Therapeutic journaling refers to the process of writing down thoughts and feelings with the aim of provoking self-examination and personal development. It is a strong intervening tool for an emotional working-through, progressive emotional functioning, and achieving heightened levels of awareness in connection with thought processes. Journaling is widely used by psychologists to enable clients to articulate their experiences and strive to change unproductive patterns of thinking. While the effectiveness of journaling has been widely shown, there is a need to investigate a wider variety of other approaches that might be able to address an even more varied set of clients’ needs.
The reason that one would turn to other strategies is that there is a feeling that not everyone may be prepared for or benefited by journaling. Others will not be able to engage in expressive writing due to cognitive impairments or emotional problems, so more or alternative strategies that can foster wellness and healing will be needed. The emerging literature highlights that the alternatives of exercise and mindfulness interventions offer other options for the treatment of mental illness, which have the potential to reduce reliance on standard pharmacotherapy (as covered in Antos et al., 2024). While clinicians consider these alternatives, they can diversify their armamentarium for therapy, offering treatments based on patient choice or clinical presentation.
During this, we will conduct a comparative review with the incorporation of journaling as an intervention technique to point out the strengths and the weaknesses of both techniques. We will also explore the therapeutic models behind these other methods and summarise their theoretical underpinning. This systematic approach is directed towards giving practitioners helpful information on how to integrate different methods into their therapy.
Read More: The Connection of Journaling with Mental Health
Evidence-Based Alternatives to Journaling
- Multidimensional alternative treatment modalities like art therapy, narrative therapy, expressive writing, mindfulness-based interventions (MBIs), bibliotherapy, audio/video self-reflection, and somatic practices complement conventional journaling.
- Art therapy is a highly effective non-pharmacological intervention that employs creative mediums to maximise mental health. Techniques like drawing and painting minimise symptoms of depression and anxiety by considerable margins, affecting far-reaching groups, ranging from chronically ill adults to survivors of trauma (Regev & Cohen-Yatziv, 2018).
- Narrative therapy emphasises the narratives that individuals narrate about themselves, forcing clients to externalise problems to develop other ways of thinking. Narrative therapy has been promising for better emotional wellness and resilience, particularly for children facing such problems as self-injury (Collection: Evidence for the effectiveness of narrative therapy, 2023).
- Expressive writing makes it possible to talk about one’s own life experiences, which can promote emotional recovery. It has been discovered to promote utmost health benefits by emotional reflection and processing (Shukla et al., 2022).
- MBIs increase present-moment awareness through meditation and mindful breathing, thus reducing stress and emotional control, especially for anxiety disorders or stress disorders (Shapero et al., 2018; Shonin et al., 2013).
- Bibliotherapy utilises literature as a treatment intervention, leading to emotional working through engaging stories and narratives.
- Audio/video self-reflection provides active, intense questioning and introspection that enhances self-awareness compared to journaling.
- Somatic modalities focus on the interrelationship between body consciousness and mental well-being, and employ methods such as breathwork to cure trauma on the body level.
These evidence-based interventions offer alternative means of enhancing the outcomes of therapy to complement usual journaling approaches.
| Mindfulness-based intervention | Target illness/population |
|---|---|
| Mindfulness-based stress reduction | Various (e.g., anxiety disorders, heart disease, chronic pain, cancer, psoriasis) |
| Mindfulness-based cognitive therapy | Maternal well-being during and post-pregnancy |
| Mindfulness-based relapse prevention | Prevention of relapse following rehabilitation from substance-use disorders |
| Mindfulness-based eating awareness therapy | indulge-eating disorders |
| Mindfulness-based childbirth and parenting | Stress and trauma resilience for military personnel |
| Mindfulness-based art therapy | Psychological health and quality of life in cancer patients |
| Mindfulness and acceptance-based group therapy | Stress and trauma resilience for military personnel |
| Mindfulness-based stress management | Stress and anxiety |
| Mindfulness-based mental fitness training | Stress and trauma resilience for military personnel |
Table 1: Sample of group-based MBIs along with target illness/population. (Shonin et al., 2013)[4]
Comparison with Journaling as an Intervention Technique
Comparison of alternative therapy methods and journaling yields data on accessibility, mental benefit, and the target population. MBIs are more accessible than traditional journaling interventions. Courses like MBSR are widely available in group or web-based courses, thereby benefiting more individuals. Access also reaches media like mobile apps and short sessions for individuals who feel overwhelmed by lengthy journaling (Shapero et al., 2018).
