Therapeutic Writing in a Group Setting for Girls with ADHD: A Case Series on Self-Perception, Self-Esteem, and...

Attention-deficit/hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation, socio-emotional difficulties, and low self-esteem. Narrative-based approaches, including therapeutic writing, may support identity development and promote adaptive self-representations. However, there is limited evidence regarding structured, group-based therapeutic writing interventions for this population, particularly for female subjects. This case series provides preliminary and exploratory evidence regarding the feasibility of and potential changes associated with this approach in female adolescents with ADHD.

This case series included four adolescents (aged 11-14 years) with a clinical diagnosis of ADHD and presenting with emotional and socio-emotional difficulties. Participants underwent a structured group intervention consisting of seven sessions integrating therapeutic writing techniques and cognitive-behavioral principles, supervised by a specialized psychotherapist. The following outcome measures were collected at baseline (t0) and post-intervention (t1): Difficulties in Emotion Regulation Scale (DERS-SF), Difficulties in Emotion Regulation Scale (SSIS-SEL), and Rosenberg Self-Esteem Scale (RSE_TOT). Data were analyzed using linear mixed-effects models, with results interpreted as exploratory estimates of pre-post changes.

Following the intervention, positive pre-post changes were observed in socio-emotional competencies and self-esteem. Statistically significant pre-post changes were observed in self-esteem and in socio-emotional competencies, particularly in self-awareness and self-regulation. Reductions were observed in emotional regulation difficulties, although these changes did not reach statistical significance.

This case series suggests that a structured group-based therapeutic writing intervention may be associated with improvements in self-esteem and selected aspects of socio-emotional functioning in adolescents with ADHD. Given the small sample size and exploratory design, findings should be interpreted cautiously and require confirmation in larger controlled studies. These findings contribute preliminary evidence to an underexplored area in the underrepresented female ADHD population and highlight the potential value of integrating narrative processes within group interventions to support both individual meaning-making and interpersonal validation.