Journal therapy, also referred to as journal writing therapy or simply writing therapy, involves the therapeutic use of journaling exercises and prompts to bring about awareness and improve mental health conditions as a result of inner and outer conflicts. According to the Center for Journal Therapy, it is the “the purposeful and intentional use of reflective writing to further mental, physical, emotional, and spiritual health and wellness.” Though there are few professionals who specialize solely in journal therapy, many psychotherapists incorporate therapeutic journal writing into their treatment.

What Is the Difference between Journal Therapy and Keeping a Journal?

Journal therapy originated in the 1960s with psychologist Dr. Ira Progoff's Intensive Journal method. With his developments, the therapeutic potential of journal writing moved into public view. Prior to this, the main function of journal writing was to record events and experiences from a narrative point of view. Keeping a diary, though most likely beneficial to its author, was not seen a therapeutic process.

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Today, journal therapy is considered a stand-alone modality—like art therapy or music therapy. Journal therapists can be trained through programs approved by the National Federation for Biblio/Poetry Therapy, or independent programs like Kathleen Adams’s Center for Journal Therapy or Dr. Ira Progoff’s Dialogue House. But those who are not trained by an approved journal therapy training program can still use journal writing with people who come to them for therapy. This integration of journal writing into different types of psychotherapy is called “therapeutic journal writing.”

One of the major differences between keeping a journal and journal therapy is the way internal experiences, thoughts, and feelings are captured. Journal therapy allows a person to write down, dialogue with, and analyze their issues and concerns. Therapeutic journal writing and journal therapy use writing prompts and exercises to support the work of therapy. The practice allows people to be reflective, introspective, and intentional about their writing.

How Does Journal Therapy Work?

Journal therapy is primarily used with people in therapy to increase awareness and insight, promote change and growth, and further develop their sense of self. Through various writing prompts and activities, a journal therapist will guide a person in treatment toward his or her goals. The act of writing things down often relieves tension and can bring clarity to the issue at hand.

Although journal writing can be used in unlimited ways, there are some general processes that most therapists use. A therapist might request that the person in therapy begin each session with a writing exercise to declare his or her intention for the session or to hone in on present concerns. A therapist might use journal writing as a mode of communication between the person in therapy and therapist, taking advantage of the extra layer of safety writing provides. At the conclusion of the session, the therapist may assign the person in therapy homework that can be processed in the next session.

There are many reasons why you might want to find a therapist that uses journal writing as part of a treatment plan. Psychotherapist and yoga therapist Dr. Lynn Somerstein, RYT, in New York City, said that she has used journal writing techniques with people who have difficulty processing their thoughts. Therapists may find similar benefits when using therapeutic journal writing with people in their care who have trouble tracking their progress, as marriage and family therapist Kathy Hardie-Williams, NCC, LPC, LMFT, in Tigard, Oregon, described: “Some have found it valuable to keep journals and then go back and read them to see how far they have progressed.”

Journal therapy and therapeutic journal writing have been used in treatment for a number of conditions, including:

Journal Therapy Exercises and Prompts

There are many creative and effective ways that journal writing may be used in treatment. Some of these techniques can be used on occasion, as in therapeutic journal writing, or for the entire course of treatment, as in journal therapy. Some examples of journal exercises and prompts one might see in therapy include:

  • Journaling with Photographs: People choose personal photographs and spend time in the session writing responses to a series of questions about the photographs. Questions can include things like “What do you feel when you look at these photos?” or “What do you want to say to the people, places, or things in these photos?”
  • Letter Writing: A person in therapy is prompted to write a letter to someone about various issues he or she is experiencing. People can choose to write to anyone, including people they know, parts of themselves, or someone they have lost. For example, an individual might write a letter to a deceased parent to tell them what he or she is going through.
  • Timed Journal Entries: This is a good technique to use with those who have difficulty focusing their thoughts. The therapist and person in therapy decide on a general topic and then the person in therapy has a brief allotment of time, usually 5–10 minutes, to write about it.
  • Sentence Stems: The therapist provides a series of open-ended sentence stems for the person in therapy to complete. For example, the therapist might suggest, ‘The thing I am most worried about is…’ or ‘I have trouble sleeping when…’ or ‘My happiest memory is…’
  • List of 100: The therapist asks the person in therapy to list 100 items that relate to a chosen theme or topic. This process will most likely result in the repetition of certain items or patterns that the therapist and individual will review and discuss. Examples of list prompts include 100 Things that Make Me Sad, 100 Reasons to Wake Up in the Morning, 100 Things I Love, or 100 Things I Want To Do With My Life.
  • Dialogue: In this technique, the therapist and person in therapy will first choose two positions, parts, or viewpoints within the person in therapy or from external sources. The person in therapy will then write a dialogue between these two entities. This process can increase awareness about a psychological struggle or supply alternative perspectives about it. For example, the therapist might suggest the person in therapy construct a conversation between his or her child self and his or her future self.

Tips for Therapeutic Journal Writing

Therapeutic journal writing has become a popular self-help tool. Additionally, many therapists assign journal writing prompts for homework. Listed below are some tips on how to include therapeutic journal writing into your self-care routine.

  • Ensure your privacy: Keep your journal materials in a safe place.
  • Return to what you have written: Save everything you write, when appropriate, and review it often. The process of going back to what you have written can not only spark inspiration for future writing, but can offer perspective on how far you have come.
  • Time yourself: Using timed writing exercises can help you avoid writer’s block and help you tap into relevant unconscious material.
  • Write freely: Hush your inner critic and ignore the urge to edit your work. Therapeutic journal writing is not meant to be pretty or grammatically correct; it is meant to be real.
  • Be honest with yourself: Honor your thoughts, feelings, and experiences with the authenticity they deserve. More work gets accomplished when you are your genuine self in your writing.

Limitations of Journal Therapy

Although many therapists and people in therapy report that journal therapy and therapeutic journal writing are effective, there are a few limitations to the practice. First, journal therapy may not be effective with people who experience cognitive or intellectual challenges. Knowing how to read and write is a must for this type of therapy. Second, some studies indicate that writing about traumatic experiences may exacerbate symptoms. Third, according to that same research, not all people report positive progress from working through trauma using therapeutic journal writing. Lastly, it is important to monitor how people in therapy are responding to journal therapy techniques and to look out for behavioral or emotional symptoms of perseveration, rumination, or obsessive-compulsiveness in their writing. These patterns of behavior can actually contribute to issues rather than improve them.

Research and Studies Related to Journal Therapy

Being creative is part of human nature and journal writing has long been a major mode of expression and creativity. Research has demonstrated the therapeutic efficacy of journal therapy for both physical and mental health. According to an article in the American Psychological Association’s Monitor on Psychology, studies "suggest that writing about emotions and stress can boost immune functioning in patients with such illnesses as HIV/AIDS, asthma and arthritis.” Furthermore, according to researchers at the Dana-Farber Cancer Institute and Harvard Medical School, therapeutic journal writing can improve the mental and physical health in cancer patients. Finally, an article published in BJPsych Advances states that journal therapy and therapeutic writing are beneficial for treating severe trauma, body image problems, and grief and loss issues.


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