There is evidence that MBIs can significantly reduce depression, anxiety, and symptoms of stress, as well as overall physical well-being (Zuo et al., 2023). They also enhance the quality of sleep, which serves as proof of the variety of their effects. Compared to this, while journaling is an emotional and mental outlet for expression, support for psychological gain is less than that of MBIs.
Target populations for each intervention need to be identified to achieve optimal effectiveness. Mindfulness interventions are ideally applied to various clinical conditions, including mood disorders and chronic pain relief (Shonin et al., 2013). They are more effective with individuals who perform optimally under organised group work or individuals who do not want medication alternatives. Journaling may be more attractive to people who perform optimally when working independently or do not like group work.
In summary, MBIs and journaling are both effective tools for enhancing mental health, but they have different characteristics to perform in specific situations and populations.
Therapeutic models allowing for alternative interventions
The Expressive Therapies Continuum (ETC), developed by Dr. Judith Rubin, brings together expressive arts and therapy for emotional healing as well as personal development. It presumes that creative expression is beneficial in assisting individuals in coping with complicated emotions, particularly in instances where conventional talk therapies are ineffective. The continuum is from low to high abstraction levels and includes modalities like art, music, dance, and drama therapy and thus provides an easier access to different areas of the psyche.
Practically, the ETC enables tailoring interventions to individual client needs. Verbal or trauma clients could make use of artistic or movement-based utilisation because these allow for non-verbal processing. Somatic therapy approaches contribute to this by including body awareness in the practice of mental health, as the ETC focuses on bodily involvement in expressive activities (Alex Bachert, 2025).
Mindfulness-based therapies (MBIs), such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), build on these non-pharmacologic treatments by incorporating cognitive methods along with mindfulness to promote moment-to-moment awareness (Allen et al., 2021; Shapero et al., 2018). Narrative therapy is also narrative-based and builds on expressive arts because it enables people to reauthor their stories through creativity, hence promoting self-concept change and affect regulation (Panina-Beard & Vadeboncoeur, 2024). The models illustrate a convergent system of modern mental health treatment, validating the success of unorthodox therapies.
Conclusion and Practitioner Recommendations
The comparison revealed that while diary writing is an ideal therapy, numerous other approaches have their strengths and are worth their place in practice. Bibliotherapy, mindfulness-based interventions (MBIs), and expressive arts therapy were all identified as powerful techniques for the improvement of emotional well-being and treatment of a range of mental disorders. Bibliotherapy, for instance, has helped those with trauma or anxiety, but further, larger studies have to be investigated to know if it is effective in the long term, especially when utilised as recreational therapy (as contentious in Vries et al., 2017, pages 21-25).
It is advised that clinicians apply a multi-modal strategy by including non-conventional methods along with traditional treatment modalities. According to the findings, MBIs and Eye Movement Desensitisation and Reprocessing (EMDR) possess strong therapeutic potential in anxiety disorders, and their co-application could substantially augment treatment (according to Antos et al., 2024). Moreover, expressive writing could facilitate emotional processing and reduce psychological distress, and this makes therapeutic style flexibility crucial (as hypothesised in Baikie & Wilhelm, 2005).
When considering the future of research, there must be attention given to not only the short-term effects of such intervention but also the longer-term effects on mental health. Research must aim at identifying particular populations that would be most from various practices of self-reflection and identify how these can be blended with conventional treatment modalities. In doing so, practitioners are in a position to create evidence-based guidelines that function as guides to best practices.
Generally, the adoption of a wide array of therapeutic modalities will allow clinicians to adapt treatment in a best-fitted way to meet distinctive client needs, encouraging resilience and psychological growth. Such a widely based approach could eventually result in more effective therapeutic interactions for clients as they tackle the complexity of their mental illness.
FAQs
1. What is therapeutic journaling, and how does it support mental health?
Therapeutic journaling is the practice of writing down one’s thoughts and feelings to promote self-reflection, emotional processing, and personal growth. It is commonly used in therapy to help clients articulate experiences, recognise patterns, and work through emotions.
