Journal therapy is a writing therapy focusing on the writer’s internal experiences, thoughts and feelings. This kind of therapy uses reflective writing enabling the writer to gain mental and emotional clarity, validate experiences and come to a deeper understanding of themself. Journal therapy can also be used to express difficult material or access previously inaccessible materials.
Like other forms of therapy, journal therapy can be used to heal a writer’s emotional or physical problems or work through a trauma, such as an illness, addiction, or relationship problems, among others. Journal therapy can supplement an on-going therapy, or can take place in group therapy or self-directed therapy.
Brief History
Ira Progoff created the intensive journal writing programme in 1966 in New York. The intensive journal method is a structured way of writing about nature that allows the writer to achieve spiritual and personal growth. This method consists of a three-ring, loose-leaf binder with four colour-coded sections: lifetime dimension, dialogue dimension, depth dimension and meaning dimension. These sections are divided into several subsections. Some of these subsections include topics like career, dreams, body and health, interests, events and meaning in life. Progoff created the intensive journal so that working in one part of the journal would in turn stimulate one to work on another part of the journal, leading to different viewpoints, awareness and connections between subjects. The intensive journal method began with recording the session in a daily log.
The field of journal therapy reached a wider audience in the 1970s with the publication of three books, namely, Progoff’s At a Journal Workshop (1978), Christina Baldwin’s One to One: Self-Understanding Through Journal Writing (1977) and Tristine Rainer’s The New Diary (1978).
In 1985, psychotherapist and journal therapy pioneer, Kathleen Adams, started providing journal workshops, designed as a self-discovery process.
In the 1990s, James W. Pennebaker published multiple studies which affirmed that writing about emotional problems or traumas led to both physical and mental health benefits. These studies drew more attention to the benefits of writing as a therapy.
In the 2000s, journal therapy workshops were conducted at the Progoff’s Dialogue House, Adams’ Centre for Journal Therapy and certificates were given through educational institutions. Generally, journal therapists obtain an advanced degree in psychology, counselling, social work, or another field and then enter a credentialing programme or independent-study programme.
Effects
Journal therapy is a form of expressive therapy used to help writers better understand life’s issues and how they can cope with these issues or fix them. The benefits of expressive writing include long-term health benefits such as better self-reported physical and emotional health, improved immune system, liver and lung functioning, improved memory, reduced blood pressure, fewer days in hospital, fewer stress-related doctor visits, improved mood and greater psychological well-being. Other therapeutic effects of journal therapy include the expression of feelings, which can lead to greater self-awareness and acceptance and can in turn allow the writer to create a relationship with his or herself. The short-term effects of expressive writing include increased distress and psychological arousal.
Practice
Many psychotherapists incorporate journal “homework” in their therapy but few specialise in journal therapy. Journal therapy often begins with the client writing a paragraph or two at the beginning of a session. These paragraphs would reflect how the client is feeling or what is happening in his or her life and would set the direction of the session. Journal therapy then works to guide the client through different writing exercises. Subsequently, the therapist and the client then discuss the information revealed in the journal. In this method, the therapist often assigns journal “homework” that is to be completed by the next session. Journal therapy can also be provided to groups.
Techniques
Journal therapy consists of many techniques or writing exercises. In all journal therapy techniques, the writer is encouraged to date everything, write quickly, keep writings and always tell the complete truth. Some of the journal therapy techniques are as follows:
Technique
Outline
Sprint
Catharsis is encouraged by allowing a writer to write about anything for a designated period, such as for five minutes or for ten minutes.
Lists
The writer writes any number of connected items in order to help prioritize and organize.
Captured Moments
Writer attempts to completely describe the essence and emotional experience of a memory.
Unsent Letters
This attempts to silence a writer’s internal censor; it can be used in a grieving process or to get over traumas, such as sexual abuse.
Dialogue
The writer creates both sides to a conversation involving anything, including but not limited to, people, the body, events, situations, time etc.
Feedback
Important to journal therapy as feedback makes the writer be aware of his or her feelings; it also allows the writer to acknowledge, accept and reflect on what they he/she has written before (thoughts, feelings, etc.).
Setting
A quiet and private environment must be created and provided throughout the entire journal writing process. This environment should contain features or elements that can make the writer feel good such as music, candles, a hot drink etc. This environment works to empower the writer and for him/her to associate good feelings with journal writing. To transition into writing, a journal writing session can be started with a drawing or sketch. After journal writing, something active should be done, such as running, walking, stretching, breathing etc. or something that is enjoyable like taking a bubble bath, baking cookies, listening to music, talking to someone, etc.
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The expressive therapies are the use of the creative arts as a form of therapy, including the distinct disciplines expressive arts therapy and the creative arts therapies (art therapy, dance/movement therapy, drama therapy, music therapy, writing therapy, poetry therapy, and psychodrama).
