Can Writing Therapy Help Troubled Teens?

Adolescent Expressive Art Therapy

Can Writing Therapy Help Troubled Teens?

Expressive arts therapy can be a very helpful tool in coping with many different types of behavioral issues and mental health problems.

Creativity is a common coping mechanism used by adults, but it is often forgotten how powerful it can be in helping children and teenagers as well. Teens are used to working in groups.

They learn in large groups in school, and tend to be social and hang out in groups as well.

Because of this, group therapy, and specifically group arts therapy, can be an effective way to help teenagers with depression, anxiety, and a multitude of other issues.

Teenagers often end up in therapy because of problems in their interpersonal relationships such as those with their parents, teachers, other figures of authority, and peers. They learn by watching those around them interacting with each other.

Important social skills such as anger management and cooperation can be picked up easily within a group therapy session. Un adults however, “talk therapy” often isn’t enough to help troubled teens. They need more innovative ways to express themselves. This is where arts therapy comes in.

Arts therapy is available in individual sessions, but you may consider group arts therapy as a less expensive and often more effective option.

Expressive Arts Therapy Can Benefit Those Who Are Dealing With:

  • Addictions
  • Grief and Loss
  • Depression’
  • Anxiety
  • Attention disorders
  • PTSD
  • Sleeping issues
  • Eating disorders
  • Relationship issues
  • Phobias
  • Trauma
  • Physical illness

Adults are not the only ones who deal with the above issues. Children and teens are commonly plagued with them too. Therefore, arts therapy should be considered for those of all ages.

What is Expressive Arts Therapy?

Expressive arts therapy is best defined as the application of any type of visual art in a therapeutic context.

It doesn’t matter what media is used, and it can be something the teen can even do easily at home such as journaling, sketching, or painting. What matters most is that the teen feels comfortable with the media(s) that they choose.

Writing, drawing, painting, sculpting, sewing, knitting, photography, and many other medias can be forms of arts therapy.

Types of Expressive Arts Therapy:

  • Creative writing therapy such as journaling, writing poetry, narrative fiction, letter writing to either to a real person in your life or to an inanimate/intangible thing you’re struggling with, writing your life story. Creative writing is a wonderful way to get emotions out that are difficult to talk about.
  • Visual art therapy such as painting, sculpting, drawing, sewing, etc. Creating something with your own two hands can help you to feel accomplished and give you a strengthened sense of self-esteem. You can also attempt to draw or paint your very emotions which can be a calming and soothing exercise which will help connect you to yourself.
  • Music therapy such as lyric/music writing, drum circles, analyzing meaning in existing music, learning a new instrument. Music is a language all its own. Sometimes just listening to the right music at the right time can help elevate your mood. Creating it yourself can help you to tell your story in a way you might not otherwise feel able to.
  • Drama therapysuch as role-playing, setting intentions and goals, telling your story through acting or writing a scene, family sculpting (the visual representation of an individual’s present family situation as they experience it). All of these things can be therapeutic forms of expression and are ways to tell your own personal story.

How Does Expressive Arts Therapy Work?

Expressive arts therapy is effective because creating art can help awaken thoughts and feelings that have been buried in a troubled person’s subconscious. Acknowledging and recognizing emotions is the first step in beginning to deal with them. Once the emotions are acknowledged, they can be expressed.

Some emotions are difficult to convey with words or conversations in therapy and are more easily expressed through art. The largest benefit of arts therapy is that it gives adults and teens a a safe and healthy outlet to express all of those new emotions.

It can also greatly improve self-esteem, as it can make teens feel so accomplished just to have created something with their own hands.

For Information and Support

Seeking help is never easy, but you are not alone! If you or someone you know is in need of mental health treatment, we strongly encourage you to reach out for help as quickly as possible.

It is not uncommon for many mental health difficulties to impact an individual for the long term.

The earlier you seek support, the sooner you and your loved ones can return to happy, healthy and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769.


  • American Art Therapy Association
  • Art Therapy Alliance
  • Creativity and Recovery: The Mental Health Benefits of Art Therapy by Guest Author. July 10, 2018.
  • American Counseling Association
  • Reaching The Tough Adolescent Through Expressive Arts Therapy Groups by Poppy K. Moon. August 12, 2006.


Therapy gone wild

Can Writing Therapy Help Troubled Teens?

When psychologist Steve DeBois, PhD, works with groups of troubled teens, he uses the evidence-based approaches that any good short-term residential-treatment therapist would use: cognitive behavioral therapy to combat negative thinking, journaling to help shed light on depression and anxiety, and group activities to overcome social phobia and develop greater self-confidence, to name a few.

