Bibliotherapy, a therapeutic approach that uses literature to support good mental health, is a versatile and cost-effective treatment option often adapted or used to supplement other types of therapy. Proponents of the approach suggest mild to moderate symptoms of several mood-related conditions can be successfully treated with reading activities.
Both individual and group therapy may utilize this method, which is considered appropriate for children, adolescents, and adults. Mental health professionals may encourage those in therapy and those who are waiting for therapy to read for guidance or self-help, developmental purposes, to learn about mental health concerns, and for the therapeutic benefits of imaginative literature.
Storytelling, creative writing, and reading have long been recognized for their therapeutic potential. The use of literature as a healing method dates back to ancient Greece, when Grecian libraries were seen as sacred places with curative powers. In the early nineteenth century, physicians like Benjamin Rush and Minson Galt II began to use bibliotherapy as an intervention technique in rehabilitation and the treatment of mental health issues. During World Wars I and II, bibliotherapy was used to help returning soldiers deal with both physical and emotional concerns.
In a 1916 article published in The Atlantic Monthly, Samuel Carothers defined bibliotherapy as the process of using books to teach those receiving medical care about their conditions, and Dorland’s Illustrated Medical Dictionary, published in 1941, officially recognized this modality as a form of mental health treatment. Bibliotherapy's use expanded further in the 1950s when Carolyn Shrodes developed a theoretical model based on the premise that people are greatly influenced by the characters they identify with in stories. The American Library Association issued an official definition in 1966, and in 1969, The Association of Poetry Therapy formed, establishing poetry therapy, a form of bibliotherapy, as a treatment modality. In the 1970s, librarian Rhea Rubin classified bibliotherapy into two categories: developmental (for educational settings) and therapeutic (for mental health settings). Her 1978 work, Using Bibliotherapy: A Guide to Theory and Practice, contributed greatly to developments in the field. In 1983, The International Federation for Biblio/Poetry Therapy was established.
Today, bibliotherapy is employed by educators, helping professionals, librarians, and even parents. Its versatility and adaptability make it an excellent supplement to self-improvement of all kinds.
Developmental bibliotherapy, primarily used in educational settings, addresses typical childhood and adolescent concerns such as puberty, bodily functions, or developmental milestones. Educators or medical professionals may often encourage parents to use this approach with their children.
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Therapeutic bibliotherapy takes many forms and can be used in conjunction with many different therapeutic frameworks. Reading has been shown to be able to help people understand the issues they are experiencing, amplify the effects of other treatment, normalize experiences with mental health concerns and care, and offer hope for positive change. Bibliotherapy can also expedite and intensify the therapeutic process by providing one potential format for therapeutic work outside of session.
The approach may be incorporated in one or more of the following ways:
- Prescriptive bibliotherapy, which is also referred to as self-help, involves the use of specific reading materials and workbooks to address a variety of mental health concerns. Self-help may be conducted with or without the guidance of a therapist. A cognitive behavioral therapist teaching someone deep breathing and emotion regulation techniques may provide that person with a practice workbook to use at home, for example.
- Books on Prescription is a program where reading materials targeting specific mental health needs are "prescribed" by mental health professionals, who might use resources such as the Bibliotherapy Education Project to find the appropriate books. Most libraries in the United States carry a set of books from the approved list for this purpose, often providing as a book list on their website. The Carnegie Library of Pittsburg is one such library. Their website also lists books for children, which cover topics like adoption, self-esteem, grief, divorce, and more.
- Creative bibliotherapy utilizes imaginative literature—novels, short stories, poetry, plays, and biographies—to improve psychological well-being. Through the incorporation of carefully selected literary works, therapists can often guide people in treatment on a journey of self-discovery. This method is most beneficial when people are able to identify with a character, experience an emotional catharsis as a result of this identification, and then gain insight about their own life experiences. A therapist might use Our Gracie Aunt by Jacqueline Woodson, a story about a brother and sister who live with their aunt due to their mother's neglect, with a child who has experienced abuse to build interactive discussions and activities around the child's experience of the story.
While this method is not typically recommended instead of a more conventional form of therapy, it is frequently used by individuals in therapy and those who are waiting to receive therapy. In the U.K., where individuals seeking professional mental health treatment may wait up to six months, bibliotherapy is considered a first step in treatment for those who do not need immediate help.
Reading can benefit individuals of any age by increasing self-awareness, improving self-esteem, and aiding in the ability to face developmental crises. Studies show reading as a form of therapy to be useful in the treatment of depression, mild alcohol abuse, anxiety, eating disorders, and communication issues.
People in therapy for issues such as family-related challenges, posttraumatic stress, or grief might also benefit from the incorporation of books and reading activities into the approach being used. Books can be incorporated easily into any number of modalities, such as family systems therapy, play therapy, and cognitive behavioral therapy, among others.
While many therapists include elements of bibliotherapy in their work with people in treatment, The International Federation for Biblio/Poetry Therapy (IFBPT) has set official standards for the practice. Practitioners interested in becoming certified poetry therapists (an umbrella term encompassing the fields of bibliotherapy, poetry therapy, and journal therapy) can pursue training from the IFBPT to obtain credentials. Studies show reading as a form of therapy to be useful in the treatment of depression, mild alcohol abuse, anxiety, eating disorders, and communication issues.
Credentials offered include:
- Certified Applied Poetry Facilitator (CAPF): These individuals typically have a bachelor's degree and some experience in psychology. They work primarily with individuals who are not experiencing mental health concerns, but they are trained to recognize when an individual is experiencing distress and may benefit from a referral to a mental health professional. They often work in schools or libraries but are often able to work in a mental health setting with the supervision of a qualified professional.
- Certified Poetry Therapist (CPT), Registered Poetry Therapist (PTR): Individuals who wish to complete requirements for either of these certifications are required to have post-graduate mental health training. They are generally licensed to work on their own with people who are experiencing mental health concerns. They may also be medical doctors. A registered poetry therapist completes advanced coursework and study to obtain the "registered" credential.
Training involves workshops and courses, peer experience, and field work, which is completed under the guidance of a mentor/supervisor. It is not necessary for a poetry therapist to be proficient in creative writing. More information can be found on the IFBPT website.
Most professionals agree reading is a productive activity that can promote good mental health, as reading has been shown to increase empathy, sharpen the mind, and impact behavior. One study found children who read the Harry Potter series were more accepting of certain minority groups, and psychologists from the New School for Social Research determined fiction improved a reader's overall ability to discern and interpret emotion in others.
Anecdotal research suggests bibliotherapy may offer significant benefit in the treatment of mental health issues, and its popularity among mental health professionals further implies positive results. Many therapists believe the inclusion of books in treatment increases participation in therapy and can decrease recovery time, providing more opportunity for insight and behavioral change while also allowing people to take more responsibility in their therapy work. Research on the efficacy of the method has shown it to be a helpful part of the treatment process for those experiencing depression, anxiety, and substance dependency.
Further research may yield more details regarding efficacy and benefits. Presently, bibliotherapy is believed to be one cost-effective and versatile option for the treatment of several mental health issues.
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