The current study examined psychological and physical health outcomes of the written disclosure paradigm and the hypothesis that the principles of therapeutic exposure account for the beneficial effects of the paradigm. Participants were randomly assigned to either a written disclosure condition or a control condition. Reactivity to the writing sessions was examined using both subjective and physiological measures. Measures of psychological and physical health were completed before and 1 month after the sessions. Participants assigned to the disclosure condition reported fewer psychological and physical symptoms at follow-up compared with control participants, though reductions were clinically significant for only 1 outcome measure. Physiological activation to the 1st disclosure session was associated with reduced psychological symptoms at follow-up for disclosure participants. Subjective reports of emotional responding corresponded with physiological reactivity. Implications of these findings are discussed.