Experimental Disclosure (most commonly recognized as structured or expressive writing) is the process of disclosing the thoughts, feelings and behaviors surrounding a significant life event through journaling, emotional or expressive writing. The Change Companies®’ Interactive Journaling® approach combines expressive writing and cognitive processing through guided questioning and restructuring strategies designed to aid individuals in their examination of the feelings and cognitions surrounding stressful, traumatic and significant life events.
Among many statistically significant variables within this study, some of the largest effect sizes were found when measuring the subjective impact of the intervention.
Of the four categories within this variable, positive attitude about intervention (r=.270) and attempts to process/make sense of event (r=.132) were found to be strongly impacted by expressive writing (Frattaroli, 2006). Interactive Journaling® applies this evidence through targeting the enhancement of self-efficacy and attitudes about changing maladaptive behaviors. Our Interactive Journaling® approach engages participants in the change process by using Motivational Interviewing principles, cognitive-behavioral strategies and the integration of the Transtheoretical Model of Behavior Change throughout a series of guided questions that involve participants in the process of writing about significant life experience. By raising awareness about risks, needs, strengths and resources participants can cognitively transform negative affect and behavior to strengthening their ability to make sense of the event and the potential solutions for change. Consequently the participants explore and rehearse skills for positive personal growth, foster pro-social values and improve social functioning.
This meta-analysis on expressive writing indicated a significant and positive impact on social relationships, cognitive functioning and educational outcomes. Moreover, those studies that provided participants with directed questions or examples had significantly larger effect sizes than studies that did not (Frattaroli, 2006). The evidence found in this meta-analysis supports the application of structured and expressive writing as an effective strategy for behavior change as found in each of The Change Companies®’ Interactive Journals.
Xerox reports that color increases readers’ attention spans and recall by 82%, comprehension by as much as 73% and learning and retention by 78%. Interactive Journals are carefully designed with numerous aesthetic and associative properties and benefits of color in mind in order to engage the participant while impacting attention, retention and comprehension. As explained by Hall (2004), colours significantly affect levels of arousal in the nervous system (Wilson, 1966; Jacobs and Hustmyer, 1974). Farley (1970) found that this arousal of the nervous system significantly impacts long-term retention. Ultimately, these findings were combined by Shieh and Lin (2000) who found that multi-color or color combinations had a greater impact on performance when measuring participants’ ability to perform visual identification tasks (cited in Hall, 2004).
The importance of color combinations is recognized and applied in the development of Interactive Journaling® while breaking the visual monotony of black and white as found in traditional workbooks. The novelty of color found in Interactive Journaling® activates the individual’s central nervous system and contributes to more attentive and gainful learning. Physiological applications of color exist in the medical field as well as schools, workplaces and other performance-driven settings.
If you’ve ever wondered why surgical gloves are always blue or green, it is to avoid a depth illusion caused by the surgeon constantly focusing on the red-violet color of human organ tissue (Vodvarka, 1999). The visual relief provided by a contrasting color allows the surgeon to regain his or her visual perception and maintain focus on the red-violet color without suffering from “ocular fatigue (Birren, 1961).” Interactive Journals help prevent this visual fatigue caused by traditional black-and-white materials and become a source of visual relief by incorporating multi-color graphics, text and backgrounds that do not drown the user’s visual sense with the monotony of a single color.
Social learning theorists explain that gaining the attention of the participant is a paramount precondition to learning. The Change Companies®' use of color attracts attention and satisfies this necessary precondition. This is supported by Jennings (2000) who found that “pleasing visuals are important because they create first impressions which result in a desire to explore further.” Because Interactive Journals are placed directly into the hands of the end user, it is essential for us to develop quality tools that are visually diverse, proven to be engaging and arousing.
Wilson, G.D. (1966). Arousal properties of red versus green. Perceptual and Motor
Skills, 23, 942-949.
Farley, F.H. (1970). Arousal, attention and consolidation in human memory. Paper
presented at American Psychological Association Annual Meeting, Miami,
Florida.
Jacobs, K.W. and Hustmyer, F. E. (1974). Effects of four psychological primary colors
on gsr, heart rate, and respiration rate. Perceptual and Motor Skills, 38, 763-
766.
Shieh, K. and Lin, C. (2000). Effects of screen type, ambient illumination, and color
combination on vdt visual performance and subjective preference.
International Journal of Industrial Ergonomics, 26, 527-536.
