RESEARCH & SUPPORTING FRAMEWORKS
Interactive Journaling®
Interactive Journaling® is an evidence-based practice for motivating and guiding individuals toward positive life change.
Home / Products & Services / Curriculum / Interactive Journaling®
JUMP TO A SECTION
Quick Navigation
INTRODUCTION
What is Interactive Journaling®?
Interactive Journaling® is an evidence-based practice for motivating and guiding individuals toward positive life change. This goal-directed, client-centered model helps participants modify their behavior as they progress through the stages of change (Prochaska & Prochaska, 2016). The behavior change technology of Interactive Journaling® includes evidence-based practices like expressive writing, motivational interviewing, cognitive-behavioral therapy and the transtheoretical model of behavior change. This technology is consistent throughout all Journals even though the application or target behavior varies from Journal to Journal.
The focus of Interactive Journaling® is the participant Journal, which includes nonconfrontational questions intended to help participants think and then write about their behaviors. Questions guide participants in considering their motivations for change, exploring their options and developing a plan with target behavior-related goals and a timeline for achieving these goals. Interactive Journals vary in length based on the target population, setting and type of delivery.
Interactive Journaling® is available in both paper-based formats and on our digital care platform, Atlas.
THE VALUE OF JOURNALS
The functions and benefits of Interactive Journaling® are similar to those described by L’Abate & Kern (L’Abate & Kern, 2002) when referring to the potential advantages of workbooks generally. One of these benefits is related to structure (L’Abate & Kern, 2002) (L’Abate, 2004). The structure of Interactive Journals means that even if a counselor, therapist or other practitioner has not been trained in a specific modality or need area, they can administer an Interactive Journal that addresses it efficaciously. Secondly, Interactive Journals allow individuals to increase self-awareness and commitments to change at their own pace. They can teach vital well-being skills and coping mechanisms without necessitating the presence of a professional (L’Abate & Kern, 2002).
Another noted advantage is specificity (L’Abate & Kern, 2002) (L’Abate, 2004). Interactive Journals deal with one specific condition or need area. The permanent messaging and directives of printed Journals may offer greater clarity to participants, as opposed to relying on listening to, understanding and integrating a practitioner’s advice in the moment. Similarly, Interactive Journals can disseminate evidence-based practices more quickly and broadly than practitioners alone may be able to (L’Abate & Kern, 2002). Interactive Journals are also versatile, meaning they can be utilized as part of structured treatment, self-directed or as a follow-up to therapy (L’Abate & Kern, 2002) (L’Abate, 2004).
L’Abate (L’Abate, 2004) argues that “workbooks are to psychological interventions what medications are to psychiatric interventions” (p. 6). Like medication, more than one workbook may be administered to treat a single condition, and if one doesn’t work, perhaps another one (or a different dosage) will.
UNDERPINNING INTERACTIVE JOURNALING®
Evidence-based Practices
Interactive Journaling® is an evidence-based practice with over 30 years of development. Distinct from a "best practice," an evidence-based practice (EBP) is an objective, balanced, and responsible use of current research and data that guides decision-making processes. Explore the evidence-based practices that underpin Interactive Journaling® below.
There are key distinctions between broadly defined psychological workbooks and the standards and norms of Interactive Journaling®.
The first of these standards is the incorporation of motivational interviewing strategies (Miller & Rollnick, 2013). Motivational interviewing is a way of communicating (verbally or through written prompts) that elicits an individual’s own motivation to change by encouraging the use of “change talk” regarding a target behavior.
Change talk is often defined as language that expresses a person’s desire, ability, reason or need to change (the acronym DARN) (Moyers, Martin, Houck, Christopher, & Tonigan, 2009). Change talk can be elicited using questions like, “What are three reasons making this change is important to you?” or “Based on what you know about yourself and your abilities, what might you do to be successful at this?” (Miller & Rollnick, 2013). While motivational interviewing is traditionally used in clinical, face-to-face settings, Interactive Journaling® also encourages “change talk” – though in a written medium – by posing reflective questions on each page that draw on the strategic evocation of change talk that is consistent with the practice of motivational interviewing.
