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Bibliotherapy is an expressive therapy that uses an individual's relationship to the content of books and poetry and other written words as therapy. Bibliotherapy is often combined with writing therapy. It has been shown to be effective in the treatment of depression. These results have been shown to be long-lasting.
Bibliotherapy is an old concept in library science. The ancient Greeks maintained that literature was psychologically and spiritually important, posting a sign above their library doors describing itself as a "healing place for the soul". In the US it is documented as dating back to the 1930s. The basic concept behind bibliotherapy is that reading is a healing experience. Literary sources can assist with the resolution of complex problems. It was applied to both general practice and medical care, especially after World War II, because the soldiers had a lot of time on their hands whilst recuperating. Also, the soldiers felt that reading was healing and helpful. In psychiatric institutions, bibliotherapeutic groups flourished during this time. The patients became preoccupied with the books and the engagement seemed to be good for their general sense of wellbeing, for a variety of reasons. Today, healthcare workers and institutions recognise the wide and varied use of bibliotherapy within a range of scenarios.
Bibliotherapy can assist children in building confidence and self-esteem. It attempts to normalize a child's world by offering coping skills and reducing their feelings of isolation, reinforcing creativity, and problem solving. It also gives parents an opportunity to discuss their children's issues with the children.
In its most basic form, bibliotherapy is using books to aid people in solving the issues that they may be facing at a particular time. It consists of selecting reading material relevant to a client's life situation. Bibliotherapy has also been explained as "a process of dynamic interaction between the personality of the reader and literature-interaction which may be utilized for personal assessment, adjustment, and growth." Bibliotherapy for adults is a form of self-administered treatment in which structured materials provide a means to alleviate distress. The concept of the treatment is based on the human inclination to identify with others through their expressions in literature and art. For instance, a grieving child who reads, or is read a story about another child who has lost a parent may feel less alone in the world.
The concept of bibliotherapy has widened over time, to include self-help manuals without therapeutic intervention, or a therapist "prescribing" a movie that might provide needed catharsis to a client.
The Online Dictionary for Library and Information Science (2011) defines bibliotherapy as:
Although the term “Bibliotherapy” was first coined by Samuel Crothers in 1916, the use of books to change behavior and to reduce distress has a long history, dating back to the middle ages. When applied in a therapeutic context, bibliotherapy can comprise both fictional and non-fictional materials. Fictional bibliotherapy (e.g., novels, poetry) is a dynamic process, where material is actively interpreted in light of the reader’s circumstances. From a psychodynamic perspective, fictional materials are believed to be effective through the processes of identification, catharsis and insight. Through identification with a character in the story the reader gains an alternative position from which to view their own issues. By empathizing with the character the client undergoes a form of catharsis through gaining hope and releasing emotional tension, which consequently leads to insights and behavioral change.
In the 1980s and early 1990s, bibliotherapy was a widely used but poorly researched therapeutic model. However, numerous randomized controlled trials (RCTs) have documented the positive effects of bibliotherapy for clinical conditions such as deliberate self-harm, obsessive–compulsive disorder (OCD) and bulimia nervosa and insomnia. Research also supports bibliotherapy as an intervention for a wide array of psychological issues including emotional disorders, alcohol addiction, and sexual dysfunction. In a recent review of psychotherapeutic treatments for older depressed people, bibliotherapy emerged as an effective intervention.
The use of bibliotherapy in mental health programs, including those for substance abuse, has been shown to be beneficial to patients in the United Kingdom where it is a popular resource.Researchers have found that bibliotherapy can successfully compliment treatment programs and reduce recidivism.
Bibliotherapy has been studied by Jennie Bolitho (2011) in relationship to libraries, health and social connection for the elderly. Bolitho set up a pilot reading program where she read the text aloud to a group of participants at a local aged care hostel. (She described “being read to as part of the nurturing experience”.) Her evaluation at the end of the 12 week program described all responses as positive and participants commented that they “look forward to the group as it made them think for themselves and gave them something to think about aside from their ailments and the monotony of the day” (p.90).
Bibliotherapy has not been vastly researched to ensure that it will be successful for all students. It has many drawbacks, that include unavailable literature on certain topics that students may be struggling with, many students not being ready to face their issues and read, and students and parents defensively implementing the therapy.[clarification needed] The resistance of using bibliotherapy is based on a lack of assertiveness, negative attitudes, anxiety, depression, sexual dysfunctions, and negative behaviors. The major issue that lies behind bibliotherapy is the lack of research that has been conducted on this therapy device.
Advantages of bibliotherapy include teaching students to solve problems, help students cope with teasing, name calling, mockery, fears, sexuality changes, anxiety, and death. Despite the limited research on bibliotherapy and its effects, many teachers have shown improved achievement and self-concept.