But instead of doing this work in a fluorescent-lit treatment facility, DeBois takes the teens into the Utah high desert, where they learn ways to defeat unproductive emotional and psychological patterns while camping and hiking in a stunning landscape of mountains, pine trees and juniper bushes.

These are not Outward Bound courses or backpacking trips, DeBois says. «Those things have value unto themselves, but we offer a layer of real therapeutic work, a traditional insight-oriented approach to addressing whatever these kids' issues happen to be.»

DeBois is clinical director of a program called Second Nature, one of a number of «private pay» programs — they're not covered by insurance — that are bringing empirically informed therapeutic techniques and therapists into the wilderness.

The trend, which began in the mid-1990s, has burgeoned over the last decade, with more and more programs offering tailored approaches for young people with clinical diagnoses or substance use problems, adults who want to move on to new life stages, and families who need interventions that pack more punch than one or two office-based sessions.

This new brand of outdoor treatment began as a reaction to some wilderness therapy programs created in the 1970s, says psychologist and adventure therapist H.L. «Lee» Gillis, PhD, of Georgia College.

Those programs lacked good oversight and were run by a mish-mash of providers, many of them unqualified and unlicensed, he and others say.

At the time, many such programs were state-funded, and some took the form of «boot camps» designed to create challenging and even punishing experiences for young clients, many of whom came from the juvenile justice system.

This type of treatment reached a nadir in 1994, when 16-year-old Aaron Bacon died from a treatable ulcer on a trip to southern Utah. When he complained of abdominal pain, his counselors called him a «faker,» then deprived him of his sleeping bag for 14 nights and food for 11 nights.

That's when the program directors and founders of five wilderness therapy programs came together for a meeting in Salt Lake City, put their differences aside, and recognized that discussing best practices and agreeing on common principles would be best for the industry.

To those ends, they created the Outdoor Behavioral Healthcare Research Cooperative to make sure these programs were properly studied and evaluated, says Keith Russell, PhD, of Western Washington University, who served as the organization's first researcher.

The cooperative's members have conducted some 200 studies, currently under the direction of Michael A. Gass, PhD, of the University of New Hampshire.

«Intentionality» — planning a program's design and treatment course in thoughtful, empirically based ways — «is so important to the success of wilderness therapy,» Gillis says.

How it works

Second Nature, founded in 1998, is one of the oldest of these «intentional» programs, says psychologist Andrew Erkis, PhD.

He heads Erkis Consulting Group, a practice specializing in helping parents of at-risk adolescents find the most appropriate wilderness therapy and other programs, including Second Nature.

Each of Second Nature's four campuses — two in Utah, one in Oregon and one in Georgia — is staffed by two or three doctoral-level psychologists as well as other mental health professionals with expertise in a variety of areas, including anxiety and depression, attention deficit disorder, Asperger's syndrome, obsessive compulsive disorder, eating disorders and trauma. (An even newer trend is to include a staff psychiatrist as part of the treatment team, Erkis notes.)

Clinical staff members conduct a thorough assessment of each child before doing anything else, says DeBois. That means young people — who have both diagnosable mental health conditions and a typical range of adolescent problems including rebellion, self-doubt and substance use — are placed with therapists and peers who match their issues, says DeBois.

Most adolescent groups are single-gender, while most young adult programs are co-ed. In addition, these courses are «open enrollment,» meaning that young people in various stages of the process live together in the same group, with new kids entering all the time and graduates exiting. «There's a lot of peer mentoring and peer modeling,» DeBois says.

Once the teens are properly assessed, the wilderness setting, the tailored therapy and the lengthy stay — which averages eight to 10 weeks — provide a crucible for growth, says DeBois.

That's because the wilderness is devoid of escape hatches: Hiding in one's room playing computer games is not an option.

In addition, the longer stay helps break down defensive barriers, with young people typically going through an avoidance stage, a learning stage, and a stage in which they start to internalize healthier thinking and behavior patterns.

«A big part of this experience is helping students experience for themselves a greater sense of self-efficacy and internal locus of control,» DeBois says.

Nature is a catalyst, too. That's because it's empowering to realize that you can survive in the wilderness, Erkis says. In addition, the outdoors nurtures physical health, which in turn fosters mental health.

«They're in an emotionally safe place, they're not going anywhere, and by the way, they're exercising, they're eating well, they're sleeping well — they're starting to look and feel great,» Erkis says.