Download Bill Miller's White Paper: Interactive Journaling® as a Clinical Tool →
Learn how we can support you in MI 4th Edition implementation →
Another therapeutic modality frequently incorporated into Interactive Journals is that of cognitive-behavioral therapy. Cognitive-behavioral therapy strives to increase a person’s awareness of their own cognitive distortions and teach them how to investigate, reappraise and challenge inaccurate and unhelpful biases (Beck & Dozois, 2011). In some cases, cognitive-behavioral skill-building is the primary focus of an entire Interactive Journal, as in the Rational Self-Counseling Journal developed for the Federal Bureau of Prisons’ Residential Drug Abuse Program (The Change Companies, 2018). In this Journal, participants learn the ABC model adapted from Ellis & Ellis (Ellis & Ellis, 2011), wherein a person experiences an Activating Event, has a Belief or cognition about the event and that cognition results in a Consequence involving feelings, behaviors and outcomes. Participants learn evidence-based skills for increasing their rational thinking and effectively challenging inaccurate thinking patterns.
In other cases, Interactive Journals will address another topic and use cognitive-behavioral skills to enhance participants’ competency in the target area. For example, an Interactive Journal on anger management might help participants challenge unhelpful thought patterns that lead to undesirable behaviors, such as, “No one gets away with treating me like this” or “If I don’t get my way, I’m going to explode.”
Whether exploring cognitive-behavioral therapy at a more comprehensive level or simply helping participants recognize how their thoughts may be affecting their outcomes, most Interactive Journals utilize a cognitive-behavioral approach to some extent, guiding individuals toward more helpful and accurate thinking patterns.
The evidence-based paradigm of expressive writing underpins Interactive Journaling®. Expressive writing is an approach in which individuals write their deepest thoughts and feelings about a difficult event, exploring the experience alongside the thoughts and emotions surrounding it (Pennebaker & Chung, 2012) (Pennebaker & Smyth, 2016). Standard expressive writing interventions invite participants to explore difficult events connected to childhood, relationships or connections of the event to the past, present or future. Subsequent research has demonstrated value in expressive writing interventions that emphasize positive experiences (Burton & King, 2004). A theme across these interventions is participant ownership: individuals are instructed to not concern themselves with spelling, grammar or punctuation, and instead focus on their deepest thoughts and feelings around the event they are describing.
Research has connected expressive writing to a number of positive physical and mental health outcomes, including improved sleep (Smyth, Pennebaker, & Arigo, 2011), cardiovascular functioning (McGuire, Greenberg, & Gevirtz, 2005), life satisfaction and subjective well-being (Pennebaker & Chung, 2012), reduction in self-reported depression (Smyth, Pennebaker, & Arigo, 2011) and increased emotional self-regulation (Davidson, Shwartz, Scheffield, McCord, Lepore, & Gerin, 2002).
Interactive Journaling® is strongly informed by the science of expressive writing, allowing participants to put down their thoughts, feelings and meaningful experiences in a structured, engaging and targeted manner. As in other expressive writing interventions, participants are encouraged to focus on their own thoughts and feelings and to not concern themselves with spelling, grammar or punctuation. Sexton & Pennebaker (Sexton & Pennebaker, 2009) point out that a broad range of groups have benefited from expressive writing, including college students, prison inmates, medical and psychiatric patients and unemployed populations. The notion that these same populations would benefit from Interactive Journaling® is supported by the literature review discussed in later sections.
The widely researched transtheoretical model (TTM) of behavior change was originally developed by Drs. James Prochaska, John Norcross, and Carlo DiClemente, along with many colleagues. Its core assumption is that people need and use different approaches depending where they are in the process of change. Rather than waiting for clients to get motivated or blaming them for being unmotivated, TTM researchers have developed practical methods for enhancing readiness and promoting positive change. The TTM conceptualizes readiness for change along a continuum with five stages of change: precontemplation, contemplation, preparation, action and maintenance. Ten processes of change have also been identified that suggest strategies to help people move through these stages.
Within the Journals, an individual’s progress through the stages of change is guided by behavioral and experiential exercises, practical assignments and the practice of new skills. Interactive Journals are designed to be useful to individuals regardless of their current level of readiness for change on a given issue. Journals communicate the idea that it is normal to be at different stages of change for different problems, and that sliding back to an earlier stage of change is a normal part of the process.
