The impact of school-based creative bibliotherapy interventions on child and adolescent mental health: a systematic review and realist synthesis protocol.

BACKGROUND: There is a need to identify evidence-based interventions to be delivered in schools that can be used to improve child and adolescent mental health and wellbeing. Creative bibliotherapy is one proposed intervention. However, there has been, to date, no comprehensive assessment of the evidence for its impact on mental health and wellbeing. To fill this gap, we will conduct a systematic review and realist synthesis. METHODS: A systematic search of the bibliographic databases APA PsycINFO, Medline (via Ovid), CINAHL, ERIC, Education Research Complete (via EBSCOhost) and Web of Science (SCI, SSCI, AHCI, ESCI) for school-based creative bibliotherapy interventions on child and adolescent mental health. Types of study to be included: cohort studies, non-randomised comparative evaluations, randomised controlled trials. The data from all included studies will be summarised descriptively and strength of evidence appraised. This is a potentially large field of practice, with heterogeneous interventions; we will use methods from intervention components analysis to describe and categorise the range of components and approaches used in included interventions. To understand how interventions work and in which contexts, we will use methods from realist synthesis to develop an exploratory account of mechanisms in different settings and for different young people (contexts). DISCUSSION: Findings will assess the range of evidence for the impact of creative bibliotherapy on child and adolescent mental health and wellbeing, the strength of evidence for the impact identified, and describe potential mechanisms. This review will be useful for a wide range of stakeholders considering implementing or developing interventions using creative bibliotherapy in school-based settings. SYSTEMATIC REVIEW REGISTRATION: This protocol was registered at the International Prospective Register of Systematic Reviews ( https://www.crd.york.ac.uk/prospero/ ), registration number CRD42023410333. This review is funded by Wellcome Trust (221457/Z/20/Z).

Effective reduction of anxiety in hospitalised children through bibliotherapy.

AIM: The process of being admitted to a hospital is widely recognised as a distressing encounter for children, frequently resulting in notable levels of anxiety. The main aim was to assess the effectiveness of bibliotherapy in reducing anxiety and to associate anxiety levels with demographic and clinical variables. METHODS: This study was conducted at a paediatric ward in a tertiary care hospital located in Tamil Nadu, India, for 3 months from 1 August 2023-30 October 2023. In this study, a one-group pre-test and post-test design was employed. A sample of 60 children, aged between 5 and 12 years, was recruited using a convenience sampling method. Spence Children Anxiety Scale was used for assessing anxiety levels. RESULTS: The mean age of the participants was 8.46 ± 1.91 years, and the majority, comprising 57%, were male. Following bibliotherapy, 72% of children showed mild anxiety, 28% showed moderate anxiety and no individual had considerable anxiety. Anxiety scores dropped 27%. Significant associations were found between anxiety reduction and variables such as age, educational status, and type of family. CONCLUSION: Bibliotherapy was notably effective in substantially reducing anxiety levels among children aged 5-12 years who were admitted to hospitals.

A qualitative feasibility and acceptability study of an acceptance and commitment-based bibliotherapy intervention for people with cancer.

Self-directed bibliotherapy interventions can be effective means of psychological support for individuals with cancer, yet mixed findings as to the efficacy of these interventions indicate the need for further research. We investigated the experience of individuals with cancer after using a new self-help book, based on Acceptance and Commitment Therapy (ACT). Ten participants with cancer (nine females and one male, 40-89 years old) were given access to a bibliotherapy self-help ACT-based book and participated in post-intervention semi-structured interviews. Five themes were generated from reflexive thematic analysis: (1) The value of bibliotherapy (2) Timing is important (3) Resonating with cancer experiences (4) Tools of the book (5) ACT in action. The book was found to be acceptable (self-directed, accessible, understandable content, good responsiveness to exercises) and feasible (easy to use, ACT-consistent). Although not explicitly evaluated, participants' reports indicated defusion, present moment awareness, and consideration of values, as the ACT processes that contributed to adjustment, via helping them to regain control over their lives and become more present within the moment. Findings also indicate that the intervention may be best accessed following completion of initial medical treatment.

Effects of traditional Chinese culture-based bibliotherapy on the spiritual health of patients with liver cancer.

