Bibliotherapy is a therapeutic approach employing books and other forms of literature, typically alongside more traditional therapy modalities, to support a patient’s mental health. Though the books recommended by therapists can encompass any genre or theme—from philosophy to memoir to self-help—bibliotherapists typically make use of fiction.
Reading specific pieces of literature and talking about them with a therapist (or in a group therapy setting) is thought to help patients understand perspectives other than their own, make sense of a difficult past or upsetting symptoms, or experience feelings of hope, contentment, and empathy. More generally, reading is also thought to improve self-esteem, self-awareness, and feelings of self-efficacy.
Some in the field recognize two distinct branches of bibliotherapy, although the dividing line between them isn’t always clear. Developmental bibliotherapy is used in community or educational settings, to help children or adults address common life challenges, such as bullying, for example. Clinical or therapeutic bibliotherapy is the use of books in a professional therapy context to treat a diagnosed disorder or alleviate the negative impacts of a diagnosed mental or physical disorder.
Bibliotherapy can be applied to patients suffering from anxiety, depression, or other mood disorders; those struggling with trauma or addiction; or those going through grief, a divorce, or other relationship-related challenges.
Bibliotherapy can be practiced in either individual or group therapy sessions, or without the guidance of a therapist at all. When conducted with a therapist, bibliotherapy is rarely used as a primary or sole modality of treatment; rather, it tends to be used in conjunction with other approaches such as cognitive-behavioral therapy or psychodynamic therapy.
Bibliotherapy is inexpensive and easy to apply. Thus, it may be particularly useful for patients short on time, those with limited funds, or those whose mental health concerns are mild to moderate.
Typically, a bibliotherapist will recommend a book or books based on their preferred modality and on the patient’s specific challenges. A cognitive-behavioral therapist, for instance, may recommend a self-help workbook outlining research-supported CBT principles; a therapist specializing in trauma, on the other hand, may recommend a novel about a character who endured childhood abuse.
The patient will then, on their own time, read the book or complete the workbook exercise as prescribed. Upon returning to therapy, the book or exercise will be discussed and used as a jumping-off point to explore coping mechanisms, personal history, or other factors relevant to the therapeutic experience.
Because patients must read between sessions, bibliotherapy does require additional effort and cost outside of the therapy room. However, many therapists who use bibliotherapy report that the practice increases patient engagement and commitment to the therapeutic process.
The idea that reading books has a positive effect on mood and mind is not new; indeed, many ancient societies, including the Greeks and the Egyptians, viewed libraries as sacred spaces with (metaphorical) healing properties.
Beginning in the 20th century, psychologists began to conduct formal research on the potential benefits of reading more generally and on bibliotherapy specifically. Overall, the literature suggests that reading books—particularly those offering a new perspective or taking a reader outside their comfort zone—can increase empathy, tolerance for others, and interpersonal skills, such as the ability to read the emotions of others.
In a therapeutic setting, bibliotherapy is thought to be effective because it provides an additional outlet for patients to work through problems and can help an individual recognize that they are not alone in their struggles. This process may occur in four stages:
- Identification: The reader affiliates with a character in the text and identifies with their problems and goals.
- Catharsis: The reader experiences the character’s emotions, struggles, and hopes from a safe, removed position.
- Insight: The reader recognizes similarities between the characters or situations in the text and the reader’s own circumstances and the decision to apply ideas from the text to the reader’s life.
- Universalization: The reader realizes they are not alone. Others have experienced similar challenges and found ways to navigate them.
Bibliotherapy may also help increase engagement in the therapeutic process, which is critical for overall success.
Therapists who utilize a wide variety of modalities may make use of bibliotherapy. Thus, when searching for a bibliotherapist, it may be helpful to learn about their primary modality and discuss with them how bibliotherapy will be incorporated into a treatment plan.
Some organizations, such as the International Federation for Biblio/Poetry Therapy, offer certifications for interested practitioners and have set official guidelines for the practice of bibliotherapy.
Regardless of a therapist’s training or preferred modality, it is, above all, important for patients to work with a clinician with whom they feel comfortable. Patients may want to ask the therapist a few questions before committing to work with them. Questions may include:
- How would they help with your particular concerns?
- Have they dealt with this type of problem before?
- What is their process?
- What is their timeline for treatment?