Bibliotherapy

Description of the Strategy

The term bibliotherapy refers to reading written material to pursue valued goals. It has been used to pursue a wide range of goals, including educating clients, decreasing anxiety and depression, enhancing social contacts, and developing study skills. There are different kinds of bibliotherapy. One concerns self-help materials designed to guide the client through assessment and/or intervention in relation to hopedfor outcomes, such as decreasing anxiety or increasing effective study behaviors. Another kind requests clients to read fictional materials or poetry to attain certain outcomes. Yet another encourages readers to read spiritual literature. Many different formats are used, and Internet-based material is likely to increase in use. Surveys of counselors in a variety of professions indicate that they often assign (prescribe) specific readings to clients. Aims may include providing information about a concern, including its prevalence, motivating readers to address it, describing a variety of change options, and helping readers select promising ones. Clinical use differs along the following six dimensions: (1) extent of helper-client contact, ranging from none to extensive; (2) use of individual or group format; (3) development of general versus specific skills; (4) the extent to which readers are requested to “interact” with the written material in terms of completing exercises to test their understanding of content; (5) whether bibliotherapy is used together with other methods; and (6) attention devoted to generalization and maintenance of positive effects. Inclusion of relapse prevention guidelines offers readers information they can review on an as-needed basis. Effective use of bibliographic methods requires generalization and maintenance of valued behaviors. Counselor guidance and support may be necessary. Support also could be provided by group members or “buddies” who are involved in group programs.

Possible benefits of bibliotherapy include attaining desired outcomes with little expenditure of time, money, and effort and accessing accurate information about topics of interest (e.g., social anxiety, depression) and how to achieve valued outcomes (e.g., enhancing self-change skills and decreasing beliefs that hinder self-change). Certain kinds of individuals are more likely than others to profit from self-help formats. People differ in their repertoires of self-change skills and in their histories of using them to attain valued outcomes. Contraindications to use of bibliotherapy include limited reading ability and small probability that the client will follow instructions, perhaps because of personal or environmental obstacles. An advantage of bibliotherapy is that it allows people to achieve desired changes on their own, although some writers point out that use of self-help manuals still ties consumers to therapists, since therapy “experts” are often the authors. Dangers of ineffective self-help [Page 179]materials include an increase in hopelessness and helplessness when desired outcomes do not occur, neglect of other methods that might be successful, such as consulting a clinician, and a worsening of problems.

Compared with the abundance of self-help books and manuals available, the evaluation of these materials is skimpy in terms of whether they do more good than harm. A meta-analysis of 70 bibliotherapy studies by Rick Marrs indicated a positive effect for bibliotherapy. A key concern for future research is the rigorous testing of claims regarding the effectiveness of bibliotherapy in relation to particular outcomes. Given the possible rationing of counselor availability and indications that bibliotherapy can be effective and/or contribute to positive effects at low cost, it is worthwhile to pursue research in this area. The effectiveness of bibliotherapy methods should be enhanced by considering empirical literature describing components of effective self-change efforts and making sure other information provided is accurate.

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