Vodvarka, Frank. (1999). Aspects of Color in regard to a session at 21st Facilitators’
Conference.
Birren, Faber. (1961). Color Psychology and Color Therapy: A Factual Study of the
Influence of Color on Human Life (New Hyde Park, New York: University
Books, Inc.) vii.
Jennings, M. (2000). Theory and models for creating engaging and immersive e-
commerce websites. Proceedings of the ACM Computer Personnel
Conference, pp. 77-85.
The objective of this study was to measure the impact of the client’s stage of change on the therapeutic outcome with a hypothesis that the working alliance would mediate the relationship between stage of change and therapeutic outcome. “The current study found that the working alliance mediated the relationship between the stages of change and the degree of improvement in clients’ symptoms. The working alliance was able to account for 89% of the direct pathway between stages of change and outcome (Emmerling, 2006).” Also, results indicate the importance of a client’s stage of change in the development and maintenance of the working alliance and its indirect effect on outcome in individual therapy (Emmerling, 2006).
The Change Companies® applies these findings through the guided content and questioning within each Journal page and within our Facilitator Guides which serve as a corollary to Interactive Journals. The personalized responses to the journaling activities become a key tool for engaging participants in their own self-change process. The open-ended questions, guided journaling exercises and other “rules of Interactive Journaling®” all contribute to the interactive nature of the intervention and enhance the helping relationship of treatment by tapping into the inner thoughts, feelings, values and goals of the individual. According to Emmerling (2006), success in building an effective therapeutic alliance is founded on the provider focusing on the individual’s internal dialogue, conflicts, self-discovery process, and “enacting key internal dialogues and by helping clients articulate the hopes and desires associated with their core emotions (Greenberg, Rice, & Elliot, 1993).”
Interactive Journaling® emphasizes the participants’ opportunities for choice and change and guides participants in applying knowledge to personal circumstances and challenging situations. Our Interactive Journaling® content and exercises coupled with our facilitator resources have been designed to directly engage participants in change-based exploration that is personally relevant, which is then channeled into a collaborative alliance through applying the principles of Motivational Interviewing within the facilitation process. This therapeutic alliance can then be used to mediate meaningful, positive behavior change. According to the findings of this study; “A very strong case can and has been made (e.g., Blatt & Zuroff, 2005) that the therapeutic relationship is itself a curative element in psychotherapy, but at the very least the working alliance is a vehicle for transmitting the active elements of therapy (Hartley & Strupp, 1983).”
Greenberg, L.S., Rice, L.N., & Elliot, R. (1993). Facilitating emotional change. New
York: Guilford Press.
Blatt, S.J., & Zuroff, D.C. (2005). Empirical evaluation of the assumptions in
identifying evidence based treatments in mental health. Clinical Psychology Review, 25, 459-486.
Hartley, D.E., & Strupp, H.H. (1994). The therapeutic alliance as an interpersonal
process. In A.O. Horvath & L.S. Greenberg (eds), The working alliance: Theory,
research, and practice (pp. 51-84). New York: Wiley.
Apodaca, Timothy R., Miller, W.R. (2003). A Meta-Analysis of the Effectiveness of Bibliotherapy for Alcohol Problems. Journal of Clinical Psychology, 59(3), 289-304.
There has been increased interest in the use of brief interventions and the delivery of alcohol treatment services through nonspecialist health care settings. One possible resource for reaching untreated individuals is “bibliotherapy.” The provision of self-help materials to motivate and guide the process of changing drinking behavior. Research on the effectiveness of self-help materials for problem drinkers has been done for three decades. This report summarizes a meta-analytic review of 22 studies evaluating the effectiveness of such self-help materials. Each study was rated on 12 methodological quality of studies was generally high relative to other treatment-outcome studies. Modest support was found for the efficacy of self-help materials in decreasing at-risk and harmful drinking. The weighted mean pre/post-effect size for bibliotherapy was .80 with self-referred individuals seeking help for drinking problems, and .65 for individuals identified through health screening. Between-group comparisons of bibliotherapy with no-intervention controls appear to have a small to medium effect, with a weighted mean effect size of .31 with self-referred drinkers; effect size was more variable in opportunistic interventions based on health screening. Finally, between-group comparisons of effects on drinking of bibliotherapy versus more extensive interventions yielded effect size values near zero. These findings provide support for the cost-effective use of bibliotherapy with problem drinkers seeking such help to reduce their consumption, and to a lesser extent with drinkers who are identified through screening as at risk.
