Bibliotherapy is a form of therapy that involves reading as part of the treatment process. It can be used for various mental health issues like depression, anxiety, and trauma. Reading materials are selected that are intended to help address a person's problems or symptoms. Research has found bibliotherapy can be an effective treatment for conditions like depression when used as part of a guided program with a mental health professional. It has also shown benefits for caregivers. Bibliotherapy can be delivered individually or in a group setting and the reading materials may include classical literature, psychology-based works, or self-help books.

1. BIBLIOTHERAPY
Dr.M.Ranganathan
Professor (Rtd)
Department of Psychiatric Social Work
NIMHANS, Bangalore

2. Introduction
• Bibliotherapy is a form of clinical or self-
empowerment therapy, often used in
connection to psychotherapy, that includes
reading as a part of a treatment.
• Therapeutic reading is useful for mental
health disorders (anxiety disorders, mood
disorders, depressive episodes, phobias, sleep
disorders ) or for strengthening psychological
well-being

3. Brief History
• In the midst of the First World War, doctors at
the Alabama Military Hospital in the United
States used books to relieve posttraumatic
stress for soldiers returning from the war.
• Then, the 1950s marked the proliferation of
research on bibliotherapy in a wide variety of
fields (nursing, social work, education)

4. • Bibliotherapy is the use of a set of selected
readings as therapeutic tools in medicine and
psychiatry;
• a way to solve personal problems through
directed reading
• The first known organized form of bibliotherapy
in clinical settings can be dated back to thirteenth
century Egypt where the hospital staff and
religious leaders at the Al Mansour Hospital in
Cairo read the Quran to their patients in addition
to medical treatment (Ruben, 1978)

5. • It was religious texts that came to be the most
used literature for early bibliotherapy up until
the mid-nineteenth century. (Tews, 1969)
• In the 1970s, it was applied to individuals
suffering from eating disorders or childhood
disorders and elderly.

6. Definition
• Bibliotherapy" be defined as a program of
selected activity involving reading materials
which is planned, conducted, and guided by a
mental health professionals.

7. • Three categories of books used in
bibliotherapy are identified
– the classical repertoire (novel, poetry, biography,
fiction)
– works based on theme psychology; they can
describe a current disorder as well as provide
information on a specific disorder.
– self-help books

8. • Aristotle (384–322 BC) presented the concept
of using literature and drama for healing and
purification (catharsis) of negative emotions.
• the neurologist Sigmund Freud (1856–1939)
referred to Aristotle's idea of catharsis when
describing how literature can have a
therapeutic effect on negative emotions
(Sachs, 1949).

9. • Similar connections between literature and
therapy can also be found in the architecture.
• Inspired by Freud's work, fairytales, symbols,
and myths became a central theme within the
Jungian psychoanalytic context.

10. • Bibliotherapy can be called
– developmental bibliotherapy
– cognitive behavioral bibliotherapy
– CBT mainly uses self-help books

11. • self-help books are an additional form of
bibliotherapy that can be used in conjunction
with cognitive behavioral therapy.
• Depression, anxiety (Popa, 2017), posttraumatic
stress disorder (Glavin, 2017), panic attacks,
insomnia and stress, and strokes and their
psychological consequences are some examples
of psychiatric and psychological conditions where
self-help books have been proven to be helpful.

12. Indicators
• Restored clinical conditions
• Free from active symptoms
• Reading habits
• Needs and interest

13. Contra-indications
• Qualitative Cognitive deficits
• Poor drug compliance and poor f/up
• Poor family support
• Negative symptoms

14. Clinical Conditions
• Depression (Floyd, 2003)
• Adolescent Depression
• Depression in Older adults
• Dementia
• Suicidal ideations
• Cognitive impairment
• Post-traumatic stress
• Anxiety
• Substance use disorder (AA – Big Book)

15. Non-clinical (Developmental)
• Isolation
• Boredom
• Empowerment
• Motivation
• Inspiration
• Attitudinal changes
• We-feeling
• Insight development
• Reformation
• Social connection
• Relaxing experience

16. Effectiveness
• In Scotland, 200 patients diagnosed with
depression; half were put on antidepressants
• the other followed a therapy program through
reading the book “Overcoming Depression” and
having related discussions with psychologists.
• At the end of 4 months, 42.6% of patient-readers
saw their degree of depression reduce
significantly compared to 24.5% of patients on
medication.
• this study was conducted using a guided self-help
CBT treatment

17. • Bibliotherapy was originally developed to
treat depression.
• It has also been used among caregivers in
recent years (Chien, 2016)
• bibliotherapy was effective in improving the
care experiences of caregivers of people with
psychosis (Chien, 2016), as well as the
resilience of caregivers who care for people
with depression (McCann, 2017).

