(2018). Horan, Sean M. official website and that any information you provide is encrypted Clarify your thoughts and feelings Know yourself better Reduce stress Solve problems more effectively Resolve disagreements with others In addition to all of these wonderful benefits, keeping a journal allows you to track patterns, trends and improvement and growth over time. Journaling is a promising intervention for the treatment of mental health disorders but requires more robust high-quality longitudinal studies to appropriately assess its efficacy. Boskovic, Mary The subsequent suggestion that the beneficial effect of expressive writing is the development of a coherent narrative over time, reflecting increasing cognitive processing of the experience, is consistent with the literature on traumatic memory and trauma treatment (e.g. * Even the simple act of writing something down lets your brain know you want to remember it. Better together: Long-term behaviors and perspectives after a practitioner-family writing intervention in clinical practice. 1Northeast Addiction and Mental Health Centre for Holistic Recovery, Calgary, Alberta, Canada, 2Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. There is additionally no current evidence-based guidance about the utility of journaling as a non-pharmacological treatment modality for family physicians. Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. It is not intended to replace face-to-face interaction and is best done with a follow-up appointment for debriefing. The revised Cochrane risk of bias tool (ROB-2)9 for randomised control trials was used to assess outcomes at the study level for each article included in this review. The analysis was performed on the following variables: type of journaling, intervention duration, journal collection/analysis, sample size, participant sex and age, and geographical region where the studies were conducted. ). Due to differences in study designs, comparisons of behaviour change/non-pharmacological interventions (eg, journaling) to conventional pharmacological treatments such as antidepressant efficacy are challenging. ). Furthermore, writing sessions are usually considerably shorter than the 4590 minutes deemed necessary to facilitate emotional habituation. Our preferred manner of stating the results from this review was in an ORs and number needed to treat. Careers, Unable to load your collection due to an error. A B-level recommendation indicates that the data are inconsistent, or limited quality patient-oriented evidence.10, This is the first study to examine the efficacy of journaling as an intervention for improving mental health outcomes with a meta-analysis. Soyka, Michael } Limited benefits were obtained for male psychiatric prison inmates (Reference Richards, Beal and SeagalRichards et al, 2000), victims of natural disaster (Reference Smyth, Hockemeyer and AndersonSmyth et al, 2002) and individuals who had experienced a recent relationship breakup (Reference Lepore and GreenbergLepore & Greenberg, 2002). 5 and 2. It enhances our immune system functioning. Zingg, Christina In a 2006 study, nearly 100 young adults were asked to spend 15 minutes journaling or drawing about a stressful . Journaling can be implemented in one-on-one sessions, A total of 20 articles and 31 outcomes are presented in this paper. Wedgwood, Lucinda Furthermore, expressive writing results in immediate increase in negative affect rather than immediate relief of emotional tension, and the obtained health benefits are unrelated to the amount of negative emotion or distress either expressed or reported just after writing (Reference SmythSmyth, 1998). Table 3 summarises the results from the meta-regression analyses performed on multiple study variables, examining also the three symptom subgroups of anxiety, depression and PTSD. e improved immune response in glandular fever. "coreDisableEcommerceForBookPurchase": false, Journaling is mindfulness in motion, says Lisann Valentin, a Shamanic life coach. and 2008. All of your writing will be completely confidential. The powerful health benefits of journaling: Psychologist James Pennebaker says that journaling strengthens immune cells called T-lymphocytes. Dont set your expectations too high. In a 2013 study published in the journal Psychosomatic Medicine, researchers found that a certain kind of journalingsometimes known as expressive writingmay help in healing physical wounds,. Finally, because meta-regression was performed within subgroups (anxiety, depression and post-traumatic stress disorder (PTSD), the number of studies within subgroups became less than 10 across several groups, and meta-regression is generally not recommended with fewer than ten studies in a meta-analysis. The only rule is that once you begin writing, you continue until the time is up. The most consistent finding has been that, over the course of writing, participants whose health improved used more positive-emotion words, a moderate number of negative-emotion words and an increased number of cognitive mechanism words (the latter include insight words such as understand, realise and causal words such as because, reason) (Reference PennebakerPennebaker, 1997b Bloomfield, David Both practices in our opinion are counterproductive to optimal journaling practices. 