2. Why might journaling not be suitable for everyone?
Not all clients are comfortable with expressive writing—those with cognitive impairments, emotional distress, or trauma histories may find journaling difficult or ineffective. In such cases, alternative interventions may be more appropriate or supportive.
3. What are some evidence-based alternatives to journaling in therapy?
Alternatives include:
- Art therapy: Uses creative expression to process emotions, especially effective for trauma and chronic illness.
- Narrative therapy: Helps clients re-author their life stories for emotional growth.
- Mindfulness-Based Interventions (MBIs): Includes MBSR and MBCT, which improve stress management and mood regulation.
- Expressive writing: Similar to journaling but more structured and emotionally focused.
- Bibliotherapy: Uses literature to reflect on emotional themes and healing.
- Audio/video self-reflection: Encourages self-awareness through spoken or recorded introspection.
- Somatic practices: Focus on bodily sensations (e.g., breathwork) to address trauma stored in the body.
4. How do Mindfulness-Based Interventions compare to journaling?
MBIs, such as MBSR and MBCT, offer structured group or digital formats and have shown greater evidence for improving sleep, mood, and anxiety. Journaling may be more suited to individuals who prefer independent work and emotional expression through writing.
5. Are these alternatives effective across different client populations?
Yes. MBIs, expressive arts, and bibliotherapy have demonstrated benefits across diverse groups, including children, trauma survivors, individuals with chronic illness, and those with mood or anxiety disorders. Tailoring the intervention to client needs and preferences is key.
6. Should therapists use only one method, like journaling or mindfulness?
No. Research recommends a multi-modal approach—combining journaling, MBIs, expressive arts, or EMDR based on client suitability. Flexibility in therapeutic style can enhance outcomes, especially when personalised to client strengths and cultural contexts.
References +
Collection: Evidence for the effectiveness of narrative therapy. (2023). https://dulwichcentre.com.au/collection-evidence-for-the-effectiveness-of-narrative-therapy/
Regev. Dafna, Cohen-Yatziv. Liat. (2018). Frontiers | Effectiveness of Art Therapy With Adult Clients in 2018—What Progress Has Been Made?. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2018.01531/full
Apoorva Shukla, Sonali G Choudhari, Abhay M Gaidhane, Zahiruddin Quazi Syed. (2022). Role of Art Therapy in the Promotion of Mental Health: A Critical Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC9472646/
Edo Shonin, William Van Gordon, Mark D Griffiths. (2013). Mindfulness-based interventions: towards mindful clinical integration. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629307/
Benjamin G Shapero, Jonathan Greenberg, Dr. Pedrelli, Dr. de Jong, Dr. Desbordes. (2018). Mindfulness-Based Interventions in Psychiatry. https://pmc.ncbi.nlm.nih.gov/articles/PMC5870875/
Zuo. Xinyi, Chen. Yifang, Tang. Yong, Zhou. Zhimiao. (2023). Frontiers | The efficacy of mindfulness-based interventions on mental health among university students: a systematic review and meta-analysis. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1259250/full
Joshua George Allen, John Romate, Eslavath Rajkumar. (2021). Mindfulness-based positive psychology interventions: a systematic review. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00618-2
Alex Bachert. MPH. (2025). Somatic Exercises for Mental Health | Charlie Health. https://www.charliehealth.com/post/somatic-exercises-for-mental-health
Zuzanna Antos, Klaudia Zackiewicz, Natalia Tomaszek. (2024). Beyond Pharmacology: A Narrative Review of Alternative Therapies for Anxiety Disorders. https://pmc.ncbi.nlm.nih.gov/articles/PMC11431799/
Karen A. Baikie, Kay Wilhelm. (2005). Emotional and physical health benefits of expressive writing | Advances in Psychiatric Treatment | Cambridge Core. https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/emotional-and-physical-health-benefits-of-expressive-writing/ED2976A61F5DE56B46F07A1CE9EA9F9F
Panina-Beard. Natalia, Vadeboncoeur. Jennifer A. (2024). Narrative therapy. https://www.ebsco.com/research-starters/social-sciences-and-humanities/narrative-therapy
Dawn De Vries, Zoe Brennan, Melissa Lankin, Rachel Morse, Brandi Rix, Teresa Beck. (2017). Healing With Books A Literature Review of Bibliotherapy Used With Children and Youth Who Have Experienced Trauma. https://js.sagamorepub.com/index.php/trj/article/download/7652/6022