18. • a meta-analysis, using bibliotherapy to
improve the mental well-being of caregivers
with neurocognitive disorders have also been
considered and suggest a favorable effect on
their well-being (Wang 2020)

19. Application of Bibliotherapy
• Cancer (anxiety, distress, and coping)
(Malibiran, 2018)
• Bibliotherapy may be helpful by facilitating
abreaction, projection, gratification,
verbalization, constructive thinking between
interviews, and reinforcement of social and
cultural patterns.

20. • Fifteen randomized controlled trials with a total of
1,113 participants (781 women; 332 men) met
inclusion criteria.
• Compared with no treatment, unassisted bibliotherapy,
Assisted bibliotherapy had significant positive effects
on female sexual functioning; no effects on male sexual
functioning were found.
• larger proportions of female participants reporting
remission of sexual dysfunction, and sexual satisfaction
was higher in treated participants, both female and
male participants (Jacques, 2021).

21. bibliotherapy services to engage with
people living with dementia
• The concept of the Book Well Program has been
adapted for people with dementia
• by including shorter, stand-alone texts and poetry
chosen to assist with dementia-related issues.
• The texts are usually printed in larger font to
allow participants to read along and the
facilitator speaks more slowly and loudly, taking
time to describe pieces in the story that need
explanation.

22. • The sessions for groups catering to people with
dementia are usually shorter than other sessions.
• An evaluation of this programme in 2010 found
that reading aloud could have positive well-being
effects as well as improve communication and
recall.
• A further evaluation in 2012 found that the
programme had a positive effect on participants
by offering an improved type of social activity
where they could connect with each other in
different ways.

23. • read-aloud bibliotherapy group for elderly
people, including some with dementia.
• The study found cognitive benefits of
participation for people with dementia
• as they conveyed that they understood the
meaning of passages read aloud and
• expressed that they were reminded of
previously forgotten memories.

24. Bibliotherapy Vs individual cognitive
psychotherapy for depression in older adults
• that treatment gains from baseline to the 2-year
follow-up period were maintained on Hamilton
Rating Scale for Depression (HRSD) and the
Geriatric Depression Scale (GDS).
• There were no significant differences between
the treatments on the GDS or HRSD at the 2-year
follow-up; however, bibliotherapy participants
had significantly more recurrences of depression
during the follow-up period. (Floyd, 2006)

25. Who can be Bibliotherapist ?
• Nursing
• Social Work
• Education
• Librarianship
– Should have a passion for connecting people with
texts

26. Five principles of Bibliotherapy
• Person-centered
• flexible and adaptable
• bibliotherapy in practice is best defined by its
ethos
• bibliotherapy is fundamentally diverse and
tailored to the needs and their interest
• inclusive and shared approach to read aloud

27. Guidelines
• avoids value judgments of texts
• Avoid prescriptive list of its activities
• members could select and bring their own
texts and
• Some can produce their own writing

28. • bibliotherapy can be provided in group
sessions
• sharing ideas about what worked

29. References
• Stip E, Östlundh L, Abdel Aziz K. Bibliotherapy: Reading OVID During
COVID. Front Psychiatry. 2020;11:567539
• Brewster L, McNicol S. Bibliotherapy in Practice: A Person-Centred
Approach to using Books for Mental Health and Dementia in the
Community. Medical Humanities (2020).
• Tews RM. Bibliotherapy. In: Encyclopedia of Library and Information
Science. Vol. 2. New York, NY: Dekker (1969). p. 448–57.
• Ruben RJ. Bibliotherapy Sourcebook. Phoenix, AZ: Oryx P (1978).
• Popa D, Porumbu D. Bibliotherapy in Clinical Context: an Umbrella Review.
Bulletin of the Transilvania University of Brasov Series VII: Social Sciences
Law (2017).
• Glavin CEY, Montgomery P. Creative bibliotherapy for post-traumatic stress
disorder (PTSD): a systematic review. J Poetry Ther. (2017) 30:95–107.

30. • Wang S, Bressington DT, Leung AYM, Davidson PM, Cheung DSK. The
effects of bibliotherapy on the mental well-being of informal caregivers of
people with neurocognitive disorder: a systematic review and meta-
analysis. Int J Nurs Stud. (2020) 109:103643.
• Malibiran R, Tariman JD, Amer K. Bibliotherapy: Appraisal of Evidence for
Patients Diagnosed With Cancer. Clin J Oncol Nurs. 2018 Aug 1;22(4):377-
380.
• Floyd M. Bibliotherapy as an adjunct to psychotherapy for depression in
older adults. J Clin Psychol. 2003 Feb;59(2):187-95.
• Floyd M, Rohen N, Shackelford JA, Hubbard KL, Parnell MB, Scogin F,
Coates A. Two-year follow-up of bibliotherapy and individual cognitive
therapy for depressed older adults. Behav Modif. 2006 May;30(3):281-94.