2008. Here's how to navigate empty nest syndrome, or the sadness, loneliness, and other emotional distress you may experience after your kids leave home. "useRatesEcommerce": true Wilhelm, Kay It could be the first thing you do when you wake up or the last thing you do before going to sleep. Shes especially passionate about helping readers feel less alone and overwhelmed and more empowered. To create a lasting journaling habit, start with several minutes or more, depending on your preference. Chung, Cindy K. Here are eight ways to slow down and embrace the, Midlife crisis in women, once considered a myth, is a well-documented event for many. The results of this work revealed that a journaling intervention resulted in an average statistically significant 5% reduction in patient scores on mental health measures compared with control arms, with a greater benefit in anxiety (9%) and PTSD (6%) symptom subgroups, and a lesser benefit in depression subgroup (2%). Compared with the participants who wrote about negative experiences or only received counseling, those who wrote gratitude letters reported significantly better mental health four weeks and 12 weeks after their writing exercise ended. Owing to the nature of APT, study results discussed below are not exhaustively referenced; instead, we have tried to give the most representative or comprehensive publications. As seen in table 2, a considerable majority (85%) of the studies implemented a short-term journaling intervention ranging from 2 to 4 journaling sessions. Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in non-clinical and clinical populations. Control participants are asked to write as objectively and factually as possible about neutral topics such as a particular room or their plans for the day, without revealing their emotions or opinions. Figure 3 illustrates a histogram depicting Cohens d effect size8 for the 31 outcomes. Describe yourself, including your personality and roles at work and home. It's a simple,. The findings of this study can be applied in primary care practice by using journaling as a low risk, low-resource intensive adjunct to standard therapy for patients with mental health concerns. Interestingly, our findings for journaling show small to moderate effect sizes, suggesting that journaling interventions show promise to become a highly efficacious evidence-based therapy once more well-designed trials are completed. Searching for moderators of the Pennebaker disclosure effect via e-mail, A closer examination of the structured written disclosure procedure, Taking pen to hand. Federal government websites often end in .gov or .mil. Overall, studies examining expressive writing demonstrate some beneficial effects in physical and/or psychological health. All rights reserved. Later, I give some feedback on the changes in writing (after linguistic analysis), if requested. In your writing, I'd like you to really let go and explore your deepest emotions and thoughts. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. Jotting down your thoughts, however, creates space and distance to consider them in a more objective way, says Sabrina Romanoff, PsyD, a clinical psychologist in New York City. The act of gratitude plays an important role in psychological wellbeing and self-actualization (Maslow, 1981). In addition, writing about emotional topics changed the way that participants interacted with others, suggesting that writing may also have an impact on objectively assessed social and linguistic behaviour (Reference Pennebaker and GraybealPennebaker & Graybeal, 2001). But in the past 30 years, hundreds of studies have uncovered the benefits of putting pen to paper with your deepest thoughts and feelings. Effect sizes are classified as small (d=0.2), medium (d=0.5) and large (d0.8).8 According to Cohen, a medium effect of 0.5 is visible to the naked eye of a careful observer.8 A small effect of 0.2 is noticeably smaller than medium but not so small as to be trivial. Internet-mediated, protocol-driven treatment of psychological dysfunction, Expressive writing moderates the relation between intrusive thoughts and depressive symptoms, Mending broken hearts: Effects of expressive writing on mood, cognitive processing, social adjustment and health following a relationship breakup, Expressive writing and health: self-regulation of emotion-related experience, physiology, and behavior, For whom does it work? Writing therapy, also known as journal therapy, is exactly what it sounds like: writing (often in a journal) for therapeutic benefits. Research suggests that writing may be more beneficial for men and, in my experience, men have certainly found it an acceptable intervention. Its also easier to add drawings to paper. Write on anything. 2009. Theyre also great when you arent sure what to journal about. This 5% difference between groups is statistically significant and indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures when compared with the control arm. Naming the specific emotions youre experiencing and accepting them reduces their strength. When youre first starting out, keep it simple. Parenting is one of the most complex and challenging jobs you'll face in your lifetime -- but also the most rewarding. You can make a list or write full sentences. Journaling saves time because there is a limited amount of face-to-face contact time in group and one-on-one counseling sessions. Shes the author of the mental health journal Vibe Check: Be Your Best You (Sterling Teen). Cohens d effect size provides a standardised representation of the distribution of means between the control and intervention group. Don't worry about spelling, grammar or sentence structure. Exploring the roles of behavioural inhibition, obsession, and confiding, Some Suggestions for Running a Confession Study, Opening Up: The Healing Power of Expressing Emotions, Writing about emotional experiences as a therapeutic process, What our words can say about us. Research suggests that happiness follows a U curve, dipping at, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. 