Dissociative clients experience disconnection from their sense of Self that negatively impacts their ability to communicate in therapy. Many therapists have clients who lean on journals for support when words fail them, yet there is little academic research into the impact of this phenomenon on the development of communication within therapeutic relationships, particularly where the journals contain creative or visual elements. 

An understanding of what is happening in and between therapy sessions may identify trends that shed light on the use of this tool and helpful recommendations for therapists to safely and comfortably navigate their dissociative clients’ journal use in and between appointments.