STRUCTURE OF INTERACTIVE JOURNALING®
Primary Elements
Each page in an Interactive Journal generally draws on the same three consistent elements: bite-sized copy that educates participants on the topic being presented (often designed to be consumed in 30 seconds or less), a graphic component (this may include illustrative photography or an educative infographic to reinforce written content) and questions to help the participant reflect on and apply what they have learned to their own goals and life experiences. Other page elements may include a first-person quote representing the target audience, “Keep in Mind” boxes to emphasize salient points on the page, drawing exercises or checkboxes that allow participants to select a response from a menu of options (selecting your top values from a list of common values, for example).
WHAT OUR PARTNERS ARE SAYING
Feedback on Use
Interactive Journals are also unique in the sense that they are always bound in high-quality, full-color booklets, differentiating them from workbook PDFs that can be printed from the internet or loose-leaf sheets compiled into a binder. A number of individuals who have participated in Interactive Journaling® have expressed the value of having a permanent, lasting resource in which to record their personal journeys of change. In an anonymous survey of self-reported feedback from 27,066 Interactive Journaling® participants in Alaska, Kentucky, New Mexico, Oklahoma, Vermont, Washington and Wisconsin, 84 percent of respondents said they planned to keep their Journals after completing the formal courses in which they were administered (The Change Companies, n.d.-a).
A separate survey was administered to 257 beneficiaries of The Salvation Army who completed Interactive Journals specifically designed for The Salvation Army Adult Rehabilitation Centers. 92% described their Journals as helpful for their rehabilitation (The Change Companies, n.d.-a). Comments from respondents included the following (The Change Companies, n.d.-b):
“I feel as though it’s like having my own personal counselor.”
“Not only has it helped me get to where I am, but so far my whole life story is between the covers. No one, at least not me, can dispute anything that is between the covers. If you cannot ask… for help, the journal will get you started”.
“I can look back on what I wrote and change it because that shows me I’m growing and that’s good.”
“What I like about my Journal is I can find out more about myself than I’ve ever known before. Thank you for helping me find myself.”
“If you really take this information seriously, I promise you, you will change… I believe that this material gave me insight.”
INTERACTIVE JOURNALING® USE DATA
Case Studies and Literature Review
Our partners support clients around the United States and Canada with behavior change, recidivism reduction, medication-assisted treatment and more on a daily basis. We are in awe of all they do and deeply thankful for their day-in and day-out work to support people in need. Below is a collection of some of the data and literature they have shared with us on how Interactive Journaling® has impacted their organization's programming and client/participant results.
RECIDIVISM REDUCTION FOR SUBSTANCE USING OFFENDERS
Population: 183 male inmates who had been previously incarcerated in the last year, who were arrested for an alcohol- or drug-related offense and who met DSM-IV criteria for substance dependence
Setting: North Carolina jail
Participants in the experimental condition for this study received one Interactive Journal, Changing Course (The Change Companies, 2008), which describes stages and processes of change (Prochaska & Prochaska, 2016), helps participants weigh the costs and benefits of making positive life change, and guides participants through the development of a plan for next steps they wish to take. The control group received a government-issued brochure containing information on substance use. Twelve months after Journals were disseminated, researchers noted recidivism rates were 15% lower for the experimental group compared to the control group (51% for the journaling group and 66% for the control group) – a statistically significant difference. Notably, independent predictors of re-arrest were severity of posttraumatic stress disorder, group assignment (Interactive Journaling® group vs. control group) and employment status (Proctor, Hoffmann, & Allison, 2012). Future research may shed light on whether Interactive Journaling® correlates with motivation to secure employment or improve a person’s mental health functioning. In a meta-analysis of 29 randomized controlled trials for recidivism reduction interventions, Beaudry (Beaudry, Perry, & Fazel, 2021) used odds ratios to calculate a recidivism risk of .54 for this intervention with a confidence interval (CI) of 95%. This was one of the lowest odds ratios in their analysis, indicating a high likelihood of efficacy.