8600 Rockville Pike Seizer, Hans-Ulrich However, it is recommended that patients be told that they can stop writing at any time, should they wish, and appropriate contact numbers should be made available in case of distress. This would likely have adversely affected results. 3 and Margarita Tartakovsky, MS, has been writing for Psych Central and other websites for more than a decade on a wide range of topics. Journaling Evokes Mindfulness There's a solid link between being happy and practicing mindfulness. From this, we can infer that journaling works better for women and this improvement in health outcomes is also supported in the literature.6. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram. Recording your thoughts and feelings in a journal . This distance is formally called cognitive defusion, a helpful concept from acceptance and commitment therapy. We are constantly evolving. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise. In addition, we suggest how expressive writing can be used as a therapeutic tool for survivors of trauma and in psychiatric settings. Journaling may boost health and well-being, 3. and On the complexities of the expressive writing paradigm, Clinical Psychology: Science and Practice, Confronting a traumatic event. Articles were included and excluded based on the criteria outlined in table 1. Patients with HIV infection showed improved immune response similar to that seen in mono-therapy with anti-HIV drugs (Reference Petrie, Fontanilla and ThomasPetrie et al, 2004) and individuals with cystic fibrosis showed a significant reduction in hospital-days over a 3-month period (Reference Taylor, Wallander and AndersonTaylor et al, 2003). Contributors: MS: planning, data collection, data analysis, synthesis, editing. Once youve calmed down a bit, you might find that your emotions are trying to tell you something: Maybe your anger is a sign that you need to set a stronger boundary with someone. The current review explores the benefits of . Go out into nature, and write about the experience. Stevenson, Jennifer K. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis, Does gratitude writing improve the mental health of psychotherapy clients? Refer to online supplemental appendix 7 for a detailed presentation of ROB-2 results. Where are you? Students with a trauma history have shown improvements in physical health (Reference Greenberg, Wortman and StoneGreenberg et al, 1996; Reference Sloan and MarxSloan & Marx, 2004a Describe something you love doing and why. HHS Vulnerability Disclosure, Help the contents by NLM or the National Institutes of Health. for this article. e think about a topic prior to the session. Subgroup analysis further indicated that when studies examining journaling in anxiety disorders, a reduction in prepost intervention scores was 9%0.09 (95% CI 0.19 to 0.01, p0.001) compared with control scores at 2%0.02, (95% CI 0.11 to 0.08, p0.001). For example, you might simply write: Cangilla advises against revisiting the raw details of difficult situations. All questionnaires and health measures used in the studies included in this review indicate that a higher score is suggestive of more severe mental illness. Hostname: page-component-6c5869dcc6-g7hsx Lumley, Mark A. The forest plot in figure 2 illustrates that following standardisation of the data there is a significant difference between control (0.01, 95% CI 0.03 bto 0.00, p0.001) and intervention arms (0.06, 95% CI 0.09 to 0.03, p0.001) between all groups. Overview One of the most effective ways to reduce stress with journaling is to write in detail about feelings and thoughts related to stressful events, as one would discuss topics in therapy, and brainstorm solutions, but there are several different ways to practice journaling. The main search concepts used as both subject headings and keywords journaling and mental health. However, many participants benefit from writing regardless of whether they write about the same traumatic experience or different experiences at each writing session. Total loading time: 0 The SORT taxonomy was used to determine quality of evidence of all studies included in this article. A meta-analysis of 13 studies using expressive writing with healthy participants (Reference SmythSmyth, 1998) found a significant overall benefit (d = 0.47, P<0.0001) and specific benefits in objective or self-reported physical health, psychological well-being, physiological functioning and general functioning outcomes. The mechanism of action appears to be complex, with the demonstrated benefits potentially resulting from some combination of immediate cognitive and/or emotional changes, longer-term cognitive and/or emotional changes, social processes and biological effects, rather than being accounted for by any single factor (Reference PennebakerPennebaker, 2004). In a study, researchers found that those with various medical conditions and anxiety who wrote online for 15 minutes three days a week over a 12-week period had increased feelings of well-being and fewer depressive symptoms after one month. Inclusion in an NLM database does not imply endorsement of, or agreement with, Write lists, make poetry, compose a song, write a letter, draw some art, or try bullet journaling. Revising traumatic memories or fostering self-regulation? Lindstrm, Torill Christine You may have heard about the positive powers of journaling, from improving memory to boosting creativity. Pick a time of the day thats good for you. It can reduce your anxiety. Writing about an event that was stressful or emotional for you may be more beneficial to your mental health than just diary writing. 