcome measures were reduction in body image distress (assessed by the 10-item Body Image Scale) and improvement in body appreciation (assessed by the 13-item Body Appreciation Scale) at 1 week after intervention. Follow-up assessments were made 1 week, 1 month, and 3 months after the writing session.

Body Image Distress and Body Appreciation Outcomes

The My Changed Body group had significantly reduced body image distress (P = .035), greater body appreciation (P = .004), and greater self-compassion (Self-Compassion Scale–Short Form; P < .001) vs the control group at 1 week. Intervention effects on body image distress were moderated by lymphedema status (P = .007) and appearance investment (P = .042). Self-compassion mediated effects on both primary outcomes.

Therapeutic effects in the My Changed Body group were maintained at 1 month for body image distress (P = .023) and body appreciation (P = .002) and at 3 months for body appreciation (P = .003). My Changed Body patients with lymphedema showed reductions in depression symptoms at 1 month (P = .001) and in anxiety at 1 week (P = .006) and 1 month (P = .017).

The investigators concluded, “This study supports the efficacy of [My Changed Body] for reducing [body image distress] and enhancing body appreciation among [breast cancer survivors].

The study was supported by Macquarie University postgraduate research funding.

Kerry A. Sherman, PhD, of Macquarie University, New South Wales, is the corresponding author for the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.