Bibliotherapy can consist solely of reading, or it can be complemented with discussion or play activity. A child might be asked to draw a scene from the book or asked whether commonality is felt with a particular character in the book. The book can be used to draw out a child on a subject (s)he has been hesitant to discuss.
Of necessity, bibliotherapy originally used existing texts. Literature that touched on the particular subject relevant to the child provided the source material. (For example, Romeo and Juliet is typically read in 8th or 9th grade as Romeo is 15 and Juliet is 13; students at that age can identify with them.) Recently it has become possible to find texts targeted to the situation; e.g. many of The Berenstain Bears books target particular behaviors and responses to certain situations.
There is a division of opinion as to whether bibliotherapy needs to take place in a therapeutic environment, with therapists specially trained in the treatment reinforcing the idea for fear of the damage that could be done even by the selection of the wrong text. Other psychologists see no reason why children can't benefit from their parents selecting meaningful reading material.
Implementing bibliotherapy in an elementary classroom can be very beneficial to both the students and the teacher. Teachers who use bibliotherapy in their classroom also learn much about the children they teach. Teachers as practitioners of bibliotherapy select appropriate reading materials and match them to the needs of individual students to assist them in the development of self-awareness, problem-solving skills, perspective-taking, and understanding of problems. The materials may include "any literacy activity, including reading (fiction, nonfiction, or poetry), creative writing, or storytelling." Teachers that select appropriate literature for their classroom needs may provide a child with a "character in a story to help the child understand himself Classroom story time and a guided discussion allows students to "become aware of problems of other children and develop empathy".
In the article "Read two books and write me in the morning", the authors highlight the fact that teachers are an integral part of a student's therapeutic team. It is the teacher who may be the first person to notice that something is troubling a child. They also note that teachers have been referred to as carryover agents, who carry out recommendations from other professionals who have suggested accommodations necessary to ensure a particular student's well-being or success in their classroom. In inclusive classrooms the teacher and the whole class play a role in meeting directly or indirectly, the needs of students with exceptionalities. Bibliotherapy can help the students in the class to learn coping skills that will help them deal with the social and emotional challenges that may occur. Books and reading are an integral part of classroom life. Through books, "children are able to see reflections of themselves, their times, their country, their concerns... well-written realistic fiction will always help readers gain a deeper understanding of themselves and others."
Bibliotherapy has three recognized stages: (1) identification, (2) catharsis, and (3) insight. Identification is when a reader associates themselves with the character or situation in the literary work. Catharsis is when the reader shares many of the same thoughts and feelings of the characters in the literary work, and insight is when the reader realizes that they relate to the character or situation and learn to deal more effectively with their own personal issues. Literary pieces allow teachers to identify for their class, or an individual student, a particular issue which they are dealing with directly or indirectly. In a class with a special needs student for example, books featuring a character with the same needs will help students experience living with a chronic condition; through a guided discussion they will able to verbalize their thoughts and concerns. This exercise will offer insight into the issue of how to help their classmate effectively. Bibliotherapy "does not prescribe meanings, nor is it a form of direct teaching; it is more an invitation and permission giving to children to unveil wisdom and insight that might otherwise be squelched."
Teachers who practice or need to use bibliotherapy can find connections to their state or provincial guidelines. A common challenge for classroom teachers is finding the right book, and although some annotated bibliographies are available online and in curriculum publications, not all issues are touched upon. A teacher may have to find their book. The following evaluation framework is suggested:
There are steps that make bibliotherapy a more effective solution for dealing with the issues that a student may be facing, including developing support, trust, and confidence with the student that is suffering from an issue, identifying other school personnel that could aid in implementing the therapy, seeking support from the student's parents or guardians, defining the issue that the student is facing and why the teacher wants to help solve it, creating goals that may help the student overcome the issue, researching books that may help with the specific problem, introducing the book to all the people that will be involved, incorporating reading activities, and evaluating the effects and successes that the book may have had on the student.
American Library Association. (2011). Bibliotherapy. Retrieved from 
Australian Public Libraries Summit. (n.d.). A bibliotherapy partnership between public libraries and health services. Retrieved from 
Bolitho, J. (2011). Reading into wellbeing: Bibliotherapy, libraries, health and social connection. Aplis, 24(2), 89-90.
Brewster, L. (2009). Books on prescription: Bibliotherapy in the United Kingdom. Journal of Hospital Librarianship, 9(4), 399-407. doi:10.1080/15323260903253456
Muller, K. (2011, February 15). Bibliotherapy. Retrieved from 
Pierce, J. B. (2010). Youth matters: A feeling for books. American Libraries. Retrieved from 
U.S. Department of Veterans Affairs. (2009, February). VA bibliography reference guide. Retrieved from 
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