Research on therapeutic writing indicates that it can offer a range of physical and psychological benefits. There is no consensus, however, concerning how writing achieves these benefits. To address this question, the authors propose a matrix framework with emotional-cognitive change processes (what can be activated) along its horizontal dimension and abstract-concrete structure (how the processes are activated) along its vertical dimension. On the horizontal dimension, writing can encourage clients who are distant from their emotional world to approach or to modulate emotional intensity, and to create meaning and coherence. Along the vertical dimension, these processes can be activated through tasks that vary in structure, including programmed writing, diaries, journaling, autobiography, storytelling, and poetry. Finally, the authors consider constraints on writing that apply to particular client groups. The matrix framework is meant to encourage clinicians to use therapeutic writing and to assist researchers in framing questions to advance our knowledge of writing as a therapeutic practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved).