An Interview with Licensed Clinical Social Worker Lisa M. Schab
Today’s teens face so many unique challenges—from bullying and gun violence to navigating an increasingly digital world and preparing for an uncertain future—that there are plenty of reasons to feel anxious and stressed out. However, research shows that many teens with anxiety aren’t seeking the psychological treatment they need to reach their goals and thrive. Unfortunately, much of this has to do with the stigma still surrounding mental health and therapy. Enter clinically based guided journaling—a fun and engaging introduction to therapeutic help that doesn’t feel like therapeutic help. Here, licensed clinical social worker Lisa Schab talks about her new guided journal, Put Your Worries Here, and why this innovative approach is so effective for anxious teens who may be resistant to traditional therapy. While journaling is not meant to be a replacement for professional counseling, for many teens it can serve as an important first step in seeking treatment. And for professionals, these journals can make excellent resources for teen clients.
How did you become interested in journaling?
It all started when I received a small diary from my grandfather on my tenth birthday. I liked recording the things I did each day in that little book, and I also added feelings that I might not have shared with anyone else. It felt good to have a safe place for my thoughts, and the diary was private—a place just for me. When I got to college I switched from the more “formal” locked diary to spiral notebooks, which offered more space for writing to flow. Again, my journal became that safe space to express anything that was inside me, and to help myself work out emotional challenges.
As I was finishing my graduate degree in social work, one day I pulled out all my old notebooks. As I looked at the recordings of my life, and realized the sanctity of this personal space, it became so clear to me that the act of journal writing had helped me navigate the ups and downs of my life in a very significant way. It gave me a space to express, look at, get to know, and work with all the material of my inner life. As someone beginning their trek as a clinician in the helping profession, I thought, “If this could help me, it could help others, too.”
As I started work as a therapist, I began using journaling with my clients, as well as teaching self-help journaling workshops. I also developed and taught professional training courses on using journaling as an adjunct to therapy.*
Can you talk about the therapeutic benefits of journaling?
Journaling has both physical and emotional benefits. Studies show that, physically, the benefits of expressive writing range from strengthening immune cells to lowering blood pressure and enhancing wound healing. Because it releases physical tension from our bodies, journaling can help to keep us in better general health all around.
In the mental/emotional realm, writing out thoughts and feelings can help us to calm and clear our minds, release pent-up feelings and everyday tension and stress, and let go of negative thoughts. It can also help us manage anxiety and depression, increase self-awareness, and enhance our overall sense of well-being. In fact, evidence tells us that writing can produce a therapeutic benefit close to that of sessions with a psychotherapist.**
Why is journaling so effective for teens in particular?
Adolescence is a time of self-discovery. Writing in a journal facilitates this, affording a safe space for questioning, observing, and exploring likes and dislikes, passions and motivations, fears and apprehensions, dreams and desires. It offers a place to practice assertiveness, find self-compassion, and build healthy self-esteem by developing a nurturing relationship with one’s authentic self. It provides an outlet for the emotional highs and lows, overwhelm, and confusion that mark the normal teen growing phase. While working in a journal, a teen can develop coping skills, empowerment, and a healthy inner anchor to enhance maturation and carry them into adulthood.
Unfortunately, many teens are still influenced by a stigma around talk therapy or counseling—afraid people will think there’s something “wrong” with them or they’re “crazy” if they seek professional help. Because writing in a journal can feel less intimidating than saying thoughts and feelings out loud, journaling can provide a first or less threatening step to help teens address emotional issues or open up with a counselor. The Instant Help Guided Journals for Teens ease teens into self-exploration by presenting insight-oriented prompts in creative and engaging ways.
For the helping professional, journaling can provide a new angle to approach therapeutic issues and gain fresh insights into the teen and their behavior patterns. This more creative, hands-on technique helps teens become more engaged, open, and hopeful about the therapeutic experience.
While journaling can be used as an adjunct to therapy, teens can also journal on their own, either freewriting or using guided prompts, such as those in Put Your Worries Here. The average teen, even without compelling clinical issues, benefits from having a safe place to express thoughts and feelings in an appropriate way.
