Writing Therapy: How It Works & Why It Helps

Journaling is frequently suggested as a technique to help people who struggle with difficult mental health symptoms.

The use of words to explore, process, and move through challenging thoughts or emotions is about as human as it gets.

But going further than journaling, there is a deeper and more intensive healing that is available through the written word: writing therapy.

A person doesn’t need to be a prolific writer, or even a writer at all, to benefit from writing therapy. All they need is a piece of paper, a pen, and some thoughtful guidance from a caring professional.

Before you continue, we thought you might like to download our five positive psychology tools for free. These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

Understanding Writing Therapy

Writing therapy, also known as journal therapy, is exactly what it sounds like: writing, often in a journal, for therapeutic benefits.

It’s easy to see the potential of therapeutic writing. Poets and storytellers throughout the ages have captured and described the cathartic experience of putting pen to paper.

“Writing is a form of therapy; sometimes I wonder how all those who do not write, compose, or paint can manage to escape the madness, the melancholia, the panic fear which is inherent in the human situation.”

– Graham Greene (1980, p. 9)

Great literature from poets and storytellers temptingly suggests that powerful healing and personal growth can be achieved with just a pen, paper, and a few moments. It may not be that easy, but it is a powerful and legitimate therapeutic tool.

James Pennebaker (2017) is credited with launching writing therapy through his research on a specific technique called expressive writing.

Writing therapy is a low-cost, easily accessible, and versatile form of expressive arts therapy you can offer clients. It can also be practiced in a group setting, with group discussions focusing on writing. It can even be added as a supplement to another form of therapy.

Whatever the format, writing therapy is a powerful tool you can use to help your clients propel their personal growth, practice creative expression, and feel a sense of empowerment and control over their life (Adams, n.d.).

Journaling vs. writing therapy

While writing therapy may sound as simple as writing in a journal, there’s a little more to it. Writing therapy differs from simply keeping a journal or diary in three major ways (Farooqui, 2016):

1. Writing in a diary or journal is usually free-form, where the writer jots down whatever pops into their head. Therapeutic writing is typically more directed and often based on specific prompts or exercises guided by a professional.
2. Writing in a diary or journal may focus on recording events as they occur, while writing therapy is often focused on more meta-analytical processes: contemplating, interacting with, and analyzing the events, thoughts, and feelings that the writer writes down.
3. Keeping a diary or journal is an inherently personal and individual experience, while writing therapy is typically led by a licensed mental health professional.

While the process of writing therapy differs from simple journaling in these three main ways, there is also another big difference between the two practices in terms of outcomes.

Keeping a journal can be extremely beneficial, whether it’s to improve memory, record important bits and pieces of the day, or just relax at the end of a long day.

These benefits are certainly not trivial, but the potential benefits of writing therapy reach much further and deeper than simply writing in a diary.

7 Benefits of Journal Therapy

For individuals who have experienced a traumatic or extremely stressful event, expressive writing guided purposefully toward specific topics can have a significant healing effect.

In fact, participants in a study who wrote about their most traumatic experiences for 15 minutes, four days in a row, experienced better health outcomes up to four months later than those who were instructed to write about neutral topics (Baikie & Wilhelm, 2005).

Another study tested the same writing exercise on over 100 asthma and rheumatoid arthritis patients, with similar results. The participants who wrote about the most stressful event of their lives experienced better health evaluations related to their illness than the control group, who wrote about emotionally neutral topics (Smyth et al., 1999).

Expressive writing may even improve immune system functioning, although the writing practice may need to be sustained for the health benefits to continue past the first few weeks or months (Murray, 2002).

In addition to these more concrete benefits, regular therapeutic writing can help the writer (Murray, 2002):

• Find meaning in their experiences
• View things from a new perspective
• See the silver lining in their most stressful or negative experiences

It can also lead to important insights about themself and their environment that may be difficult to determine without focused writing (Tartakovsky, 2015). This can include the practice of cognitive restructuring, a technique that allows the writer to identify, evaluate, and correct inaccurate or unhelpful thought patterns (Ezawa & Hollon, 2023).

Overall, writing therapy has proven effective for different conditions and mental illnesses, including (Farooqui, 2016):

• Post-traumatic stress
• Anxiety
• Depression
• Obsessive-compulsive disorder
• Grief and loss
• Chronic illness issues
• Substance abuse
• Eating disorders
• Interpersonal relationship issues
• Communication skill issues
• Low self-esteem

4 Different Types of Therapeutic Journaling

There are several different types of journaling or writing techniques that can be considered therapeutic or otherwise beneficial for mental and emotional health. Four of these types are described below.