BACKGROUND: Liver cancer is a serious global health problem and is associated with poor spiritual health. Bibliotherapy is beneficial in improving health outcomes in cancer patients, yet there is a lack of empirical evidence of its effect on the spiritual health of liver cancer patients in China. The study aimed to investigate the effects of bibliotherapy based on Chinese traditional culture on the spiritual health of patients with liver cancer in China. This study was approved by the Ethics Committee of Hunan Normal University School of Medicine and registered with the Chinese Clinical Trial Registry with the registration (No: 2021260), which registration in June 30th 2021. METHODS: A total of 60 patients with liver cancer were divided into the intervention group (n = 30) and the control group (n = 30) through WeChat. The intervention group received bibliotherapy therapy based on traditional Chinese culture, while the control group received routine care. Spiritual health was assessed using the Spiritual Attitude and Involvement List (SAIL) and compared before and after the intervention between the two groups. The chi-square test and t-test were used to analyze the intervention effects. RESULTS: The two groups were comparable in all baseline characteristics including the SAIL score. After 5 weeks of intervention, the score of SAIL increased significantly from 96.76 ± 15.08 to 106.93 ± 13.82 in the intervention group (t = - 29.380, p < 0.001), while no significant difference in SAIL score was observed in the control group (from 95.27 ± 16.40 to 95.31 ± 16.24, t = - 0.189, p = 0.852). Similar patterns were also observed in its three dimensions of connecting with oneself, connecting with the environment, and connecting with transcendence. CONCLUSIONS: Our study showed that bibliotherapy based on traditional Chinese culture using the WeChat platform can greatly improve the spiritual health of patients with liver cancer and has the potential to be widely applied to cancer patients to improve their well-being.

Remote cognitive behaviour therapy for social anxiety disorder: A meta-analysis.

Remote cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) has the potential to improve access to treatment by reducing economic, geographic, and psychological barriers. The aim of this study was to use a meta-analytic approach to examine the efficacy of the different remote CBT methods for treating SAD. A systematic electronic database search was used to identify 31 studies (n = 2905; mean age range: 24.73-41.65 years; mean female representation = 60.2 %). Pooled within-group analyses indicated large effect sizes from pre-treatment to post-treatment (Hedges' g = 1.06; 95 % CI: 0.96-1.16) and pre-treatment to follow up (g = 1.18; 95 % CI: 1.03-1.33) for remote CBT. Internet-delivered CBT (g = 1.08; 95 % CI: 0.98-1.19) and application-delivered CBT (g = 1.19; 95 % CI: 0.75-1.64) produced large within-group effect sizes. Bibliotherapy-delivered CBT (g = 0.79; 95 % CI: 0.45-1.13) produced medium within-group effect sizes. Pooled between-group findings indicate that remote CBT treatments were more effective than passive control (g = 0.87; 95 % CI: 0.70-1.03) and non-CBT remote treatments (g = 0.41; 95 % CI: 0.17-0.66), and were at least as effective, or slightly more effective, than face-to-face CBT treatments (g = 0.34; 95 % CI: 0.14-0.54). These findings have important implications for the dissemination of remote and stepped-care treatments for SAD.

Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155.

Using bibliotherapy to rebuild identity for people with aphasia: A book club experience.

BACKGROUND: Aphasia book clubs were developed to support connecting with literature and reading for pleasure within an aphasia-friendly environment. Bibliotherapy is an evidence-based therapeutic approach, in which a book is selected to address the challenges facing the reader. Its aim is to facilitate a deeper understanding of a lived experience in order to promote healing, strategy development, and adjustment. Aphasia book clubs provide an opportunity to discuss books about the challenges associated with aphasia. A recent book, Identity theft: Rediscovering ourselves after stroke recounts the stroke recovery story of Dr. Debra Meyerson and 22 other stroke survivors. Identity Theft focuses on the need to reconstruct positive identities despite remaining disabilities to facilitate rebuilding rewarding lives. The purpose of this study is to understand the impact of reading Identity Theft in an aphasia book club for people with aphasia (PwA). METHOD: 27 PwA read the book Identity Theft in one of four online aphasia book clubs offered by two universities. Weekly discussions were facilitated by graduate SLP students under the supervision of experienced clinicians. At the end of the 10 week program, semi-structured qualitative interviews were conducted with participants to understand the lived experience. Interviews were analyzed using reflexive thematic analysis. RESULTS: Analysis of the interview data generated four main themes and 13 subthemes. The main themes included: Mechanism for Reflection, Power of Community, Engaged Learning, and Therapeutic Environment. Interview extracts illustrate the way these themes support increasing self-efficacy and rebuilding a positive identity. CONCLUSION: The themes align positively with outcomes associated with the bibliotherapy process. Themes also integrate into a self-management model that promotes self-efficacy through education, support, awareness, problem solving and goal setting. Caveats included determining participant readiness to examine recovery issues and facilitator preparation. Aphasia book clubs surrounding psychosocial texts may help PwA reconstruct a positive post-stroke identity.

