Journal therapy (K. Adams)

Domain VIII · Creative & expressive arts therapies · Kathleen Adams · 1985 · Colorado, USA

What it is

Journal therapy is writing done with therapeutic intent. It focuses on the writer's inner experience, thoughts and feelings, and it is used in individual therapy, in groups or alone. Adams calls herself a "clinical journal therapist". She is a Licensed Professional Counselor (LPC) and has pioneered…

Format

• Journal therapy is a set of graded techniques plus a stance. It is not a fixed protocol with a set number of sessions. None of the sources give a typical course length for individual work. For groups, Your Brain on Ink has a facilitator's guide with session plans for 1-hour, 90-minute and 2-hour…
• The Journal Ladder (organising model). Adams developed the Ladder while working with highly traumatised patients in a psychiatric hospital. It is built on structure, pacing and containment. The Ladder is a continuum of techniques. At the bottom are concrete techniques with more structure, pacing…

Who practises it, and how they are trained or regulated

• Phase A, Stabilise and orient. Goals: find out how the client relates to writing (literacy, past diaries, shame, privacy at home). Agree how writing will be stored. Teach contained techniques such as sentence stems, sprints and lists. Move on when the client can start and stop a write on cue, close with a reflection write, and leave the session regulated.
• Movement is two-way. If a client becomes dysregulated during or after writing, step back down to more structure. Adams's rule: if writing worsens a person's state, stop and reassess.
• Version followed: Kathleen (Kay) Adams's journal therapy as taught by her Center for Journal Therapy (founded 1988) and its Therapeutic Writing Institute, organised around her Journal Ladder model of structure, pacing and containment. Sources: Adams's own published account (2014 interview); the Center's 14-technique list as reproduced by Colorado State University's SpeakOut! programme; the publisher pages for…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Drawings are not diagnostic, so do not interpret them as evidence of abuse or disorder.
• Flooding at the feeling stems. Shorten the write or go back to single stems. It is working when the last stems give a clearer meaning or action.
• Asking a trauma survivor to write from the perpetrator's point of view. Do not set this. It is working when the client can hold two views at once.
• A cluster that runs into traumatic material. Choose a safer branch for the write. It is working when the write surprises the client or names a theme.
• Lists of self-blame. If one appears, redirect to a list of resources or evidence. Working when: the client sees patterns or can rank what matters most.

Problems the guide addresses

• Pacing trauma disclosure
• Distress after writing, and how to close
• Privacy and storage of written material
• Literacy, language and disability access
• Stuck clients and blank pages
• Resistance and non-adherence
• Ruptures
• Children, adolescents and safeguarding
• Other modality-specific difficulties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.