1. Expressive writing

Expressive writing is a specific technique popularized by psychologist James Pennebaker. It requires writing about a traumatic or particularly difficult experience for 15 to 20 minutes each day without stopping, for a total of three to five days (Mirgain & Singles, 2016).

This intensive technique has tons of research behind it, showing that it can help people organize their memories and build a deeper understanding of things that have happened to them. It can also foster a new sense of meaning around the difficult events and encourage people to let go of the emotions that are holding them back from healing (Mirgain & Singles, 2016).

Expressive writing is a particularly powerful tool for those with post-traumatic stress disorder, although the evidence shows it can be helpful for addressing symptoms from a wide range of disorders (Mirgain & Singles, 2016). However, it’s not for everyone; those who have severe trauma or psychiatric disorders may not be able to access its benefits.

2. Gratitude journaling

One of the most powerful and widely practiced formats for therapeutic writing is gratitude journaling.

Gratitude journaling involves writing down things the writer is grateful for each day. Regular practice will train their mind to become more focused on the positive and make it easier to find things to be grateful for.

To guide your clients on starting a gratitude practice, the experts at the Berkeley Greater Good Science Center (n.d.) have these instructions:

1. Be as specific as possible.
2. Go for depth over breadth (be detailed about a few things instead of listing everything).
3. Get personal (gratitude for people is more impactful than gratitude for things).
4. Try subtraction, not just addition (think about negative things missed, avoided, or escaped in addition to good things experienced).
5. See good things as “gifts.”
6. Savor surprises (record events that were unexpected or surprising).
7. Aim for variety (focus on different details each time you write).
8. Write regularly (every day or at least every other day).

Most people choose to do gratitude journaling at the end of the day so they have a full day’s worth of experiences to draw from, but it can be practiced at any time of the day.

3. Reflective journaling

Reflective journaling is the documentation of daily experiences and the personal interpretation of them. Essentially, reflective journaling is akin to keeping a diary about what happens in daily life, but with the added emphasis on recording interpretations of what happened (Leftwich, 2019).

You can provide the following questions to guide your clients in reflective journaling (Schroder, n.d.):

1. Why did you make a particular decision?
2. Was the experience a positive or a negative experience?
3. What were the actions available to you during the experience?
4. What did you think after the experience was over and the emotions had subsided? How does this compare to your thoughts during the experience?
5. What did you learn from the experience for the future?
6. What would you do differently next time?
7. What life lessons did you learn?
8. What will you do next time?

Although reflective journaling can be a powerful tool for individual learning and growth, it’s not a replacement for more targeted forms of writing therapy.

4. Trauma-informed writing

Trauma-informed writing is undertaken with thoughtful consideration of the client and their mental state, given the context of the trauma they have experienced (Kroeker, 2023).

Trauma-informed writing is created with the understanding that trauma has a big impact on how we think, feel, and respond to things around us, and is committed to the six principles of being trauma-informed (Kroeker, 2023):

• Safety
• Transparency and trustworthiness
• Peer support
• Collaboration and mutuality
• Empowerment, voice, and choice
• Cultural, historic, and gender issues

For more information on trauma-informed writing and how to do it, see this resource from the National Center on Domestic Violence, Trauma, and Mental Health (2014).

Use this resource to practice trauma-informed writing yourself to build familiarity with the technique before introducing it to clients.

When you introduce it to your clients, inform them that it’s a far-reaching skill; they can apply the principles of trauma-informed writing every time they put pen to paper, building compassion and empathy for themselves as they write.

When & How to Use Therapeutic Writing

There are many ways to begin writing for therapeutic purposes.

When introducing therapeutic writing to your clients, share the following guidelines to set them up for success:

• Use whichever format works best for you, whether it’s a classic journal, a cheap notebook, an online journaling program, or a blog.
• If it makes you more interested in writing, decorate or personalize your journal/notebook/blog.
• Set a goal to write for a certain amount of time each day.
• Decide ahead of time when and where you will write each day.
• Consider why you want to write in the first place. This could be your first entry in your journal.

Next, introduce the WRITE method (Adams, n.d.):

1. What do you want to write about?
2. Review or reflect on your topic. Close your eyes, take deep breaths, and focus.
3. Investigate your thoughts and feelings. Just start writing and keep writing.
4. Time yourself. Write for five to 15 minutes straight.
5. Exit “smart” by rereading what you’ve written and reflecting on it with one or two sentences.