Webb, Thomas L., Sheeran, Paschal. (2006). Does Changing Behavioral Intentions Engender Behavior Change? Psychological Bulletin, 132(2), 249-268.
Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention-behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention – behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d=0.66) leads to a small-to-medium change in behavior (d=0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.
This pilot study measured the impact of the use of Manual-assisted Cognitive Therapy (MACT) on parasuicide attempts versus treatment as usual (TAU). The MACT intervention included problem-solving techniques, self-monitoring of thoughts and feelings, coping strategies, pros and cons of substance abuse and harm-reduction strategies delivered through a participant manual and accompanying worksheet. This study demonstrates the impact of participant self-change resources coupled with facilitated sessions focused on discussing the participants’ work in the manual and worksheets. Similar to the MACT intervention, The Change Companies®’ Interactive Journaling® approach blends the process of self-exploration of thoughts, feelings and behaviors through participant resources, bibliotherapy and facilitated discussion targeted on the Interactive Journal and rehearsal of learned skills. Furthermore, “Our initial findings show that the cognitive-behavioural approach can be successfully combined with bibliotherapy (Lidren et al. 1994).”
The most statistically significant finding was the decrease of depressive symptoms with the MACT treatment compared to the treatment as usual group. This study demonstrates the potential of therapeutic writing and manualized cognitive therapy as an effective intervention for repetitious self-injurious behavior.
Lidren, D.M., Watkins, P.L., Gould, R.A., Clum, G.A., Asterino, M. & Tulloch, H.L.
(1994). A comparison of bibliotherapy and group therapy in the treatment of panic disorder. Journal of Consulting and Clinical Psychology, 62, 865-869.
Stein, L.A.R., Lebeau-Craven, R. (2002). Motivational Interviewing and Relapse Prevention for DWI: A Pilot Study. Journal of Drug Issues, 1051-1070.
Driving while impaired is a serious national health problem, and there is a need to develop effective treatments for persons arrested for Driving While Intoxicated (DWI). Motivation for changing substance use behaviors may be critical for avoiding further infractions. Once motivated, the client may more readily develop skills that enhance efficacy to cope with situations leading to DWI. Motivational Interviewing (MI: Miller & Rollnick, 1991) was delivered to DWI-involved clients to enhance motivation to change. It was followed by Relapse Prevention (RPl Marlatt & Gordon, 1985) to develop coping skills, and showed general improvement at the end of the four-week treatment. This pilot study (N=25) indicates that more well controlled clinical trials are warranted to study the effectiveness of MI/RP in treating persons engaged in DWI.
Guastella, A.J., Dadds, M.R. (2006). Cognitive-Behavioral Models of Emotional Writing: A Validation Study. Cognitive Therapy Research, 30, 397-414.
Previous research suggests that the Pennebaker writing paradigm may improve physical and psychological health; however, onsonsistent findings suggest that it may not be suitable for community dissemination in its current format. This study manipulated writing instructions across groups in order to emphasise putative emotional processes. Three processes were isolated consistent with cognitive-behavioral models of trauma: exposure, devaluation, and benefit-finding. Essay content reports, text analysis, distress, arousal, and physiological data demonstrated that participants assigned to different writing instructions responded during and after the writing session in a manner that was consistent with the putative emotion process. The results highlight the potential for the writing paradigm as a research tool for emotional processing.
Beck, R., Fernandez, E. (1998). Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis. Cognitive Therapy and Research, 22(1), 63-74.
Anger has come to be recognized as a significant social problem worthy of clinical attention and systematic research. In the last two decades, cognitive-behavioral therapy (CBT) has emerged as the most common approach to anger management. The overall efficacy of this treatment has not been ascertained, and therefore, it was decided to conduct a meta-analysis of this literature. Based on 50 studies incorporating 1,640 subjects, it was found that CBT produced a grand mean weighted effect size of .70, indicating that the average CBT recipient was better of than 76% of untreated subjects in terms of anger reduction. This effect was statistically significant, robust, and relatively homogenous across studies. These findings represent a quantitative integration of 20 years of research into a coherent picture of the efficacy of CBT for anger management. The results also serve as an impetus for continued research on the treatment of anger.
Baikie, K.A., Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11, 338-346.