Effectiveness of a transdiagnostic emotion regulation training in an at-risk sample: a randomized-controlled trial of group-based training versus self-help bibliotherapy.

OBJECTIVES: Subclinical psychotic, depression, and anxiety symptoms form a transdiagnostic 'at-risk state' for the development of mental disorders. Emotion regulation has been identified as a transdiagnostic factor relevant to the formation of these symptoms that can be successfully addressed in clinical interventions. Here, we tested whether a group-based emotion regulation training would be effective in reducing distress and at preventing the transition to mental disorders in an at-risk sample. METHODS: Participants with distressing subclinical psychotic, depression, or anxiety symptoms (n = 138) were randomly allocated to either the 8-week group-based affect regulation training (ART; Springer, New York) or an 8-week self-help bibliotherapy (BT). They underwent biweekly measurements during the intervention, as well as at a six- and 12-month follow-up. In an exploratory analysis, we tested whether the ART would be superior to BT in preventing the transition to any mental disorder at 12-month follow-up. We also tested for differences in trajectories of psychopathology and emotion regulation (via questionnaires) and emotion regulation in daily life (via the experience-sampling method). RESULTS: Participants in the ART condition showed a greater improvement of emotion regulation in daily life than those with BT, but the ART was not superior over BT in preventing the transition to mental disorders. There were significant longitudinal reductions from pre- to post-intervention for general psychopathology and symptoms but no superiority of the ART over BT. CONCLUSIONS: Despite its efficacy in improving emotion regulation skills, the ART does not produce effects on psychopathology that justify its recommendation over self-help approaches.

Intervención comunitaria: el impacto de la lectura en la salud emocional / Community intervention: the impact of reading on emotional health

El malestar emocional es una queja habitual en lasociedad y en las consultas de Atención Primaria.La biblioterapia se ha mostrado eficaz en la mejora de síntomas de depresión y ansiedad leves.El siguiente estudio trata de valorar el impacto dela biblioterapia en la calidad de vida de pacientesdel centro de salud (CAP) El Carmel (Barcelona)con ansiedad y/o depresión leves diagnosticadas,con el objetivo de mejorar la percepción de la propia salud emocional.Se trata de un estudio piloto cuasi-experimentalen colaboración con la biblioteca municipal dondese valora, a lo largo de 1 año, la percepción dela propia salud de los pacientes antes y despuésde una intervención de biblioterapia por medio deescalas validadas, evidenciando una mejoría enla autopercepción de sintomatología ansiosa, nosiendo la mejoría estadísticamente significativaen el caso de la depresión. (AU)

The emotional distress is a habitual complaint in oursociety and in the Primary Care consultations. The bibliotherapy has shown efficient to improve the minordepression symptoms and anxieties.This research consists in assessing the impact of bibliotherapy in the quality of life in the patients of Carmel’s primary health care center (Barcelona). Theywere diagnosed with minor anxiety and depression.The target of this work is to enhance the perception oftheir own mental health.It is a pilot quasi-experimental study in collaborationwith the public library. Over a year, an evaluation takesplace about the perception of their particular mentalhealth before and after an intervention of bibliotherapy. The evidence is an improvement in the self-perception of anxiety symptomatology, not resulting asthe most significant statistic in the case of depressionsymptoms. (AU)

Digital bibliotherapy as a scalable intervention for suicidal thoughts: A randomized controlled trial.

