Reflection is an essential component of clinical reasoning in occupational therapy practice. The specialty area of mental health practice can elicit awareness and introspection for occupational therapy students at personal and professional levels. This article, a qualitative case study, describes the use of interactive journals in the mental health component of an undergraduate occupational therapy curriculum to foster and develop reflective skills. Students kept journals and submitted them biweekly; faculty members responded to the journals in writing within 24 hr. The journals were analyzed for common themes over the length of the course as well as at each biweekly period. Frequent themes were students’ increased awareness and openness to the specialty area and positive changes in attitude associated with new knowledge and experiences. The results indicate that interactive journals in academic courses have the potential to be an effective strategy to promote reflection.