Implementing Interactive Journals in treatment planning

Interactive Journals can be a valuable resource for creating ongoing individualized treatment planning. Interactive Journaling^® supports a person-centered, strength-based and individualized approach. It can also strengthen the therapeutic alliance, a critical component of a person’s engagement with the treatment planning process. Interactive Journals can draw out insights related to a person’s cultural identity, strengths, preferences and past successes. They are also helpful in aligning with the fourth edition of the ASAM criteria. For example, they can help in identifying a client’s social determinants of health, including status in housing, transportation, discrimination, education, employment, access to food and other resources.

The following are additional considerations related to the use of Interactive Journaling^® in individualized treatment planning and service delivery:  

Comprehensive treatment planning assessment

Treatment planning always begins with what the individual wants from treatment. Clients’ reflections in their Interactive Journals can help you meet them where they are, increase engagement and buy-in, and better understand their readiness and confidence for change in identified problem areas. Useful insights from Journals that can be incorporated into clinical documentation include: 

• statements about what the person is hoping to get out of treatment
• reflections on the person’s strengths and areas for growth 
• statements about the person’s values and how they will use these values in treatment
• statements about existing coping skills and sources of support
• changes the person is already considering 
  
  

Additionally, Interactive Journaling^® can provide the following insights to support ongoing collaborative treatment planning: 

• Identifying strengths and supports: Interactive Journals help clients identify the strengths, values and sources of support that can help them achieve their treatment goals. 
• Identifying challenges/potential barriers to change: Interactive Journals provide a space for clients to reflect on potential barriers that may get in the way of their treatment goals. Additionally, they provide strategies for addressing common barriers and space for making plans to address their own barriers.  
• Collaborative goal setting: In line with the structure of most treatment plans, Interactive Journals provide space for clients to write down their individual SMART objectives and break them into smaller action steps. Journals evoke change talk (statements about desire, abilities, reasons or needs to change) with questions like, “What do you want your life to look like?”; “What has helped you in the past?” and “What makes this important to you today?”
• Providing person-first language: Journals can provide “I” statements in clients’ own words to include in the treatment plan, in addition to the “as evidenced by” language that supports person-centered planning and validates the person’s own perspective. This can increase clients’ confidence and commitment to their plan, rather than feeling frustrated or discouraged by unrealistic expectations.
  
  

Objectives and action steps

Interactive Journals can serve as valuable interventions to move individuals toward treatment plan objectives and support efforts in other relevant programs and services. Clinicians can recommend pages to assign to address specific objectives related to your client’s treatment plan. Clinicians can also use the Journals to identify appropriate activities and action steps relative to a client’s stage of change. Some examples of skills addressed in Interactive Journals include: 

• coping skills (e.g., stress management, diet, exercise, sleep, mindfulness)
• daily reflection and progress tracking
• life skills (e.g., job readiness, finding safe housing, financial literacy, time management)
• relationship skills (e.g., building a support network, resisting social pressure, setting healthy boundaries, helpful communication)
• rational thinking skills: Interactive Journals use a cognitive-behavioral approach to help clients improve their thinking and get more helpful outcomes.  

When clients have completed assigned passages in their Journals, you as a clinician can reinforce their learning and engagement by posing follow-up questions, conducting role-plays, and assigning out-of-session practice of the skills presented in the Journals. You can then assign additional relevant Journal pages to continue to address treatment plan objectives. 

Progress tracking and transition plans

The client’s treatment team can review Journals together to track their progress. This can help with ongoing assessments, making relevant changes to the treatment plan and building your client’s confidence in their ability to reach their goals and transition to a less intensive level of care. 

Preventing a return to use

Clients’ Journals can help them identify their triggers, including risky thinking, emotions, people, places and things. Their Journals can also help clients create a plan to avoid a return to use. This can be incorporated into their treatment plan and recurrence and remission maintenance plans.

Contingency plans are another important component of treatment planning. Should an individual return to use, one possible intervention is for the client to work with the treatment team on The Change Companies’ Getting Back on Track Interactive Journal, which helps individuals reflect on what they can learn from their return to use and how they can use their strengths and past experiences to continue to make progress.

When used with clients’ treatment plans, Interactive Journals can help guide your work together, strengthen the therapeutic alliance and bolster the success of your clients in treatment and long-term recovery.