The setting also allows psychologists to work in fun and nonpathologizing ways. For instance, DeBois treated an extremely shy boy who was deeply anxious that others would judge him harshly. DeBois suggested the staff play charades and give the boy an assignment that made him the center of attention — an exercise that helped the boy see that being in the spotlight wasn't so scary.

«Being in this kind of setting allows therapy to happen in this backdoor way where it doesn't feel therapy,» DeBois says.

Family dynamics

Other psychologists are taking families, adults and couples out to the wilderness for therapeutic experiences. Psychologist Scott Bandoroff, PhD, launched the field of «wilderness family therapy» in 1990 when he observed that young people who had made great gains on wilderness therapy trips tended to lose ground when they got home, the result of returning to negative family dynamics.

Given the difficulty of scheduling time for a whole family, plus the cost of these ventures, Bandoroff tends to take families out for three-day weekends.

These sessions can make a big impact, he has found, thanks to a combination of being removed from daily life and its distractions; doing exercises to build trust and teamwork; taking solo trips where family members have a chance to ponder their individual issues and roles; and participating in group activities that end with a reward, a beautiful mountain view.

Families also set and agree on goals what they've learned, so they can continue to work on issues raised during their time out, says Bandoroff, who heads Peak Experience, a wilderness therapy training and practice firm in Ashland, Ore.

Looking to the future

These programs aren't perfect, those involved admit. For one thing, they're expensive, costing from $20,000 to $30,000 for two months.

As such, they tend to be available only to wealthier clients, since insurance doesn't pay for anything but discrete therapy sessions in the wilderness, and publicly funded programs generally dried up with the 2008 recession. For another, the quality of these programs remains variable.

While many programs are reputable state-licensed programs with top-notch therapists, others have more questionable credentials, Erkis says.

Because so much time is spent outdoors without parental supervision, ethical, safety and health issues may also arise, so it behooves parents to find well-vetted programs, Erkis says. Finally, follow-up is a problem with some programs, though good programs make sure clients receive recommendations for additional care or placement if needed.

That said, research is starting to show that some of these programs can be effective.

A 2010 Journal of Therapeutic Schools and Programs article by Ellen Behrens, PhD, and colleagues, for instance, examined several large-scale, multi-center longitudinal studies and found that youth in these programs improved significantly in mood and behavior during treatment, and that those improvements continued when they returned home. Meanwhile, in six years of tracking participants and parents over a number of programs, Second Nature researchers found significant improvements in the youngsters' overall motivation, life skills, interpersonal relationships, hope, self-confidence and emotional control both at graduation and at six-month follow-ups. Importantly, parents perceived those differences, too.

For Bandoroff, there is no doubt that the combination of being in a beautiful natural setting and working on your issues with highly trained professionals is a winning one that more psychologists should consider exploring.

«You get spoiled for life when you see how quickly change can occur,» he says.

Tori DeAngelis is a writer in Syracuse, N.Y


Writing Therapy: Using A Pen and Paper to Enhance Personal Growth

Can Writing Therapy Help Troubled Teens?

Have you ever been feeling low, down in the dumps, stuck in a rut, or just plain stressed out?

Of course, the answer to that question will be “yes” for everyone!

We all fall on hard times, and we all struggle to get back to our equilibrium.

For some, getting back to equilibrium can involve seeing a therapist. For others, it could be starting a new job or moving to a new place. For some of the more literary-minded or creative folks, getting better can begin with art.

There are many ways to incorporate art into spiritual healing and emotional growth, including drawing, painting, listening to music, or interpretive dance. These methods can be great for artistic people, but there are also creative and expressive ways to dig yourself a rut that doesn’t require any special artistic talents.

One such method is writing therapy. You don’t need to be a prolific writer, or even a writer at all, to benefit from writing therapy. All you need is a piece of paper, a pen, and the motivation to write.

Before you read on, we thought you might to download our 3 Positive Psychology Exercises for free. These science-based exercises will explore fundamental aspects of positive psychology including strengths, values and self-compassion and will give you the tools to enhance the wellbeing of your clients, students or employees.

You can download the free PDF here.

What is Writing Therapy?

Writing therapy, also known as journal therapy, is exactly what it sounds – journaling for therapeutic benefits.

Writing therapy is a low-cost, easily accessible, and versatile form of therapy. It can be done individually, with just a person and his pen, or it can be guided by a mental health professional. It can be practiced in a group, with group discussions focusing on writing. It can even be added as a supplement to another form of therapy.

