How Does Bibliotherapy Work?

Bibliotherapy is a form of creative arts therapy that uses literature to help you improve your life by providing information, support, and guidance through reading books and stories. Books and other written material can influence human emotions and provide wisdom, emotional connection, insight, and comfort. 

When dealing with conditions such as anxiety and depression or coping with grief, sometimes it can be challenging to make sense of what is happening in your mind and body, especially if you don’t have any other experience to compare it to. Bibliotherapy is a way to help bridge this gap.

Understanding Bibliotherapy

The concept of reading as a way to help facilitate the healing process and meet therapeutic goals is a common strategy in many treatment approaches. So what separates bibliotherapy from other established theories of psychotherapy such as cognitive behavioral therapy (CBT)?

What makes bibliotherapy different is the fact that a therapist will typically view bibliotherapy as a therapeutic approach, and therefore, use it as an adjunct part of the treatment process.

When used in a group therapy setting, bibliotherapy allows participants to give and receive feedback about their interpretations of the literature and how it relates to their issues. It also helps improve communication and encourages more in-depth conversations and connections for participants. 

Types of Bibliotherapy

There are a number of types of bibliotherapy that can be used in clinical and educational settings as well as at home.

• Creative bibliotherapy, which often takes place in a group setting, with stories, poems, and fiction read and discussed by the group
• Developmental bibliotherapy, which is used in educational settings as well as by parents to explain childhood and adolescent issues like puberty or bullying
• Prescriptive bibliotherapy, which uses self-help books either in a clinical setting or at home to help modify thought patterns, feelings, and actions
• Therapeutic bibliography, which is used in combination with other types of therapy to manage psychological issues

Bibliotherapy Techniques

If bibliotherapy sounds like a good fit, you might be wondering how a therapist uses this tool during a counseling session. Sam Gladding, PhD, a professor at Wake Forest University's Online Master’s in Counseling and Human Services program who specializes in creativity in counseling describes bibliotherapy as a dynamic three-way interaction involving the use of a book, a counselor, and a client.

Gladding points out that it’s crucial that the book or story relates directly to the client's difficulty so that they identify with the protagonist in the novel or story. The counselor and client then come back together to talk about the way the protagonist handled their problems and the applicability of the solution or solutions in the book to the client's situation. 

Licensed marriage and family therapist, Chad Perman, MA, LMFT, of New Page Therapy agrees: "Typically, therapists will use bibliotherapy to assign clients specific books to read outside of the session," he says. This strategy, says Perman, can help facilitate empathy, insight, conversation, and self-growth.

Most therapists trained in bibliotherapy will have a list of books that relate to different issues. There are also several sites and databases online that give suggested or recommended titles based on a particular concern or mental health issue.

What Bibliotherapy Can Help With

While reading, in general, is beneficial to just about everybody, Perman says targeted bibliotherapy can be specifically useful for the following issues:

• Anxiety
• Depression
• Eating disorders
• Existential concerns such as loneliness, meaninglessness, freedom, and death
• Relationship issues
• Substance use

Gladding adds that bibliotherapy may also be helpful for managing anger, socially inappropriate behavior, and shyness. "Issues regarding how to handle grief, rejection, or almost any of the negative 'isms' such as racism, sexism, ageism, may also be addressed through bibliotherapy," says Gladding. 

Benefits of Bibliotherapy

When using bibliotherapy, a therapist might choose a self-help reference such as a workbook of calming exercises for a person with anxiety. Or, they may select a story with a fictional character that is dealing with grief and trauma from losing a loved one for a client who recently experienced a death in the family.

Gain Personal Insight

Bibliotherapy helps you to gain insight into the personal challenges you’re dealing with and develop strategies to address the most concerning issues. It can also help promote problem-solving, understanding, and self-awareness.

Receive Benefits Outside of Treatment

Agreeing on a book to read in-between sessions gives the therapist a format for assigning homework outside of treatment. This approach can help deepen the meaning of a therapeutic session and facilitate greater learning. Another way a therapist can use bibliotherapy, says Gladding, is through a prevention model, which can help people learn ways of coping with life's challenges.

Gain Perspective

One of the more compelling reasons for using bibliotherapy is that it can help you see how other people, such as characters in a book, address and deal with similar issues. When you identify with a fictional or non-fictional character, especially on an emotional level, you're able to see that there are others who are also navigating and coping with personal struggles. 

Effectiveness of Bibliotherapy

Studies show that bibliotherapy can by useful in the treatment of anxiety, depression, eating disorders, and more.

Depression

A systematic review found bibliotherapy to be an effective long-term treatment for adults with mild depression. After follow-up periods ranging from three months to three years, six adults showed a decrease in depressive symptoms.

Eating Disorders

An online survey found self-help bibliotherapy to be more effective than fiction about eating disorders which was perceived by participants as detrimental to their mood, self-esteem, body image, and diet and exercise habits.

Child Behavior

Creative bibliotherapy has been found to be effective in helping children, ages 5 to 16, with internalizing behaviors (anxiety and depression), externalizing behavior (aggression), and prosocial behavior (behavior intentions and attitudes toward others).

Anxiety and Stress

One study in college students found that 10 weeks of mindfulness-based stress reduction bibliotherapy resulted in a significant decrease in anxiety, stress, perceived stress, and anxiety sensitivity as well as an increase in overall quality of life.

Things to Consider

While bibliotherapy can benefit people of all ages with a vast range of needs, it will only be effective if you’re willing to read and share. In general, bibliotherapy is not recommended if you or someone you love:

• Is experiencing psychosis and is unable to distinguish reality from fantasy
• Has limited intellectual ability or attention span
• Does not enjoy reading

The books that your therapist suggests may also vary depending on your needs and preferences. For example, if you dislike reading fiction books, your therapist might recommend non-fiction stories or therapeutic workbooks.

Certain types of books and literature should be avoided in bibliotherapy. This includes propaganda and misleading information that promotes harmful, destructive, or false beliefs.

How to Get Started

When searching for a therapist who incorporates bibliotherapy into their treatment sessions, the first place to look is online. You can search this specialty by Googling bibliotherapy + your city. For example, "bibliotherapy + Seattle." 

In addition to training in bibliotherapy, make sure to check for other credentials and titles such as LMFT, LCSW, PsyD, PhD, psychotherapist, and licensed professional counselor (LPC) when conducting your search.

Perman says if you're looking for a therapist with more formal training in bibliotherapy, you can find a directory of providers on the International Federation for Biblio/Poetry Therapy website.

There are a number of professionals from many helping disciplines that belong to The National Association for Poetry Therapy, according to Gladding. He says this group uses the word "poetry" broadly to mean any written word. An excellent place to start is by looking at their website and publications.

Additionally, checking Google Scholar and other academic sources may yield scholars who are also counselors and can either help directly or recommend others who can. 

Takeaway

Bibliotherapy can be a helpful tool for gaining insight into the challenges you are facing. It can be something your therapist uses to spark conversations about your experiences and how to cope. It's also something you might try on your own by reading novels, self-help books, or therapeutic workbooks that focus on the specific issues you are experiencing. If it sounds right for your, look online to find a bibliotherapist in your area who can provide further guidance.