Finally, have your clients keep the following in mind while they are journaling (Howes, 2011):

• Don’t worry about what to write about. Just focus on taking the time to write and giving it your full attention.
• Don’t worry about how well you write. The important thing is to write down what makes sense and comes naturally to you.
• Remember that no one else needs to read what you’ve written. This will help you write authentically.

10 Writing Therapy Exercises

As great as the benefits of therapeutic journaling sound, it can be difficult to get started. It can be a challenge to start even the most basic of healthy habits.

If your clients are wondering how to begin, encourage them to try these tips and exercises to start their regular writing habit (Hills, n.d.):

1. Start writing about where you are in your life at this moment.
2. For five to 10 minutes, just start writing in a stream of consciousness.
3. Start a dialogue with your inner child by writing in your nondominant hand.
4. Cultivate an attitude of gratitude by maintaining a daily list of things you appreciate, including uplifting quotes.
5. Start a journal of self-portraits.
6. Keep a nature diary to connect with the natural world.
7. Maintain a log of successes.
8. Keep a log or playlist of your favorite songs.
9. Write about something you are struggling with in the third person.

If they’re still having a tough time getting started, tell them to consider trying a “mind dump.” Researcher and writer Gillie Bolton suggests simply writing for six minutes (Pollard, 2002).

Instruct them not to pay attention to grammar, spelling, style, syntax, or fixing typos — they should just write. Once they have mind-dumped, they can then focus on identifying a theme.

The theme should be something concrete, like something from their childhood with personal value. This exercise can help your clients ensure that their therapeutic journal entries go deeper than typical diary entries.

9 Powerful Prompts for Therapeutic Journaling

The following ideas and writing prompts are valuable ways to help your clients continue their journaling practice or to get themselves unstuck if they’re unsure what to write about next. These prompts can also be helpful for journaling for anxiety.

Here are five writing exercises you can assign to clients who are dealing with pain (Abundance No Limits, n.d.):

1. Write a letter to yourself.
2. Write letters to others.
3. Write a poem.
4. Free write (just write everything and anything that comes to mind).
5. Create a mind map with your main problem in the middle and branches representing different aspects of the problem.

If those ideas don’t get their creative juices flowing, try these additional prompts (Farooqui, 2016):

1. Journal with photographs
   Choose a personal photo and use journaling to answer questions like, “What do you feel when you look at these photos? What do you want to say to the people, places, or things in these photos?”
2. Timed journal entries
   Decide on a topic and set a timer for 10 or 15 minutes to write continuously.
3. Sentence stems
   These prompts are the beginnings of sentences that encourage meaningful writing, such as, “The thing I am most worried about is …, I have trouble sleeping when …, My happiest memory is …”
4. List of 100
   Create lists of 100 based on prompts like, “100 things that make me sad, 100 reasons to wake up in the morning, and 100 things I love.”

4 Tips for Practitioners Offering Writing Therapy

While writing can be a powerful technique for anyone with the time and interest, it is most effective when offered by a qualified mental health care provider.

If you’re interested in offering writing therapy to your clients, there are several things you can do to prepare yourself to provide the best possible care:

1. Consider getting a certified journal therapist credential from the Therapeutic Writing Institute.
2. Look into training and education on therapeutic writing and reflective writing.
3. Familiarize yourself with the techniques in this article.
4. Try it yourself! A good therapist will experiment with their tools before providing them to clients.

Other Resources From PositivePsychology.com

If you’re interested in more information on writing therapy, using the arts in healing work, or positive psychology resources more broadly, our website offers a ton of helpful resources.

For example, we offer expressive writing worksheets with exercises and examples.

There’s also a deeper dive into the benefits of journaling, which can be really effective for working through mild and moderate stress and building better wellbeing for those without a diagnosis or more serious mental health problems.

If you’re interested in how to build the arts into your practice, this article on expressive arts therapy will give you ideas on how to integrate artistic modalities and infuse creativity into your healing work.

If you’re looking for more science-based ways to help others enhance their wellbeing, consider this signature collection of 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.

A Take-Home Message

In this piece, we went over what writing therapy is, how to do it, and how you can harness healing through writing to benefit your clients. Remember that therapeutic writing is not a replacement for therapy with a well-qualified professional, but it can be a powerful supplement to the therapeutic relationship.

Thanks for reading, and happy writing!

We hope you enjoyed reading this article. Don’t forget to download our five positive psychology tools for free.

ED: Updated Oct 2025