OBJECTIVE: Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increased perceived shared experience and optimism. METHOD: Using a randomized waitlist-controlled trial, we tested the effect of digital narrative-based bibliotherapy among 528 adults visiting a social media platform dedicated to providing mental health support. Participants were randomized to either a treatment condition (n = 266), in which they read one suicide narrative per day for 14 days or to a waitlist control condition (n = 262). The primary outcome was a measure of desire to die assessed daily for the 14-day trial period and at 2-week follow-up. RESULTS: Participants in the treatment condition reported lower desire to die than participants in the control condition during the 14-day trial period (ß = -0.26, p = .001) and at 2-week follow-up (t = -2.82, p = .005). Increased perceived shared experience (indirect effect b = -0.55, p < .001) and optimism (indirect effect b = -0.85, p < .001) mediated the effect of treatment on desire to die. CONCLUSIONS: Digital narrative-based bibliotherapy may be an effective intervention for those at risk for suicide, and may work in part by increasing feelings of perceived shared experience and optimism. Future research is needed to test the generalizability of these results to other platforms, groups, and conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Development of an Evidence-Based Telephone-Coached Bibliotherapy Protocol for Improving Dementia Caregiving Appraisal.

Caregiving appraisal is the caregivers' cognitive evaluation of caregiving stressors. It determines the caregiving outcomes and caregiver health. Dementia caregivers have shown relatively negative caregiving appraisals. However, there is a lack of interventions to improve caregiving appraisal. This study describes the multi-phase process of developing and validating an evidence-based bibliotherapy protocol for improving the caregiving appraisal of informal caregivers of people with dementia. Two phases were included in the development: In Phase 1, a series of reviews of theory and evidence were conducted to identify the theoretical underpinnings, the core components, the dosage, and the mode of delivery of evidence-based bibliotherapy. In Phase 2, focus groups consisting of an expert panel of 16 clinicians and academics were used to validate the intervention protocol. Evidence synthesis was used in Phase 1 to formulate a draft intervention protocol. Content analysis was used in Phase 2 to work out the principles to revise the intervention protocol. The validated evidence-based bibliotherapy protocol included eight weekly sessions, and each session targeted improving one aspect of the essential factors that influence caregiving appraisal. This study provided a culturally sensitive and contextually appropriate evidence-based bibliotherapy protocol ready to be tested in a clinical trial.

How I approach the use of bibliotherapy in caring for children with oncologic and hematologic conditions.

Bibliotherapy utilizes storybook readings to foster expressive therapy for children. Storybooks represent a readily available yet underutilized support tool in pediatric hematology and oncology care settings. Storybooks can help explain a new diagnosis, treatment plan, body changes, and identity adjustment in a relatable way for patients to then have a safe space to process questions and emotions. This paper serves as a "how to" guide for clinicians to consider bibliotherapy for a patient, select suitable book options, and introduce and incorporate bibliotherapy as part of comprehensive care.

Efficacy of journaling in the management of mental illness: a systematic review and meta-analysis.

OBJECTIVES: Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. We seek here to present this synthesis that may begin to inform future research and eventual evidence-based guideline development. DESIGN: Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. These studies addressed the impact of a journaling intervention on PTSD, other anxiety disorders, depression or a combination of the aforementioned. ELIGIBILITY CRITERIA: Peer reviewed, randomised control trials on the impact of journaling on mental illness were included. INFORMATION SOURCES: MEDLINE, EMBASE and PsycINFO. RESULTS: The data are highly heterogeneous (control arm=I2 of 71.2%, intervention arm=I2 of 83.8%) combined with a B-level Strength of Recommendation Taxonomy recommendation. It was additionally found that there is a significant pre-post psychometric scale difference between control (-0.01, 95% CI -0.03 to 0.00) and intervention arms (-0.06, 95% CI -0.09 to -0.03). This 5% difference between groups indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures. Cohen's d effect size analysis of studies suggests a small to moderate benefit. CONCLUSION: Further studies are needed to better define the outcomes. Our review suggests that while there is some randomised control data to support the benefit of journaling, high degrees of heterogeneity and methodological flaws limit our ability to definitively draw conclusions about the benefit and effect size of journaling in a wide array of mental illnesses. Given the low risk of adverse effects, low resource requirement and emphasis on self-efficacy, primary care providers should consider this as an adjunct therapy to complement current evidence-based management.

Effects of Developmental Bibliotherapy on Subjective Well-Being of Older Adults Living in Nursing Homes: A Quasi-Experimental Study.

