What Is Bibliotherapy And Can It Help With Children And Mental Health?

"Books serve to show a man that those original thoughts of his aren't very new after all." - Abraham Lincoln

Have you ever read a book that drew you in and made you feel like you were a part of the story? How about a book that made you happy or sad, or changed the way you view a particular situation? If you have, you may understand the basic rationale behind bibliotherapy.

Bibliotherapy, just like other creative arts therapies, has been gaining popularity in the past few years. It has been said that bibliotherapy can help you work through emotions, learn how to handle them better and get through some of life's more difficult times. 

What is bibliotherapy? Definitions of bibliotherapy

We can attempt to define bibliotherapy by looking at the two root words from which it is derived.

However, that is quite a general definition. The American Association of Psychology defines bibliotherapy as "a form of therapy that uses structured reading material." It then expands on this by highlighting that bibliotherapy is frequently used in combination with other forms of psychotherapy to reinforce particular concepts or demonstrate behavioral strategies. 

In 1966, an American Library Association division referred to as the Association of Hospital and Institution Libraries defined bibliotherapy as “the use of selected reading materials as therapeutic adjuvants in medicine and psychiatry; also guidance in the solution of personal problems through directed reading."

Apart from referring to the technique, "bibliotherapy" can also refer to the actual printed material used in the technique.

The history of using books and both fictional and nonfictional literature as therapy

Reading has long been known to have therapeutic value. The effect of the written word on a person's emotions and mental state has been acknowledged from the times of the Ancient Egyptians. For example, the entrance to the library of King Ramses II of Egypt was adorned with the inscription "The House of Healing for The Soul."

Hospitals have used literature to counsel both practitioners and patients dating back to the Ancient Greeks. The Greek philosopher Aristotle has pointed out the connection between books and wellness, suggesting that reading works of fiction could promote healing.

In the early 1800s, physicians Benjamin Rush and John Minson Galt II advocated for reading as entertainment and therapy. They influenced the development of patients' libraries in mental hospitals. During the First World War, military hospitals used the resources in their libraries to combat emotional trauma in wounded soldiers and returning veterans.

It was around 1916, that Presbyterian minister and writer Samuel Crothers coined the word "bibliotherapy" to describe the "process in which specific literature, both fiction and non-fiction, was prescribed as medicine for a variety of ailments."

Throughout its history, bibliotherapy has been closely linked to libraries and, in particular, to hospital libraries. However, it was not until the mid-1900s that its use became more widespread, reaching into areas such as general medical practice and education.

Types of bibliotherapy for children and individuals with mental health issues

There are various ways in which bibliotherapy may be delivered, depending on the client's needs. Let us take a look at each one.

Developmental bibliotherapy

This form of bibliotherapy can be seen when teachers and parents use books or other printed material to help children understand the developmental milestones they are going through. Typical topics aimed at young and adolescent children include losing baby teeth and puberty.

Reading material that aims to inform older persons about aging milestones can also be considered Developmental Bibliotherapy. The information helps the reader to better understand and cope with the changes they are going through.

Prescriptive bibliotherapy for treating mental health concerns

Also known as Self-Help, Prescriptive Bibliotherapy can be used to treat a range of mental health concerns. In this form of bibliotherapy, the therapist may suggest a self-help workbook with exercises and techniques for the client to practice outside of the time spent in the session. Examples include behavior modification exercises for someone receiving help with anger management or breathing exercises to cope with an anxiety disorder.

The material may also be educational information on the client's specific mental health issue, the treatment process they are engaged in, and what they can expect at each stage. Additionally, a therapist utilizing Prescriptive Bibliotherapy might suggest specific reading material to help clients get through a difficult time in their life, such as a divorce or empty nest syndrome.

Books on prescription

This approach to bibliotherapy involves collaboration between mental health professionals and public libraries. Therapists "prescribe" books for their clients based on a predetermined list of books dealing with different mental health conditions. Public libraries are provided with the list and generally carry one or more copies of each book.

Instead of buying the "prescribed" book, the client can borrow it from the library and return it once they are done with it. 

Creative bibliotherapy which uses both fictional and nonfictional literature

Creative Bibliotherapy relies heavily on works of fiction, such as novels and plays, but may also include biographies and autobiographies. It takes the reader/client through three distinct stages:

Identification

The reader identifies with one of the characters in the book, who may be facing the same situations or uncertainties that they are facing. This provides the reader with the feeling that they are not the first or only ones to go through this issue and that others have found ways to overcome it.

Catharsis

Psychological catharsis involves the release of pent-up emotions and relief from the stress associated with them. Reading about someone else's experience with a painful situation similar to our own (even if the story is fictional) can help us examine our own situation and its negative effects on our thoughts, emotions, and behavior. By bringing them to the fore and acknowledging them, we become better able to deal with them.

Insight

Through identification and catharsis, the reader comes to a better understanding of themselves and their life experiences. The reader can reflect on their situation and judge whether the solution offered by the story will work for them.

Who is bibliotherapy for?