Whatever format is chosen, writing therapy can help the user to propel their personal growth, practice creative expression, and feel a sense of empowerment and control over the user’s life (Center for Journal Therapy, n.d.).

It’s easy to see the potential of therapeutic writing – after all, poets and storytellers throughout the ages have captured and described the cathartic experience of putting pen to paper. Great literature from such poets and storytellers makes it tempting to believe that powerful healing and personal growth are but a few moments of scribbling away.

However, while writing therapy seems as simple as writing in a journal, there’s a little more to it.

Writing therapy differs from simply keeping a journal or diary in three major ways:

  1. Writing in a diary or journal is usually free form, in which the writer jots down whatever pops into his or her head, while therapeutic writing is more directed, and often prompts or exercises.
  2. Writing in a diary or journal is generally focused on recording events as they occurred, while writing therapy is focused on thinking about, interacting with, and analyzing the events, thoughts, and feelings that the writer writes down.
  3. Keeping a diary or journal is an inherently personal and individual experience, while journal therapy is generally led by a licensed mental health professional (Farooqui, 2016).

While the process of writing therapy differs from simple journaling in these three main ways, there is also another big difference between the two practices in terms of outcomes.

Benefits of Writing Therapy

Keeping a journal can be extremely helpful for the user, whether it helps them improve their memory, record important bits and pieces of their day, or just helps them relax at the end of a long day. These are certainly not trivial benefits, but the potential benefits of writing therapy reach further and deeper than simply writing in a diary.

In individuals who have experienced a traumatic or extremely stressful event, expressive writing can have a significant healing effect. In fact, participants in a study who wrote about their most traumatic experiences for 15 minutes, four days in a row, experienced better health outcomes up to four months later (Baikie & Wilhelm, 2005).

Another study tested the same writing exercise on over 100 asthma and rheumatoid arthritis patients, with similar results. The participants who wrote about the most stressful event of their lives experienced better health evaluations related to their illness (Smyth, Stone, Hurewitz, & Kaell, 1999).

A recent study suggested that expressive writing may even improve immune system functioning, although it may need to be sustained for the health benefits to continue (Murray, 2002).

In addition to these more concrete benefits, regular therapeutic writing can help the writer find meaning in their experiences, view things from a new perspective, and see the silver linings in their most stressful or negative experiences (Murray, 2002). It can also lead to important insights about yourself and your environment that may be difficult to determine without focused writing (Tartakovsky, 2015).

Overall, writing therapy has proven effective for many different conditions or mental illnesses, including:

How To: Journaling for Therapy

There are many ways to begin writing for therapeutic purposes.

If you are working with a mental health professional, he or she may provide you with directions to begin journaling for therapy.

If you are planning on starting to write for therapy on your own before meeting with a therapist, there are some good tips out there to get you started.

First, think about how to set yourself up for success:

  • Use whichever format works best for you, whether it’s a classic journal, a cheap notebook, an online journaling program, or a blog.
  • If it makes you more interested in writing, decorate or personalize your journal/notebook/blog.
  • Set a goal to write for a certain amount of time each day.
  • Decide ahead of time when and/or where you will write each day.
  • Write down what makes you want to write in the first place – this could be your first entry in your journal.

Next, follow the five steps to WRITE:

  • W – What do you want to write about? Name it.
  • R – Review or reflect on it – close your eyes, take deep breaths, and focus.
  • I – Investigate your thoughts and feelings. Just start writing and keep writing.
  • T – Time yourself – write for 5 to 15 minutes straight.
  • E – Exit “smart” by re-reading what you’ve written and reflecting on it with one or two sentences (Adams, n.d.)

Finally, keep the following in mind while you are journaling:

  • It’s okay to write only a few words, and it’s okay to write several pages – just write at your own pace.
  • Don’t worry so much about what to write about, just focus on taking the time to write and giving it your full attention.
  • Don’t worry about how well you write – the important thing is to write down what makes sense to you and what comes naturally to you.
  • Write as if no one else will read it – this will help you avoid “putting on a show” rather than writing authentically (Howes, 2011).

It might be difficult to get started, but the first step is always the hardest! Once you’ve started journaling, try one of the following ideas or prompts to keep yourself engaged.

Writing Ideas & Journal Prompts

The following ideas and writing prompts are great ways to continue your journaling practice or to get yourself “unstuck” if you’re not sure what to write about next.

