Evaluation of bibliotherapy joanne callinan hslg 2013

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Evaluation of bibliotherapy joanne callinan hslg 2013

  1. 1. Evaluation of Bibliotherapy ServiceJoanne CallinanLibrarian, Milford Care CentreFunding obtained from the Irish Hospice Foundation
  2. 2. Bibliotherapy• Concept of bibliotherapy is not new• Reading therapy, healthy reading• Therapeutic use of reading material(written word)
  3. 3. Self-helpGP Prescriber SchemeClinical bibliotherapy
  4. 4. Grief• Death of a spouse ranks first out of 43 stressfulevents Social Readjustment Rating Scale(Holmes & Holmes, 1970)• Responses to grief may be emotional such asfear, guilt, anxiety, depression and anger;physical such as weight loss or gain, insomniaand increased risk of illness; behavioural andspiritual.
  5. 5. Objectives1. To develop a list of recommendedresources which will consist of evidencebased self-help materials2. Selection of material, implementation andadministration of the program.3. To evaluate the impact of structuredBibliotherapy from the library,bereavement service users and socialworker / volunteer perspectives.
  6. 6. Workbooks
  7. 7. Evaluation1.• Semi structured interviews with focus groupbereavement support volunteers, social workers todetermine their attitudes and experiences of theMCC Bibliotherapy Service before and after2.• Audit of borrowing from the collection3.• Book comment sheets returned by book users–they included question such as (a) did you find thisbook useful? (b) would you recommend it tosomeone who
  8. 8. Qualitative ResearchSemi-structuredinterviewsSocial workers (n= 5)Focus GroupBereavement supportvolunteers (n= 5)
  9. 9. of bibliotherapy?• Three social workers had heard of the word“bibliotherapy”• One participant mentioned a book that she hadread “Bibliotherapy for bereaved children”• One participant had worked with an art therapistwho used stories with children• They all had used literature and recommendedbooks to bereaved clients
  10. 10. How do you decide what literature to use?• Depended on what material was available in the SocialWork Department• Searched for additional material on the internet• Importance of material that is suitable and specific to theneed of the individual• Academic ability of the person, their relationship to theperson who had died, their experience of it and how theywant to come at it
  11. 11. What experiences have you had so far?• All of the participants had experience of using literaturesuch as leaflets & pamphlets for bereavement fromCruse• “They’re easy reading I suppose and they synopsizethings for people”• Some participants said they used it as “standardpractice” a lot of the time or as the need arises• BSV: “I don’t think I’ve ever in a group situation said Ithink it would be good for people to read x,y,zbooks..which now that I think of it - I wonder aboutbecause I think reading can have many benefits.”
  12. 12. How do you decide when and withwhom to use it?• Depends on the individual situation• Participants generally know from their ownassessment whether it would be beneficial• Where an appointment with a social worker isnot possible for awhile, sending out literaturemight provide a bridge• If someone wasn’t open to engaging in one-to-one direct support
  13. 13. Experiences of using literature• “It is good to give themsomething in writing aswell as having a session….To take away withthem even if theydon’t read itstraight away, theycan go back to it…soI would use it quite a bitreally in terms ofbereavement work”• “It’s always handy to have areference or some booklet toexplain things to people thatare stuck in any way sothey don’t have to takesomeone’s account asthe only source ofinformation -foraffirmation”
  14. 14. Normalization of grief reactionsIf someone is specifically looking for normalisationaround their grief, I would often give them a 2 pagesheet of paper with normal grief reactions. If I have asense that they might be able for more, I might givethem a leaflet..And if they come and say I’m really intoreading books, then I might go to the next level,recommending a book
  15. 15. Literature specific to the individualI was even looking this morning ..I was sending out agirl stuff because she’d lost a grandparent and anuncle. I couldn’t find anything on the loss of agrandparent now. I ‘m sure there could besomewhere but that’s an example …… a lot of thestuff I’ve sent her out is on the loss of a parent orsibling ……whereas, looking for the more specificstuff is an ongoing thing… …
  16. 16. What responses have you had with thosewhom you have used it?• Reactions to bibliotherapy had been mixed but overall itwas positive• Can be difficult to know people’s response to itsometimes• Positive response: It can reduce people’s sense ofisolation and that a lot of people have the same feelingsas them• Negative effect: The opposite could be true. It mayreinforce their sense of isolation further.“The negative has been that people feel that it doesn’t really reflect theirexperience, it’s the opposite effect. they feel there the only ones who feelthat particular way.”