EMPLOYMENT AND HOUSING STABILITY FOLLOWING REENTRY
Population: 195 inmates from a low-security federal correctional institution who participated in the Federal Bureau of Prisons’ Residential Drug Abuse Program (RDAP)
Setting: Community post-release
RDAP is a nine-month program for inmates with a documented history of substance use who meet the criteria for a substance use disorder. The program involves small group therapy, one-to-one meetings with prison treatment staff and Journal groups specially designed to process the content of the Interactive Journals disseminated to participants each month. These Journals have been customized in partnership with the Federal Bureau of Prisons to align with the content and objectives of RDAP. Moore compared the post-release status of individuals who completed RDAP with those who dropped out partway through the program. At 48 months post-release, it was observed that RDAP completers were two times less likely to engage in criminal activity than noncompleters, four times less likely to engage in substance use and 10 times more likely to gain employment and housing stability. As a result, RDAP completers were three times less likely to have their supervision revoked than those who did not complete the program (Moore, 2011).
RECIDIVISM REDUCTION IN COURT DIVERSION PROGRAMMING
Population: Individuals who had not completed a diversion program in the past 4 years, offered diversion programming while in court
Setting: Johnson County, North Carolina
Johnston County’s CorrectiveSolutions offers services for diversion, alternatives to incarceration, drug testing and monitoring. Its diversion program includes the use of select Interactive Journals from The Change Companies’ ReThink Now and MEE curricula. Other program components include a socioeconomic needs assessment to put participants in touch with community resources; a community accountability component involving apology letters, restitution efforts and community service; and drug testing if applicable. The study compared individuals who were offered the diversion program but did not enroll with individuals who completed the diversion program. Both groups were offered the program between October 2017 and March 2018. A 26-month analysis showed that recidivism rates for the non-enrolling group were 47%, while rates for those who completed the program were 15%, indicating a 32% decrease in recidivism rates for program graduates (CorrectiveSolutions, 2022).
DECREASE IN BEHAVIORAL ISSUES: THERAPEUTIC DIVERSION
Population: 463 inmates with high mental health needs, enrolled in a Therapeutic Diversion Unit
Setting: North Carolina prison system
Individuals in restrictive housing for an extended period of time have an increased risk of self-injurious behavior, more general mental health symptoms and an increased prevalence of trauma. A therapeutic diversion unit was created with the goal of decreasing the population of mentally ill offenders assigned to restrictive housing over an extended period of time, to increase emotional regulation and prosocial skills, to decrease violence and promote a healthy and safe transition into the general population or the community. The unit incorporated dedicated multidisciplinary staff, structured treatment that included The CHALLENGE Interactive Journaling® series, group and individual therapy and positive out-of-cell time. Pre-post results indicated improvements in a number of areas, including understanding and communicating, self-care, cognitive restructuring and decreases in DSM-5 symptom measures of depression, anger, anxiety, personality functioning and others (Remch, Mautz, Burke, Junker, Kaniuka, Proescholdbell, Marshall, & Naumann, 2021).
MOTIVATION TO CHANGE DRINKING BEHAVIORS: DUI/DWI
Population: 872 DUI and DWI offenders in Oklahoma
Setting: Impaired driving program
Participants in this study were asked to complete an Interactive Journal with content specific to impaired driving behaviors (Scheck, Hoffmann, Proctor, & Couillou, 2013). A pre-post test measuring program knowledge showed significant improvement after completing the course. A second questionnaire examined the subjective value participants placed on the Interactive Journals. 94.7% of participants said the program would help them change their drinking behaviors. 88.4% intended to keep their Journals following completion of the course. 80.2% of respondents reported sharing the information from their Journal with others or intending to do so in the future (Scheck, Hoffmann, Proctor, & Couillou, 2013). Importantly, participants reported that the most useful components of the Journal were not the parts that communicated impaired driving information, but the pages that allowed them to develop plans for change and set goals for the future (Scheck, Hoffmann, Proctor, & Couillou, 2013).
