Bibliotherapy: Reading your way to better Mental Healthby Nicola on 2013-03-25
Reading your way to better Mental Health
By Dr Nicola Davies
There is growing concern over the mental health in Nunavut, especially among Inuit. This concern is well-founded, with one small community-based study identifying higher than expected rates of depression, anxiety and alcohol use in Nunavut (Haggarty et al., 1999). Indeed, rates of these illnesses exceeded those of other Canadian Indigenous communities. In addition, a one-year chart review carried out in Iqaluit found that the most common diagnoses given were (Law & Hutton, 2007):
- Adjustment Disorder
- Major Depression
Frequent co-morbidities included:
- Substance Abuse
- Mood Disorder
- Post-Traumatic Stress Disorder
- Personality Disorder
When tackling mental health and well-being, it is important to consider that the practice of modern day psychological treatment embraces more than counselling or psychotherapy sessions and, indeed, more than merely prescribing psychotropic medications. The spectrum of psychological interventions has broadened to include self-help initiatives, such as Bibliotherapy.
Bibliotherapy is the addition of targeted, relevant literature to a client’s treatment. This reading material is read by the individual outside of the therapy session. Bibliotherapy originated in the 1930’s in libraries that categorized books and other written material designed to help people modify how they felt, what they thought, or their behaviors. Librarians and counselors worked together to select (or “subscribe”) the literature to people with various problems. Today, this type of literature, used for therapeutic purposes, is known as ‘self-help’ and covers every conceivable subject imaginable.
As simplistic as this treatment may appear to be, Bibliotherapy has proven to be an effective tool in helping people to cope with complex emotional problems, life changes and mental illness. Evidence that such therapy facilitates positive behavioral changes is increasingly documented within the literature (Campbell & Smith, 2003).
Bibliotherapy in Action
One of the key benefits of bibliotherapy is that it provides an opportunity for readers to directly identify with the people within the pages. An association is developed, helping people release pent up emotions and open up to the possibility that they can change the direction of their lives, as have the people within the book. It also serves to help promote and develop personality growth. Indeed, bibliotherapy has proven to be essential in helping people cope more effectively in areas such as child abuse, death, divorce and hundreds of other life situations (Campbell & Smith, 2003).
Reading books, articles or other literature that relates to the issues a person faces is beneficial for providing education about a problem, aiding with recovery, and providing tools for living and staying healthy. For example, a person with an eating disorder can be helped with information relating to the various stages of their disorder; from the cultural bias of being overweight through to dieting and keeping the weight off.
Examples of the successful application of bibliotherapy include treatment of alcohol or substance abuse, eating disorders, agoraphobia and a host of anxiety, mood and stress disorders. A study published in Behavior Therapy reported the effectiveness of bibliotherapy for people with panic disorder, with or without agoraphobia (Nordin, 2010). A much earlier study found similar benefits of bibliotherapy for panic disorder, especially when combined with group therapy (Lidren et al., 1994). Not only did the two combined reduce the number and severity of panic attacks, depression and other symptoms, but it was also found to increase self-efficacy (i.e. self-belief in overcoming the disorder).
The successful use of bibliotherapy is based on the keen awareness of the individual’s circumstances, personality and emotions. Treatment requires very careful planning so that the individual’s goals can be met with resulting desired outcomes. This includes the eventual ability of the client to relate, and then respond, to the materials within the self-help literature. Armed with this, clients ideally will experience an emotional cleansing along with insight into their problems, both of which are needed to make positive changes.
Bibliotherapy can be approached in a variety of ways in order to provide individualized support. Indeed, several approaches to bibliotherapy have developed since its inception. So-called “traditional” bibliotherapy, intended to get individuals to react positively or negatively to reading material, is not commonly practiced today. Instead, more modern applications are used, such as encouraging interactivity, connection and enlightenment. Since its underlying premise is to guide clients to identify with the characters in the material, successful bibliotherapy places an emphasis on encouraging association with these characters. Such association facilitates the release of emotions, including letting go of the feelings of isolation often experienced when a person believes they alone have a specific problem. Following this association, in many cases, comes new ways of interacting, problem-solving and living based upon reflection of what has been read.
Recent bibliotherapy has increasingly added interactivity to the therapeutic process. The reader actually becomes connected to the character on an intellectual and emotional level. As such, a response occurs that includes making positive behavioral changes such as participation in positive activities like writing in journals and group discussions (Anderson & MacCurdy, 2000; Morawski & Gilbert, 2000).
The Future of Bibliotherapy
Photo courtesy of David Ho.
Along with the diversity of issues people face in society, the practice of bibliography is expected to expand as a therapeutic tool. Its use has grown extensively in treating children and teens with various problems. Most recently, it has been met with success in treating very young children (Dirks, 2010).
Bibliotherapy is also currently incorporated into therapy for people with problems in areas which were once left unspoken, such as sexual dysfunction (Mintz, Balzer, & Bush, 2010).
Worldwide, bibliotherapy is used as a companion to more traditional therapies for people of all ages, situations and disorders. With a documented track record of success, it is expected to continue to be one form of therapy widely used around the globe – both as an adjunct to other treatments and as a sole self-help tool.
Dr Nicola Davies is a Psychology Consultant and Freelance Writer with an interest in health and well-being. Her publications can be viewed at www.healthpsychologyconsultancy.com. Alternatively, you might like to sign up to her free blog: http://healthpsychologyconsultancy.wordpress.com/
Anderson, C. M. & MacCurdy, M. M. (2000). Writing and healing: Toward an informed practice. Urbana, IL: National Council of Teachers of English.
Campbell, L. F., & Smith, T. P. (2003). Integrating self-help books into psychotherapy. Journal of Clinical Psychology, 59(2), 177-186.
Dirks, K.L. (2010). Bibliotherapy for the Inclusive Elementary Classroom. Senior Honors Theses. Paper 237.
Lidren, D.M., Watkins, P.L., Gould, R.A., Clum, G.A., Asterino, M., & Tulloch, H.L. (1994). A comparison of bibliotherapy and group therapy in the treatment of panic disorder. Journal of Consulting and Clinical Psychology, 62, 865–869.
Haggarty, J, Cernovsky, Z, Kermeen, P, & Merskey, H. (1999). Psychiatric disorders in an Arctic community. Canadian Journal of Psychiatry, 45(4): 357-362.
Law, S & Hutton, EM. (2007). Community Psychiatry in the Canadian Arctic – Reflections from a 1year continuous consultation series in Iqaluit, Nunavut. Canadian Journal of Community Mental Health, 26(2): 123-140.
Mintz, L., Balzer, A., & Bush, H. (2010). Bibliotherapy for low sexual desire among women: Evidence for effectiveness. Presented at the 118th Convention of the American Psychological Association, San Diego, CA, August 2010.
Morawski, C. M. & Gilbert, J. N. (2000). Developmental interactive bibliotherapy. College Teaching, 48(3), 108-114.
Nordin, S., Carlbring, P., Cuijpers, P., & Andersson, G. (2010). Expanding the limits of bibliotherapy for panic disorder. Behavior Therapy, 41, 267-276.