Unlike traditional arts expression, the process of creation is emphasized rather than the final product. The expressive therapies are based on the assumption that people can heal through the various forms of creative expression. Expressive therapists share the belief that through creative expression and the tapping of the imagination, people can examine their body, feelings, emotions, and thought process.
Brief History
Margaret Namburg, Edith Kramer, Hanna Kwiatkowska and Elinor Ulman have been credited with being the pioneers of the field of sensory art therapy. While all of these scientists made significant contributions, Margaret Namburg has been hailed the “Mother of Art Therapy”. Her work focused on the use of art, mainly as a psychoanalytic diagnostic tool. It followed closely other psychoanalytic practices of the time, and was viewed as the communication of unconscious ideas and emotions that were being expressed by the patient.
Modern Approaches
Today’s art therapy is broken down into three different approaches:
Approach
Outline
Psychodynamic
The psychodynamic approach uses terms such as “transference” and defence mechanism to describe why individuals express the art in the way they do, and why this is an expression of the subconscious.
Humanistic
The humanistic approach is more of a positive psychology approach, and is defined by an optimistic view of humans, and how expression through their art allows them to take control over these emotions.
Learning and Development
The learning and developmental approach focuses on the art therapy as a method to assist children who have emotional and developmental disabilities.
Definition and Credentialing
Expressive arts therapy is the practice of using imagery, storytelling, dance, music, drama, poetry, movement, horticulture, dreamwork, and visual arts together, in an integrated way, to foster human growth, development, and healing. Expressive arts therapy is its own distinct therapeutic discipline, an inter-modal discipline where the therapist and client move freely between drawing, dancing, music, drama, and poetry.
According to the National Organisation for Arts in Health (NOAH), what distinguishes the six creative arts therapies – art, dance/movement, drama, music and poetry therapy as well as psychodrama – from expressive arts therapy is that expressive arts therapy interventions are designed to include more than one of the “expressive” art forms (art, dance, drama, music, poetry), whereas creative arts therapists, such as art, dance/movement, drama, music, poetry and psychodrama therapists, are often intensively trained and educated to use only one modality in their practice. However, NOAH also acknowledged that the terms “are often used interchangeably in the field”, and that in any case all such professionals should collaborate closely.
The International Expressive Arts Therapy Association (IEATA) is the responsible organisation handling the credentialing of expressive arts therapists.
The National Coalition of Creative Arts Therapies Association (NCCATA) connects all six modalities of the creative arts therapies. However, each modality of the creative arts therapies has its own national association that regulates professional credentials, establishes educational standards and hosts annual conferences for the purpose of exchanging new ideas and research.
Education
Each national association of the different modalities of expressive therapies sets its own educational standards. In the United States, there are a fair number of colleges that offer approved programmes in compliance with the national associations’ credentialing requirements.
There are 37 universities for music therapy, 34 universities for art therapy, seven universities for dance/movement therapy, and five universities for drama therapy, as well as 5 universities for expressive arts therapy, that have approved master’s degree programmes in the United States. In addition, the American Music Therapy Association (AMTA) has 75 undergraduate music therapy programmes approved. Once finished with an academic degree, potential therapists have to apply for credentialing at the responsible national association.
Creative Arts Therapies Modalities
There are six creative arts therapy modalities, recognised by the NCCATA, including art therapy, dance therapy, drama therapy, music therapy, poetry therapy and psychodrama. In some areas, the terms Creative Arts Therapy and Creative Arts Therapist may only be used by those who are properly licensed, as is the case in the State of New York.
Art Therapy
Created in the 1940s, Art therapy consists of the combination of psychotherapy and art. The creative process as well as the created art piece serves as a foundation for self-exploration, understanding, acceptance and eventually healing and personal growth. The creative act in therapy therefore can be seen as a means of re-experiencing inner conflict connected to resolution. The four main types are expression, imagination, active participation, and mind-body connection. Assisting in those with depression, breast cancer, and asthma, art therapy can be done at any age and does not require and skill set. Art Therapy has undergone extensive research which revealed that it decreases anxiety, increases self-concept and quality of life, and reduces negative thoughts. With two main goals in mind, Art Therapy strives to enhance personal and relational goals for those in need. Self-esteem, social skills, and cognitive functions are also said to be an area of importance. A certified art therapist is essential in order for the therapy to ensure improvement, however common art therapy using even a friend to discuss trauma can be enough to help someone.
Dance/Movement Therapy
Like other creative arts therapy modalities, dance/movement therapy is based on the assumption that “mind, body and spirit are inseparable and interconnected” (ADTA). Movement is the primary tool of intervention in a therapy session, but dance/movement therapy also uses the art of play in therapy. Like other creative art therapies it uses primarily nonverbal communication. Dance and movement therapy has shown to be the most beneficial in those who enjoy exercises that involve less talking an expression through movements.