For instance, you could try the five writing exercises from this blog:

  1. Writing a letter to yourself
  2. Writing letters to others
  3. Writing a poem
  4. Free writing (just writing everything that comes to mind)
  5. Mind mapping (drawing mind maps with your main problem in the middle and branches representing different aspects of your problem)

If those ideas don’t get your juices flowing, try these prompts:

  • Journaling with Photographs – choose a personal photo and use your journal to answer questions “What do you feel when you look at these photos?” or “What do you want to say to the people, places, or things in these photos?”
  • Timed Journal Entries – decide on a topic and set a timer for 10 or 15 minutes to write continuously.
  • Sentence Stems – these prompts are the beginnings of a sentence that encourage meaningful writing, such as “The thing I am most worried about is…”, “I have trouble sleeping when…”, and “My happiest memory is…”
  • List of 100 – these ideas encourage the writer to create lists of 100 prompts “100 Things That Make Me Sad,” “100 Reasons to Wake Up in the Morning,” and “100 Things I Love” (Farooqui, 2016).

Psychologist Margarita Tartakovsky provides a handy list of 30 prompts (2014). Some of these include:

  1. My favorite way to spend the day is…
  2. If I could talk to my teenage self, the one thing I would say is…
  3. Make a list of 30 things that make you smile.
  4. The words I’d to live by are…
  5. I really wish others knew this about me…
  6. What always brings tears to your eyes?
  7. Using 10 words, describe yourself.
  8. Write a list of questions to which you urgently need answers.

If you’re still on the lookout for more prompts, try the lists outlined here.

Exercises and Ideas to Help You Get Started

As great as the benefits of therapeutic journaling sound, it can be difficult to get started. After all, it can be a challenge to start even the most basic of good habits!

If you’re wondering how you begin, read on for some tips and exercises to help you start your regular writing habit.

This list of ten handy tips can help get you started:

  • Start writing about where you are in your life at this moment.
  • For five to ten minutes just start writing in a “stream of consciousness.”
  • Start a dialogue with your inner child by writing in your subdominant hand.
  • Cultivate an attitude of gratitude by maintaining a daily list of things you appreciate, including uplifting quotes.
  • Start a journal of self-portraits.
  • Keep a nature diary to connect with the natural world.
  • Maintain a log of successes.
  • Keep a log or playlist of your favorite songs.
  • If there’s something you are struggling with or an event that’s disturbing you, write about it in the third person.
  • Develop your intuition and learn to listen to yourself (Hills, n.d.).

If you’re still having a tough time getting started, consider trying a “mind dump.” This is a quick exercise that can help you get a jump start on therapeutic writing.

Researcher and writer Gillie Bolton suggests simply writing for six minutes (Pollard, 2002). Don’t pay attention to grammar, spelling, style, syntax, or fixing typos – just write. Once you have “dumped,” you can focus on a theme. The theme should be something concrete, something from your childhood with personal value.

This exercise can help you ensure that your therapeutic journal entries go deeper than the more superficial diary or journal entries.

More prompts, exercises, and ideas to help you get started can be found at this link.

A Take Home Message

In this piece, we went over writing therapy – what it is, how to do it, and how it can benefit you. I hope you learned something new from this piece, and I hope you will keep writing therapy in mind the next time you find yourself considering a visit to a therapist’s office.

Have you ever tried writing therapy? Would you try writing therapy? How do you think it would benefit you? Let us know your thoughts in the comments!

Thanks for reading, and happy writing!

We hope you enjoyed reading this article. Don’t forget to download our 3 Positive Psychology Exercises for free.

If you wish for more, our Positive Psychology Toolkit© contains over 300 science-based positive psychology exercises, interventions, questionnaires and assessments for practitioners to use in their therapy, coaching or workplace.

  • Adams, K. (n.d.). It’s easy to W.R.I.T.E. Center for Journal Therapy. Retrieved from
  • Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment 11, 338-346.
  • Farooqui, A. Z. (2016). Journal therapy. Good Therapy. Retrieved from
  • Hills, L. (n.d.). 10 journaling tips to help you heal, grow, and thrive. Tiny Buddha. Retrieved from
  • Howes, R. (2011, January 26). Journaling in therapy. Psychology Today. Retrieved from Murray, B. (2002). Writing to heal. Monitor. Retrieved from
  • Pollard, J. (2002). As easy as ABC. The Guardian. Retrieved from
  • Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Journal of the American Medical Association 281, 1304-1309.
  • Tartakovsky, M. (2014). 30 journaling prompts for self-reflection and self-discovery. Psych Central. Retrieved from
  • Tartakovsky, M. (2015). The power of writing: 3 types of therapeutic writing. Psych Central. Retrieved from


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