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. In the expressive writing paradigm, participants are asked to write about such events for 15-20 minutes on 3-5 occasions. Those who do so generally have significantly better physical and psychological outcomes compared with those who write about neutral topics. Here we present an overview of the expressive writing paradigm, outline populations for which it has been found to be beneficial and discuss possible mechanisms underlying the observed health benefits. In addition, we suggest how expressive writing can be used as a therapeutic tool for survivors of trauma and in psychiatric settings.
Ullrich, P.M., Lutgendorf, S.K. (2002). Journaling About Stressful Events: Effects of Cognitive Processing and Emotional Expression. Annals of Behavioral Medicine, 24(3), 244-250.
The effects of two journaling interventions, one focusing on emotional expression and the other on both cognitive processing and emotional expression, were compared during 1 month of journaling about a stressful or traumatic event. One hundred twenty-two students were randomly assigned to one of three writing conditions: (a) focusing on emotions related to a trauma or stressor, (b) focusing on cognitions and emotions related to a trauma or stressor, or (c) writing factually about media events. Writers focusing on cognitions and emotions developed greater awareness of the positive benefits of the stressful event than the other two groups. This effect was apparently mediated by greater cognitive processing during writing. Writers focusing on emotions alone reported more severe illness symptoms during the study than those in other conditions. This effect appeared to be mediated by a greater focus on negative emotional expression during writing.
Mikk, J. (2008). Sentence length for revealing the cognitive load reversal effect in text comprehension. Educational Studies, 34(2), 119-127.
The cognitive load theory recommendations for enhancing the success of teaching are effective up to a certain boundary. The paper is dedicated to finding this boundary line in sentence length for 17-18-year-old students. The students filled in the blanks in 30 cloze tests. The cloze test results were correlated with the percentage of sentences over the boundary line. When the boundary-line was low, the coefficient of correlation increased with the rising of the line and the coefficient began to drop when the boundary line passed 140 characters. This size of the boundary line indicated the sentence length, up to which the taking of the load from the learners’ mind was effective. The sentences with 130-50 characters were the most suitable for the students.
Cherry, K.E., Dokey, D.K., Reese, C.M., Brigman, S. (2003). Pictorial Illustrations Enhance Memory for Sentences in Younger and Older Adults. Experimental Aging Research, 29, 353-370.
In these studies, the authors examined the effects of verbal and pictorial illustrations on younger and older adults’ recall of the content of short sentences. During acquisition, base and elaborated sentences were presented under one of three encoding conditions: (a) sentences only; (b) sentences with matching pictures; (c) incomplete sentences with matching pictures. At test, participants recalled the main action of the sentences. Base sentences were recalled more often than elaborated sentences when strict scoring criteria were used. However, older adults showed a recall advantage for elaborated sentences compared to base sentences when lenient scoring criteria were applied. Positive effects of pictorial illustrations occurred for both age groups. Implications for the design of instructional formats to improve older adults’ retention of textual material are discussed.
McKay, E. (1999). An Investigation of Text-based Instructional Materials Enhanced with Graphics. Educational Psychology, 19(3), 323-335.
A total of 45 participants attended workshops to learn how to write PASCAL programs. All of the participants completed the CSA and their CSA-ratio was used to select pairs of similar CSA-ratios. One participant from each pair was given a text-only instructional booklet, while the other was given a text-plus-graphics instructional booklet. The treatment groups were controlled for instructional format (text-only/text-plus-graphics) and cognitive style. The independent variable were used to test for their effect on learning abstract computer programming concepts. It was found that the Verbal-Imagery cognitive style and instructional treatment interacted in their effect on the performance-difference scores. The Novice-Verbal programmers performed best with a text-plus-graphics instructional format, performing significantly better than the Novice-Imagers’ subgroups using the same text-plus-graphics material. Conversely, the Novice-Imagers participants performed better with the material. However, the Experienced-Imagery participants performed better with the text-plus graphics instructional material than the Experienced-Verbalisers. Overall, the Verbalisers’ worst performance occurred with the text-only materials, while their best performance occurred with the text-plus-graphics material. This pilot experiment suggests that learning performance is affected by an interaction of cognitive style and instructional format.
Dirkx, J.M. (2008). The Meaning and Role of Emotions in Adult Learning. New Directions for Adult and Continuing Education, 120, 7-18.
This chapter describes different ways of understanding emotions and their role in adult learning. The author suggests that our understanding of emotions is shifting from one where they are viewed as an obstacle to reason and knowing to more holistic and integral ways of knowing one’s self and the world.