06/05/50-therapeutic-journal-prompts-for-mental-health/ For more information or support: The data, however, have a high degree of heterogeneity indicated by an I2 of 71.2% in the control arm and an I2 of 83.8% in the intervention arm. Reference PennebakerPennebaker's (1985) theory proposed that actively inhibiting thoughts and feelings about traumatic events requires effort, serves as a cumulative stressor on the body and is associated with increased physiological activity, obsessive thinking or ruminating about the event, and longer-term disease. However, given its simplicity, expressive writing appears to have great potential as a therapeutic tool in diverse clinical settings or as a means of self-help, either alone or as an adjunct to traditional therapies (see also Reference Smyth and HelmSmyth & Helm, 2003; Reference PennebakerPennebaker, 2004). (2020). The SORT has three levels of recommendation of evidence including A-level, B-level and C-level. Davies, Richard ; Reference Smyth, Pennebaker and SnyderSmyth & Pennebaker, 1999) used in most of the subsequent expressive writing studies involves participants writing about traumatic or emotional experiences (Box 1) for 35 sessions, often over consecutive days, for 1520 minutes per session. Three studies implemented a long-term journaling intervention ranging from 7 to 32 journaling sessions. 2. Its your space to create whatever you want to express your feelings. Given the large number of studies conducted to date, with only a few finding any worsening of symptoms for those writing about traumatic experiences, the expressive writing paradigm appears to be reasonably safe for participants, even if no specific benefits are obtained. journaling have been shown to positively affect physical, emotional and mental health, journaling continues to be an underutilized school counseling tool. We seek to state in terms relevant to primary care clinicians the current state of the data and provide further areas for study. The immediate impact of expressive writing is usually a short-term increase in distress, negative mood and physical symptoms, and a decrease in positive mood compared with controls. Schaufel M et al. Similarly, a 12-week study evaluating the impact of daily "positive affect" journaling found, "Journaling was associated with decreased mental distress and increased well-being relative to baseline. The Gratitude Journal: Prompts, PDFs, and Worksheets. Here are some of the benefits of journaling: Reduces stress Helps manage depression and anxiety Helps prioritize fears and concerns Provides opportunity for recognizing triggers Allows space for positive encouragement and self-talk Benefits of Writing 1. Huon, Gail Think of yourself as a puzzle: You get to discover a different piece or pattern every single day. It shines a spotlight on the invaluable things in your life that you might not always recognize. Secondary screening involved reading full-length articles and was done by MS, BSD and PS. Gratitude can decrease depression, anxiety, difficulties with chronic pain and risk of disease. and Mohammad Ziaul Islam Chowdhury (PhD Candidate) - tasks performed: statistical analysis; Gursharan Kaur Dalam - tasks performed: data extraction; Melissa Marshall, PhD (final manuscript revision); Chantal Hansen, MGIS (final manuscript revision). Journaling provides a concrete method for learning who we are and identifying what we need. Dr. Pennebaker, one of the first researchers in this area, found that writing about emotionally difficult events or feelings for just 20 minutes at a time over four consecutive days was associated with both short-term increases in physiological arousal and long-term decreases in health problems, such as immune system functioning. A unique social and behavior outcome of journaling is this: it can improve your mood and give you a greater sense of overall emotional well-being and happiness. After the first and second months, participants reported greater resilience. Successful outcome in expressive writing requires: b revealing subconscious thought processes, c being able to discuss the writing with a significant other, d being able to write freely for one's self. The results suggest that the act of journaling is highly adaptable and has the opportunity to be a great tool for bettering mental health and promoting personal growth. Evaluating the short-term distress produced by writing about emotionally traumatic experiences [abstract], Writing about the perceived benefits of traumatic events: implications for physical health, Personality and Social Psychology Bulletin, Symptom management in older primary care patients. Consider the other persons perspective and motives behind some of their actions, says Romanoff. Theres no hard-and-fast rule on what you should write. Disagreements over study eligibility were resolved through discussion with HSG. In your journal, you can explore something thats bothering you, write about the present moment, or play with a prompt. If a pill that could do this, everyone would be taking it. Keep it simple. Try different formats. It can feel like work, and the expectation of writing every day may deter some people. The effectiveness of prolonged exposure as a treatment for post-traumatic stress (Reference Foa and RothbaumFoa & Rothbaum, 1998) led to the suggestion that the writing paradigm may produce extinction of negative emotional responses through repeated writing about traumatic memories (Reference Lepore, Greenberg, Bruno, Lepore and SmythLepore et al, 2002). Radcliffe, Alison M. As a library, NLM provides access to scientific literature. Their mental well-being continued to improve during the 12 weeks of journaling. improved mood greater well-being In addition, a study of 70 adults with medical conditions and anxiety found that writing about positive experiences, like gratitude, for 12 weeks was linked to:. Expressive writing also produces longer-term benefits in self-reported health outcomes such as visits to the doctor (Reference Cameron and NichollsCameron & Nicholls, 1998), physical symptoms (Reference Park and BlumbergPark & Blumberg, 2002) and number of days out of role because of illness (Reference Pennebaker and BeallPennebaker & Beall, 1986; Reference Smyth, True and SoutoSmyth et al, 2001). 