Drama Therapy
Drama therapy refers to the combination of the two disciplines drama/theatre and psychotherapy. Drama Therapy, as a hybrid of both disciplines, uses theatre techniques to treat individuals with mental health, cognitive, and developmental disorders. Through the art of play and pretend, patients gain perspective in therapy to their life experiences, which in the field is referred to as “aesthetic distance”.
Music Therapy
Music Therapy is the use of music, music-making, or other music-related interventions within a therapeutic relationship. Music therapy is a broad field with many areas and populations to specialize in. A holistic practice, music therapy can address emotional/psychological, cognitive, communication, motor, sensory, pain, social, behavioural, end of life, and even spiritual needs. This is due in part to music being processed in many areas of the brain. Music therapy helps patients “communicate, process difficult experiences, and improve motor or cognitive functioning” (Jenni Rook, MT-BC, LCPC, 2016). When used as psychotherapy, at its core, music therapy may use music as a symbolic representation and expression of the psychological world of the individual.
Music Therapy also benefits a variety of disorders, like cardiac and mental disorders. It aids those who suffer from depression, anxiety, autism, substance abuse, and Alzheimer’s. In cases where a person is suffering from mental disorders, music relieves stress, improves self-esteem, etc. Evidence has shown that people who have used Music Therapy in the past have improved in several aspects of life that do not concern just those suffering from mental illness. In music therapy people may improve their singing which may then impact their ability to speak. Therefore, it can change several aspects of life, not just those of helping mental illness.
Poetry Therapy
Poetry therapy (also referred to using the broader term bibliotherapy) stands out from other creative arts therapies, which are all based on the assumption of the existence of a language that functions without words. Poetry therapy, however, is the use of the written word to bring healing and personal growth.
Psychodrama
Psychodrama is a distinct form of psychotherapy developed by Jacob L. Moreno in the early 20th century. Moreno, a trained psychoanalyst himself, had the goal of creating a more effective, action-based form of psychoanalysis as developed by Sigmund Freud and Carl Jung. He developed a clear three phase structure (warm up, action, sharing) to his therapy as well as multiple intervention-methods that are still used by psychodrama therapists today.
Although related, psychodrama and drama therapy describe different modalities within the field of creative arts therapies. Whereas psychodrama uses real-life experience of the patients in therapy to “practice new and more effective roles and behaviors” (ASGPP), drama therapy lets the patients explore more fictional stories, such as improvised scenes, myths or fairy tales.
Benefits
Benefit
Outline
Self-Discovery
This discovery often leads to a relief of emotional tension caused by past events, and can be used as a coping mechanism.
Empowerment
Art therapy gives individuals the ability to articulate their fears and stresses in a non-conventional way, and often leads to sense of control over these emotions.
Stress Relief
Effective for stress relief by itself, but can provide even better results if paired with other relaxation devices such as guided imagery.
Physical Pain Relief and Rehabilitation
Art therapy has been shown to help decrease pain in patients who are recovering from illness and injury. It has also been used in patients who are chronically or terminally ill, to provide relief and pain control.
Empirical Evidence
Ball (2002)
Ball conducted long-term research on five children who were considered to be severely emotionally disturbed. These children participated in 50 art therapy sessions, and the results suggested that the art therapy was successful, and the children showed marked progress in their treatment over the course of the 50 sessions.
Pifalo (2006)
In this study, 41 girls or young women who had been sexually abused were given structured group art therapy for eight weeks, and were measured before treatment using the Briere’s Trauma Symptom Checklist for Children (TSCC). They were given the test again after the treatment, and for 9 out of 10 of the girls, a statistically significant reduction in scores on the test were observed.
Bar-Sela, Atid, Danos, Gabay & Epelbaum (2007)
This study worked with 60 adults who had cancer. These adults attended weekly individual art therapy, in addition to watercolour painting classes. After just four sessions, the experimental group saw marked and significant improvement in depression and fatigue, as measured by the Hospital Anxiety and Depression Scale and a brief fatigue inventory. While they showed a decrease in depression, there was no significant difference in the levels of anxiety of the patients.
Gusak (2006)
In this study, the researcher worked with 29 incarcerated men. The men attended eight sessions of group art therapy, and were tested before and after the treatment using the Beck Depression Inventory Short Form. After the eight sessions, all of the men showed significant improvement in the symptoms of depression and their score on the Beck Depression Inventory reflected these improvements.
Bulfone et al. (2009)
In this study Bulfone et al. utilised music therapy as their treatment. 60 women who had been diagnosed with stage 1 or 2 breast cancer were randomly assigned to a control or experimental group. The control group received standard assistance before chemotherapy, while the experimental group had the chance to listen to music before the chemotherapy began. The results showed that the anxiety levels of the experimental group were significantly lower than those of the control group, and also showed a significantly lower level of depression.
This page is based on the copyrighted Wikipedia article <https://en.wikipedia.org/wiki/Expressive_therapies >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.
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