  17. 17. Positive feedback from parentZ was a parent whose child was terminally ill.She was able to track down an article from theLibrary that was on adults coping with a childwith life-long illness and they found that sohelpful. It was a massive support to them
  18. 18. Comments• “Books aren’t written for individuals. They’re written to give genericadvice and how there interpreted or perceived then depends very muchon the individual and where there at. You definitely get a variety offeedback”• BSV “The feedback I would be getting is that they are looking forsomething. It came up towards the end of a session one night”• “They’re apologizing.. they don’t have the time…sometimes when itcomes to it, they may not have the inclination and that’s more for books,…..sometimes people feel they can maybe dip in and out of it so theyread a little bit and come back to it in their own time .”
  19. 19. NormalizationWhat I would find is that a lot of people comeback and say I was finding it hard to findsomeone who knew what I was talking aboutbut when I read the booklet, it showed me thefeelings were normal….that I wasn’t goingmad cause, sometimes when people aregrieving, they can be afraid they’re loosingtheir mind nearly, they’re so distraught so ithelps that as well
  20. 20. Are there any barriers to it’simplementation or use?• Whether to loan books and the process forborrowing - difficulty getting books back• Illiteracy• Some people don’t like reading• Books might be written too theoretical/academic, small print, no pictures- might be off-putting for some people
  21. 21. What do you feel the benefits ofbibliotherapy have been?• Reassurance for people that what they are feelingis normal• It allows people “to do for themselves”• Less dependent on others for support• Allows people to do use it in the privacy of theirown home and in their own time• People have more control over whether they takeit on board and when• Could be considered more objective when it iswritten down
  22. 22. Children’s booksI certainly think that with the parents that itdoes aid communication and conversationshappening between parents and children inpreparation for a death or trying to makesense of the grief afterwards
  23. 23. Difficulties• Awareness• Logistical• Ensure the trolley is marked clearly• Not enough time in the group session• Difficulty concentrating on reading
  24. 24. Do you think it would be beneficial in abereavement support service ?All of the participants said it would be beneficial in bereavement supportIt can compliment other therapies“Been able to tailor it to the specific need”“Some people aren’t open to one-to-one support..they just don’t want togo there..in that way bibliotherapy could be useful..they could get a bitof support from the literature”
  25. 25. AuditTotal number of books in the trolley 58Number of books for Children 13Number of books for Teenagers 7Number of books borrowed from January to December 58Brochures and Leaflets from Irish Hospice Foundation,Cruse, HSE, and Barnardos were also available 13
  26. 26. Feedback from Bereaved Clients• Fourteen book comment forms were received• Seventy-five per cent were female• Twelve were referring to adults books.• 86% was positive feedback.• 93% would recommend the book to someone who had aloss.• Negative:– One person felt the material in “The Orphaned Adult” was suitedto someone who lost their parents when they were in their 40’s/50’s.– One individual didn’t identify with the personal stories in “Widowto Widow”
  27. 27. • NICE Guidelines have shown thatBibliotherapy is effective in the earlystages of stepped care programmes foranxiety and depression and for alleviatingmild or moderate psychological distress(NICE 2004)Role of bibliotherapy
  28. 28. For future• Ensuring the trolley is open at the start of the night• It’s better to have it at the very start i.e. the 1st or 2ndweek after the group starts• Ensure the trolley is stocked with leaflets / brochures• Ensure updated list of available books / resources isprovided to Social workers and BSV• Have duplicate copies of books that are heavily usede.g. “The Courage to grieve”• Greater accessibility to the trolley• Availability of DVDs or CDs
  29. 29. Links withCompassionate Communities• First project in Ireland, project in Limerick cityand Newcastle West• Watch House Cross Public Library, Moyross,40% of books borrowed from bibliotherapycollection were specifically dealing with death• Dooradoyle Public Library• Poetry Display
  30. 30. A book is the only place in which you can examinea fragile thought without breaking it, or explorean explosive idea without fear it will go off inyour face. It is one of the few havens remainingwhere a mans mind can get both provocationand privacy.~Edward P. Morgan
  31. 31. Joanne CallinanLibrarian / Leabharlannaí,Milford Care Centre, LimerickEmail / R-Phost: j.callinan@milfordcarecentre.ieGO RAIBH MAITH AGAT

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