Journaling for Mental Health: Helping Patients to “Write Their Way Out”

The mental health benefits of journaling are well-documented. However, patients often don’t know how or where to begin. A quick search for “mental health journal” on Amazon elicits over 50,000 results, from leather-bound booklets with blank pages to daily habit trackers.

Many of these publications claim to be “backed by science” or “endorsed by therapists,” though few have authors with any clinical training. How do you sort through the noise to determine which journals might help your patients? Here is a summary of the research on journaling for mental health, including a list of the guided journals most often recommended by therapists.

Types of Journaling

Research has primarily focused on two types of journaling: gratitude and expressive. Gratitude journals prompt users to reflect on the people and things they are most thankful for. Expressive journaling concentrates on thoughts and feelings related to emotionally-significant events like trauma or loss. 

Benefits of Journaling

Reduces anxiety

Ever since James Pennebaker’s seminal work on expressive writing in the 1980s and 90s, researchers have documented the efficacy of journaling for reducing anxiety. A recent literature review reported that expressive journaling has a “significant” effect on symptoms of stress and anxiety among healthy and subclinical populations. And a 2018 study at Penn State showed that 12 weeks of expressive journaling reduced anxiety and increased perceived resilience in adults with comorbid anxiety and medical conditions. Experts theorize that writing down worries helps to “offload” them from working memory, freeing cognitive resources for other things.

Alleviates depression

A 2013 study found that patients with major depressive disorder who journaled for 20 minutes a day for 3 consecutive days experienced a significant decrease in depressive symptoms. Patients in the treatment group wrote their deepest thoughts and feelings about emotionally meaningful experiences, while patients in the control group wrote about daily activities. The reduction in depressive symptoms persisted at the 4-week follow-up.

Improves physical health

Numerous studies have demonstrated the physical health benefits of journaling. For example, patients with asthma and rheumatoid arthritis reported a reduction in symptoms after 3 consecutive days of expressive journaling. Journaling has even been shown to lower virus levels in patients infected with HIV. Researchers theorize that writing boosts immunity by reducing stress hormones in the body.

Improves memory

In an experiment with college undergraduates, students who completed three 20-minute sessions of expressive journaling showed advances in working memory when compared to a control group. These students also achieved higher GPAs both immediately after the experiment and in the following semester. The results of the study indicate that journaling may work to improve memory by reducing intrusive and avoidant thoughts.

Guided Journal Recommendations

As any good pharmaceutical ad will tell you, “Results may vary from person to person.” The journal that will be the most helpful for your patient depends on a variety of factors, including personal preference, clinical profile, and the amount of time they are able to dedicate to writing. However, here are 4 guided journals that are often recommended by therapists:

The 5-Minute Journal

For patients who need something quick and simple, this gratitude journal checks all the boxes. Based on gratitude research, The 5-Minute Journal offers a series of prompts, weekly challenges, and inspirational quotes. The pages are undated, so patients can complete the reflections at their own pace. There is even a version for Spanish speakers.

The Anti-Anxiety Notebook

Written by therapists, this journal is based on the principles of Cognitive-Behavioral Therapy (CBT). It includes pages for recording thoughts and feelings around an anxiety-provoking event, a checklist of cognitive distortions, and space to reframe the experience. There are also exercises for reducing anxiety and tips from CBT-trained clinicians.

The CBT journal for mental health

This journal is a good choice for someone who is just getting started in therapy and unsure of what approach is going to be the most helpful. Written by a therapist, The CBT Journal for Mental Health prompts users to explore core values, practice self-care, develop self-compassion, and make SMART goals. There are writing prompts, positive affirmations, and guided exercises and activities.

Zen as F*ck

Although this wins the prize for the catchiest title, it may not be the best choice for patients who dislike profanity. Zen as F*ck is for people who are curious about mindfulness but roll their eyes at New Age promises of butterflies and rainbows. Quirky, humorous, and irreverent, this journal encourages readers to embrace imperfections, find peace in the chaos of everyday life, and cultivate self-compassion.

Conclusion

In an increasingly saturated market, it can be difficult to determine which mental health journals might help your patients. Journals that encourage users to process, analyze, and organize their experiences are typically more effective than those that focus on “venting.” Setting a time limit can be helpful, especially if what your patient is writing about is traumatic. Finally, your patients will reap the most benefits if they can let go of any “rules” around grammar or the quality of writing. Used appropriately, journaling can help your patients “write their way” toward greater self-awareness, resilience, and overall well-being.