How can journaling help with teen anxiety?
As with all of us, teens hold anxiety in different places in their body, which may manifest as butterflies in the stomach, pressure on the chest, tightness in the neck, headache, jaw clenching, or even light-headedness (as well as others). We can help ourselves to dissipate these symptoms by releasing them through almost any kind of physical movement, including journaling. When the writer is comfortable and lets go of judgment about what they’re expressing, the repetitive motion of the hand and pen crossing the paper or the fingers tapping the keyboard can both release physical tension initiated by anxiety and have a soothing effect.
Anxiety is also released when we let our thoughts and feelings out onto paper. It changes them from an abstract to a concrete (letters and words on paper) form, and helps get them “outside of us.” This makes them feel less overwhelming, and us feel more balanced and stable. Teens especially need help with this, as their emotions tend to be more intense and fluctuate more often and more rapidly. Journaling can help teens let go of the shaky and apprehensive qualities of anxiety and reground themselves.
When used as part of the counseling process, journaling can also assist professionals working with anxious teens. Where direct questioning and exploration might feel threatening, journaling prompts are more subtle and can bypass defenses. Freewriting or non-guided journaling can be used effectively, as mentioned earlier. In addition, prompts such as those in Put Your Worries Here are specifically developed to help teens with anxiety. These creative prompts can help teens identify anxiety triggers, develop coping skills, and release anxiety in the moment, while still maintaining comfort with the process. (All prompts are evidence-based and grounded in the principles of cognitive behavioral therapy, dialectical behavioral therapy, mindfulness-based therapies, experiential therapies, or neuroscience.)
What’s the difference between guided journaling and regular journaling?
Both guided and regular journaling involve self-expression on paper, but guided journaling gives the writer a specific starting point, and usually has a particular goal in mind. The Instant Help Guided Journals for Teens are designed as guided journals purposely to give teens an active and real-time way to address emotional issues directly, in a nonthreatening manner. The journals use guided prompts specifically to steer the teen to the goal of managing their current problem. Each journal addresses a distinct clinical topic—such as anxiety, depression, anger, emotional regulation, et cetera and the prompts in these journals have all been set up to help the teen work on that issue. So, for example, a few prompts from the anxiety journal, Put Your Worries Here, are:
Design a peace tattoo. Where would you put it?
Your anxiety just texted you, again. Write your response and remind it that you’re the boss.
Create a collage using anything that brings you peace.
The universe is speaking calming thoughts to you. What is it saying?
Write your anxious thoughts that include words like “never,” “always,” “everyone,” and “no one.” Circle those you can prove are 100% true.
As you can see, these prompts also take the teen beyond just the written word, and invite them to use additional journal techniques, such as drawing and collaging to help reduce their anxiety.
What's the future of guided journaling in the professional community?
With this new series we are hoping to bring helping professionals a clear and effective way to use journaling with clients, students, and patients, and to give teens an engaging and useful vehicle for self-help on their own. While many clinicians may be aware that journaling can be helpful, they aren’t as sure about how or when to use it. Our goal is to not only provide the guided journal itself, but also to educate helping adults on its use.
Often, even as trained and experienced professionals, we find ourselves in need of a new technique, a new approach, a new skill that can help our teen clients who are apprehensive, “stuck,” or hard to engage with. With adolescent clients especially, we are frequently seeking something novel or unique that can catch their attention, keep their attention, or help them dig deeper or make progress without having therapy feel like a chore or a threat.
In addition, a significant desire is that because of the creative, engaging format, this set of books will contribute to reducing the stigma around mental health issues, and thereby get more help to more struggling teens.
* Two of those courses are available for continuing education credits through Professional Development Resources at https://www.pdresources.org/
** Edward J. Murray (1991), professor of psychology at the University of Miami
Lisa M. Schab, LCSW, is a licensed clinical social worker with a private counseling practice in the greater Chicago, IL, area. She has authored seventeen self-help books and workbooks for children, teens, and adults, including The Anxiety Workbook for Teens and The Self-Esteem Workbook for Teens.