2011. The meta-regression yielded some clues as to sources of heterogeneity including study population, age and gender composition, length of time of journaling intervention (<30days or >30days), and whether journals were collected/analysed. Does writing about suicidal thoughts and feelings reduce them? Bae, Jin-Hee 2008. This last factor of journal collection and/or analysis is critical to acknowledge given this was revealed to be a statistically significant moderator. In addition, recent linguistic studies have shown that session-to-session variations in pronoun use are related to health improvements, which may reflect a transformation in the way people think about themselves in relation to others and the world (Reference PennebakerPennebaker, 2002). At the start, try not to bite off more than you can chew. The impact of writing on physiological, absentee, and self-reported emotional well-being measures, A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations, Effects of an emotional disclosure writing task on the physical and psychological functioning of children of alcoholics. Evidence from a randomized controlled trial, Expressive writing and its links to mental and physical health, A review of school-based positive psychology interventions, Effect size (Cohen's D) of cognitive screening instruments examined in pragmatic diagnostic accuracy studies, RoB 2: a revised tool for assessing risk of bias in randomised trials, Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature, Journaling about stressful events: effects of cognitive processing and emotional expression, E-journaling: achieving interactive education online. thoughts and feelings) is helpful (Reference Pennebaker and BeallPennebaker & Beall, 1986; Reference Smyth, Pennebaker and SnyderSmyth & Pennebaker, 1999). Evaluating theories underlying the written disclosure paradigm, Further examination of the exposure model underlying the efficacy of written emotional disclosure, Written emotional expression. However, the data did not present in a manner that allowed for us to calculate these numbers. In addition, we only included randomized controlled trials (RCTs) in this study and thus, may have missed important studies on journaling which used different study designs. The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions, Expression of stressful experiences through writing: Effects of a self-regulation manipulation for pessimists and optimists, The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-being, A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma. Journaling about your feelings is linked to decreased mental distress. It could be argued that any efficacy that may be attributable to journaling may well be diminished due to the lack of a training/preparatory session. 9 Feb 2023 5 Benefits of Journaling for Mental Health 14 May 2018 by Jeremy Sutton, Ph.D. Scientifically reviewed by Saima Latif, Ph.D. Expressive writing results in significant improvements in longer-term physical health outcomes such as illness-related visits to the doctor (Reference Pennebaker and BeallPennebaker & Beall, 1986; Reference Pennebaker, Kiecolt-Glaser and GlaserPennebaker et al, 1988; Reference Pennebaker and FrancisPennebaker & Francis, 1996; Reference King and MinerKing & Miner, 2000), blood pressure (Reference Davidson, Schwartz, Sheffield, Lepore and SmythDavidson et al, 2002, citing Crow et al), lung function (Reference Smyth, Stone and HurewitzSmyth et al, 1999), liver function (Reference Francis and PennebakerFrancis & Pennebaker, 1992) and number of days in hospital (Reference Norman, Lumley and DooleyNorman et al, 2004). Journaling can help you figure out your next step, cambridge.org/core/journals/advances-in-psychiatric-treatment/article/emotional-and-physical-health-benefits-of-expressive-writing/ED2976A61F5DE56B46F07A1CE9EA9F9F#B2, ncbi.nlm.nih.gov/pmc/articles/PMC5767148/, ncbi.nlm.nih.gov/pmc/articles/PMC6305886/, ncbi.nlm.nih.gov/pmc/articles/PMC6907914/, Moving from an Empty Nest to Post-Parental Growth, Midlife Crisis in Women: How to Find Your Silver Lining, write the story of your life in six words. Start a gratitude journal. Although the empirical findings are at times equivocal and further research is required to clarify populations for whom writing is clearly effective, there is sufficient evidence for clinicians to begin applying expressive writing in therapeutic settings with caution. Journaling was also associated with less depressive symptoms and anxiety after one month and greater resilience after the first and second . The following databases were searched: MEDLINE, EMBASE and PsycINFO (March 2020). "coreDisableSocialShare": false, Changes in circulating lymphocyte numbers following emotional disclosure: evidence of buffering?
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