BEHAVIORAL IMPROVEMENTS FOR JUSTICE-INVOLVED YOUTH
Population: 36 justice-involved youth
Setting: Maine Department of Corrections, Division of Juvenile Services
In this pre-post outcomes assessment, youth engaged in the Forward Thinking Interactive Journaling® curriculum, developed in collaboration with the California Department of Corrections and Rehabilitation, Division of Juvenile Justice (The Change Companies, 2013). Staff received The Change Companies’ comprehensive Interactive Journaling® training in advance of implementation. Participants completed the curriculum’s seven Interactive Journals: Family, Relationships & Communication, Individual Change Plan, What Got Me Here?, Responsible Behavior, Substance Use and Handling Difficult Feelings. Participants were administered a pre-post assessment that measured comprehension of topics within the curriculum and cognitive-behavioral skill acquisition. 100% of completed surveys showed improvements, with an average 23% improvement across Journals, and the strongest improvement at 37% with the Journal Handling Difficult Feelings. Juvenile Community Corrections Officers (JCCOs) completed a facilitator survey following implementation. 75% of JCCOs identified that the Journals were directly linked to case plan achievement, 100% identified that they will utilize the skills learned in program facilitation in their ongoing cases and 100% identified that they agree the specific Journals positively impacted the youth (O’Neill, Williamson, & Morse, 2020).
BEHAVIORAL IMPROVEMENTS: RESTRICTIVE HOUSING PROGRAM
Population: 240 program graduates of Arizona Department of Corrections’ restrictive status housing program (RSHP)
Setting: Arizona Department of Corrections (ADC) RSHP
ADC has implemented a contingency management approach in its restrictive status housing program (RSHP). Inmates receive incentives to complete programming discipline-free. Programming includes the use of The Courage to Change Interactive Journaling® curriculum in group counseling. Programming also includes self-study, educational television (ETV) modules, adherence to program rules and regulations, and supportive interactions with staff and other participants. The study looked at post-completion changes in a range of behavioral areas. At six and twelve months post-completion, there were statistically significant changes in major violations, staff assaults, inmate assaults and drug violations. At six months, the majority of the participants (52%) had no violations following their release from the program (Meyers, Infante & Wright, 2018).
DECREASE IN PTSD: GENDER-RESPONSIVE TRAUMA PROGRAM
Population: 150 women
Setting: Drug court treatment programs
In the experimental group for this study, an Interactive Journal designed specifically for women, Women in Recovery (Covington & The Change Companies, 2002), was administered alongside an 11-session trauma treatment program. The control group received “treatment as usual” in a local outpatient facility. Researchers saw a significant decrease in PTSD symptoms and better treatment performance in women in the experimental group compared to the control group at 21-month follow-up. Women in the experimental group were also more likely to complete treatment and less likely to receive sanctions or disciplinary action during treatment (Messina, Calhoun, & Warda, 2012). An obvious limitation of this study was not being able to identify Interactive Journaling®’s contribution to these outcomes. Other treatment elements like group therapy, participants’ therapeutic relationship with the facilitator and the program’s trauma-informed approach likely also played a role in participant success. However, when we consider the ways in which Interactive Journals reinforce program content and allow for deeper personal application, it is possible that they helped extend the impact of therapy and enhanced retention and application outside of the group environment. Future research may help us better understand this function of Interactive Journaling®.
Beaudry, G. B., Yu, R., Perry, A. E., & Fazel, S. (2021). Effectiveness of psychological interventions in prison to reduce recidivism: A systematic review and meta-analysis of randomized controlled trials. The Lancet, 8, 759-773.
Beck, A. T., & Dozois, D. J. (2011). Cognitive therapy: Current status and future directions. Annual Review of Medicine, 62, 397-409.
Burton, C. M., & King, L. A. (2004). The health benefits of writing about intensely positive experiences. Journal of Research in Personality, 38(2), 150-163.
CorrectiveSolutions. (2022). CorrectiveSolutions case study: Recidivism in Johnson County, NC. Mission Viejo, CA: CorrectiveSolutions.
Covington, S., & The Change Companies (2002). Women in recovery. The Change Companies.
Davidson, K., Shwartz, A. R., Scheffield, D., McCord, R. S., Lepore, S. J., & Gerin, W. (2002). Expressive writing and blood pressure. In S. J. Lepore & J. M. Smyth (Eds.), The writing cure: How expressive writing promotes health and emotional well-being (p. 17-30). American Psychological Association.
