Bibliotherapy

It was a Facebook ad that caught my attention: Earn your certification to become a bibliotherapist!

As an ELA teacher, I know a thing or two about spotting Latin or Greek roots, so I understood whatever this was, it had to do with books. If books were involved, I was all in - so I clicked on that ad.

Bibliotherapy, often referred to as book therapy, is a creative arts therapy that involves story telling or reading specific books that often help an individual improve empathy, tolerance and interpersonal skills. This therapy works best for people who enjoy reading and reflecting on what they’ve read. It is not typically suitable for patients with intellectual difficulties, attention struggles or experiencing psychosis.

Using literature to help improve mental health is not a new idea. Ancient cultures like the Greeks and Egyptians saw libraries as spaces that symbolically held healing abilities. Poems, myths and plays provided comfort and understanding when it could be emotionally difficult to grasp what was happening in their life. Beginning in the early 20th century, psychologists started to study the benefits of reading and, especially, as a therapeutic technique.

Most people are familiar with self-help books, which certainly have their place in therapeutic practices. In addition to these types of books, fictional stories can be a powerful tool for a person to use to gain insights into their particular challenges and ways to cope. Reading can improve self-esteem, self-awareness and self-efficacy. However, it is important to avoid recommending books that contain propaganda and misleading information that encourages harmful beliefs.

Most therapists use fiction to assist with treatment. These stories can model problem-solving, self-awareness and understanding. If a person can connect to characters, fictional or not, they may feel less alone. Literature can help patients understand perspectives besides their own and make sense of upsetting situations. Assigning reading can be a way to give “homework” between therapy sessions. Their purpose is to go deeper into understanding the therapeutic work being done and aid in learning.

The process of realizing one is not alone in their mental health struggles happens in four phases:

• Identification - reader connects with character and their problem

• Catharsis - reader engages with character’s emotions, problems and roots for their success

• Insight - reader sees the similarities between the character and/or situation and their life

• Universalization - reader recognizes they aren’t alone.

Bibliotherapy can be used in individual or group therapy. This technique can be combined with other modalities like psychodynamic therapy or cognitive behavioral therapy. It is effective with treating mild to moderate forms of anxiety, depression, mood disorders, trauma, addiction, grief, divorce, and relationship challenges. Additionally, this type of treatment is inexpensive and easy to apply. Patients short on time or have limited finances would find this a possible path for treatment.

In a 2017 randomized trial by Hazlett-Stevens and OrenIn, a ten-week study involving college students struggling with anxiety, bibliotherapy decreased anxiety and perceived stress while improving their quality of life. That same year, a long-term study* found using bibliotherapy to help with mild depression produced positive results. These patients did need follow-up, ranging from three months to three years.

When looking for a therapist who practices bibliotherapy, it is important to ask if they have training and how would they use it with their treatment plan. The International Federation for Biblio/Poetry Therapy is an organization that provides standards in training and credentialing as well as a list of certified bibliotherapists.

Bibliotherapy is a low-threatening and accessible way for people to understand their emotions, reduce stress, and explore new coping strategies through the stories they read. When paired with reflection or structured discussion, it can assist and reinforce a person's insights. Bibliotherapy offers readers the opportunity to see themselves in stories—and use those insights to grow, heal, and move forward.

*Reference:

Gualano, M. R., Bert, F., Martorana, M., Voglino, G., Andriolo, V., Thomas, R., Gramaglia, C., Zeppegno, P., & Siliquini, R. (2017). The long-term effects of bibliotherapy in depression treatment: Systematic review of randomized clinical trials.Clinical Psychology Review, 58, 49–58.