The current study sought to create a developmental bibliotherapy material database (DBMD) and examine the effectiveness of developmental bibliotherapy on subjective well-being of older adults living in nursing homes. Based on the reading needs of older adults, we developed a DBMD, which included 327 materials with five themes: Health Care, Current Affairs and Politics, Historical Biographies, Geriatric Culture, and Psychological Adjustment. Fifty-four single materials were randomly selected from the DBMD to perform the intervention. This study used a quasi-experimental, single-group pre-/post-survey approach. Sixty-four older adults participated in the study for 6 weeks. Immediately before and after the intervention, older adults completed the Optimism-Pessimism Scale and Memorial University of Newfoundland Scale of Happiness. There were significant improvements in older adults' optimistic tendency and subjective well-being (p < 0.05). Reading materials in the DBMD promoted older adults' optimistic attitude toward life, reduced negative emotions, and improved subjective well-being. [Journal of Psychosocial Nursing and Mental Health Services, 60(7), 15-22.].

The Efficacy of a Forgiveness Bibliotherapy: A Randomized Controlled Trial with Nursing Students.

Purpose of study: The need for forgiveness education for nursing self-care and forgiveness facilitation has risen. Therefore, the present pilot study tested the efficacy of an 8-week forgiveness bibliotherapy with a small number of undergraduate nursing students. Design of study: Matched pairs of nursing students were randomly assigned to either the experimental group or no-contact control group. The experimental group, using 8 keys to forgiveness by R. Enright (2015) as the treatment manual, read one chapter a week for 8 weeks and provided weekly reflections. Forgiveness and forgiveness-related outcome measures were administered at pretest, posttest, and one-month follow-up. Findings: At the posttest, the experimental group had significantly greater improvement in forgiveness compared to the control group with a large effect size, which was maintained at one month follow-up. There was no other significant difference between the two groups. Within-group comparisons of the experimental group showed improvement in forgiveness, anxiety, depression, and fatigue from pre to post testing periods and forgiveness, anger, anxiety, depression, and fatigue from pre to follow-up testing periods. Conclusion: Use of bibliotherapy may be a cost-effective way to promote the virtue of forgiveness for students in nursing programs.

"Medicinable Literature": Bibliotherapy, Literary Caregiving, and the First World War.

Histories of bibliotherapy often emphasize the importance of the First World War in stimulating the development of bibliotherapeutic theory and practice. The word itself was used in a 1916 article by the American author Samuel McChord Crothers, while histories of bibliotherapy in the United Kingdom often foreground H. F. Brett-Smith's so-called "fever chart" of therapeutic books for treating shell-shocked soldiers. Despite this, however, we argue that a full account of wartime bibliotherapy (particularly the importance of British hospital libraries in its development) has yet to be told. This article draws on the papers of British military hospital personnel to describe the range of "literary caregiving" supporting the treatment of sick and wounded soldiers during the conflict. It traces the social and professional networks underlying these schemes. Finally, it shows how British volunteer librarians helped develop a specifically medicalized language of caregiving through books, thereby contributing to the early development of bibliotherapy.

Very Young Child Survivors' Perceptions of Their Father's Suicide: Exploring Bibliotherapy as Postvention Support.

Each year in the United States, 7000 to 30,000 children experience their parent's suicide. Due to the stigma associated with suicide, feelings of guilt, and intense grief, surviving family members avoid talking about suicide. Over time, children struggle with confusion and intense emotions associated with their parent's suicide. In this study, seven adults, who reported being younger than six years old at the time of their father's suicide, participated in individual semi-structured interviews. Participants' responses highlight the challenges that young children face due to limited memories of their deceased parent. Interviews concluded with an opportunity for participants to review and express their impressions of 10 children's picture books. Participants offered impressions about how these books may or may not be helpful in supporting young child survivors. Implications for applied practice include considering how children's literature may open communication and assist children in navigating Worden's tasks of grief: (a) accepting the reality of their parent's death; (b) facing the grief and pain; (c) adapting to life changes due to their father's suicide, in particular adapting to altered family relationships; and (d) building memories of the deceased loved one, when possible, to ensure healthy attachment to the deceased parent. Participants' insights provide considerations for selecting children's literature for bibliotherapy. Due to young child survivors' increased risk for attempting and completing suicide, supporting child survivors of parent suicide not only addresses postvention needs but aligns with suicide prevention.