The technique is often used to address mild to moderate symptoms of a range of social, emotional, behavioral, and psychological conditions. It can be used to supplement traditional forms of therapy when treating patients with:

• Mood disorders, such as depression
• Anxiety, including illness anxiety disorder (hypochondria)
• Stress due to somatic symptom disorder
• Mild alcohol and substance misuse
• Various types of addiction
• Stress-related physical disorders
• Eating disorders
• Grief
• Post-traumatic stress disorder (PTSD)
• Sexual dysfunction
• Anger management issues
• Low self-esteem
• Agoraphobia
• Developmental crises
• Interpersonal issues, including family-related and communication issues

Apart from persons dealing with the conditions and issues listed above, almost anyone can benefit from bibliotherapy to bolster their personal growth. It can help persons in need of coping strategies to transition through milestones, such as becoming a parent, entering retirement, graduating from college, and major relocation. Bibliotherapy is also useful to persons who have endured abuse and those engaging in self-destructive behaviors or coping with a chronic illness.

While persons who enjoy reading fiction and those who routinely use works of non-fiction as sources of information will enjoy the technique, you do not have to be an avid reader for bibliotherapy to help you. Professionals who offer bibliotherapy are trained to discern what type of material is best suited for you, which they will recommend.

Who is bibliotherapy NOT for?

While a therapist can adapt the delivery of bibliotherapy to suit the vast majority of clients, there are some instances in which the technique is not recommended. These include cases where the client is psychotic and so cannot distinguish reality from fantasy. They, along with clients who display limited attention span and those with limited intellectual ability, would be better served with other approaches to therapy rather than using bibliotherapy.

Likewise, someone who does not enjoy reading and who would not normally read for entertainment or as a way to seek out information may not be the right fit for bibliotherapy.

International Federation for Biblio Poetry Therapy: Who can provide bibliotherapy? 

The term bibliotherapist is usually used for someone who has received formal training and certification in bibliotherapy. The International Federation for Biblio/Poetry Therapy (IFBPT), which uses the term "poetry therapy" to include "applied poetry facilitation, journal therapy, bibliotherapy, biblio/poetry therapy, and poetry/journal therapy," trains and certifies three categories of bibliotherapists:

Certified applied poetry facilitator (CAPF)

This type of bibliotherapist possesses a Bachelor's degree (at minimum) along with "love and knowledge of literature and writing with an understanding of basic psychology and group dynamics." Their training in bibliotherapy equips them to work with generally healthy individuals and groups in schools, libraries, and other developmental settings.

While they are trained to discern symptoms of mental illness, CAPFs must refer distressed clients to appropriate mental health professionals. Also, CAPFs must be supervised by a qualified mental health professional when they work in mental health settings.

Certified poetry therapist (CPT)

The Certified Poetry Therapist designation is reserved for those who have completed training in bibliotherapy and are either a medical doctor or have at least a Master's degree in a mental health field. 

Registered poetry therapist (PTR)

These bibliotherapists have the same medical or mental health qualifications as the CPTs. Still, they have "an advanced level of training and fieldwork, commensurate with the highest levels of clinical practice." The PTR designation is the highest one awarded by the IFBPT.

Whether or not they are formally trained in bibliotherapy, many different mental health professionals use bibliotherapy as a part of their range of treatments for clients. These include psychiatrists, psychologists, counselors, therapists, and clinical social workers.

The connection between bibliotherapy and writing therapy

Bibliotherapy and writing or journal therapy often go hand-in-hand because writing has been shown to make the act of reading even more therapeutic in several ways. On the one hand, thoughts and emotions evoked by the reading material can be jotted down for a discussion with the therapist in session.

On the other hand, writing provides a way to express how reading relates to and affects you. Writing in bibliotherapy helps you build greater awareness of yourself as it allows for a deeper understanding of both what is read and your reaction to it.

Aside from writing therapy, other forms of creative arts therapies (dance, music, art, and drama) are often combined with bibliotherapy as a mode of expression for the client. These outlets of expression can prove to be particularly useful with children who may not be able to write or have not mastered expression through writing.

Seven benefits of bibliotherapy

Here are seven other reasons bibliotherapy is a good choice.

1. Books are available on a wide and ever-increasing range of topics.
2. The range of material means there is something to suit every kind of reader.
3. Any printed material can be used, as well as movies, videos, and songs.
4. Bibliotherapy is less costly than many other forms of therapy.
5. Bibliotherapy can be done remotely.
6. Persons may choose to use audiobooks instead of printed ones.
7. The material can be read to young children who have not yet mastered reading.

Furthermore, when used with other therapies, bibliotherapy can heighten their benefits and reduce the time and money spent on those therapies.

A couple of precautions

Because of bibliotherapy's self-directed, self-help nature, some persons might opt to treat themselves and refrain from seeking professional advice about the issue they are facing. However, a trained professional would have been able to listen to their symptoms, diagnose the problem, and guide them through bibliotherapy if it is indeed the recommended approach.

Additionally, many self-help books are available, promising to help the reader cope with personal issues such as grief, low self-esteem, and depression. However, not all of these books have been verified as to the validity of their content. As such, they may pose more of a risk to the reader's well-being instead of delivering the help they claim.

Get support with online therapy

Looking for a therapist to support your bibliotherapy or other progress? Regain has options available for you including phone and video sessions with a specifically matched mental health professional. These sessions can happen on your schedule from your own home.

Additionally, online therapy has been found in recent studies to be just as effective as in person therapy for delivering reliable and results-oriented assistance. It can also be more affordable to those for whom traditional therapy is not an easy option.