Ellis, A., & Ellis, D. J. (2011). Rational emotive behavior therapy. American Psychological Association.
L’Abate, L. & Kern, R. (2002). Workbooks: Tools for the expressive writing paradigm. In S. J. Lepore & J. M.
Smyth (Eds.), The writing cure: How expressive writing promotes health and emotional well-being. American Psychological Association.
L’Abate, L. (2004). The role of workbooks in the delivery of mental health services in prevention, psychotherapy, and rehabilitation. In L. L’Abate (Ed.), Using workbooks in mental health: Resources in prevention, psychotherapy, and rehabilitation for clinicians and researchers. Haworth Reference Press.
McGuire, K. M. B., Greenberg, M. A., & Gevirtz, R. (2005). Autonomic effects of expressive writing in individuals with elevated blood pressure. Journal of Health Psychology, 10, 197-207.
Meyers, T. J., Infante, A., & Wright, K.A. (2018). Addressing serious violent misconduct in prison: Examining an alternative form of restrictive housing. International Journal of Offender Therapy and Comparative Criminology, 62(14)
Messina, N., Calhoun, S., & Warda, U. (2012). Gender-responsive drug court treatment: A randomized controlled trial. Criminal Justice and Behavior, 39(12), 1539-1558.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). The Guilford Press.
Moore, M. J. (2011). Examining participants’ motivation to change in Residential Drug Abuse Program graduates: Comparing “stages of change” assessment data with post-release status [Doctoral dissertation, University of Minnesota].
Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S. (2009). From in-session behaviors to drinking outcomes: A causal chain for motivational interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113-1124
O’Neill, C., Williamson, G., & Morse, S. (2020). Change Companies: Forward Thinking Journaling Pilot Program Statistical Report. Maine Department of Corrections, Division of Juvenile Justice.
Pennebaker, J. W., & Chung, C. K. (2012). Expressive writing: Connections to physical and mental health. In H. S. Friedman (Ed.), The Oxford handbook of health psychology. Oxford University Press.
Pennebaker, J. W., & Smyth, J. M. (2016). Opening up by writing it down: How expressive writing improves health and eases emotional pain. Guilford.
Prochaska, J. O., & Prochaska, J. M. (2016). Changing to thrive: Using the stages of change to overcome the top threats to your health and happiness. Hazelden.
Proctor, S. L., Hoffmann, N. G., & Allison, S. (2012). The effectiveness of interactive journaling in reducing recidivism among substance-dependent jail inmates. International Journal of Offender Therapy and Comparative Criminology, 56(2), 317-332.
Remch, M., Mautz, C., Burke, E. G., Junker, G., Kaniuka, A., Proescholdbell, S., Marshall, S. W., & Naumann, R. B. (2021). Impact of a prison therapeutic diversion unit on mental and behavioral health outcomes. American Journal of Preventive Medicine. Advance online publication.
Scheck, A. M., Hoffmann, N. G., Proctor, S. L., & Couillou, R. J. (2013). Interactive journaling as a brief intervention for level-II DUI and DWI offenders. Journal of Alcohol & Drug Education, 57(3), 66-85.
Sexton, J. D., & Pennebaker, J. W. (2009). The healing powers of expressive writing. In Kaufman, S. B. & Kaufman, J. C. (Eds.), The psychology of creative writing (pp. 264-276). Cambridge University Press.
Smyth, J. M., Pennebaker, J. W., & Arigo, D. (2011). What are the health effects of disclosure? In A. Baum, T. A.
Revenson, & J. Singer (Eds.), Handbook of health psychology (2nd ed., pp. 175-191). Routledge.
The Change Companies (2008). Changing course. The Change Companies.
The Change Companies (2013). Forward thinking curriculum. The Change Companies.
The Change Companies (2018). Rational self-counseling. The Change Companies.
The Change Companies (2021). The Change Companies. changecompanies.net
The Change Companies (n.d.-a). Participant feedback data on using Interactive Journaling. The Change Companies. changecompanies.net/evidence/?id=41
The Change Companies (n.d.-b). Response of beneficiaries to my new life: A personal journey: A report to the Eastern USA territory of The Salvation Army from The Change Companies. The Change Companies. changecompanies.net/evidence/?id=15