Bibliotherapy in Counseling Practice CED 703 Dr.Dale Pehrsson Dr. Paula McMillen

Come, and take choice of all my library, and so beguile thy sorrow. William Shakespeare, Titus Andronicus (Act IV, Sc1, 1.34)

Just what IS bibliotherapy? Bibliotherapy is a combination of the Greek words for therapy and books Samuel Crothers first coined ‘Bibliotherapy’ in 1916 (Atlantic Monthly) “Treatment through books” (Pardeck & Pardeck, 1998) or “Therapeutic use of literature” (Cohen, 1993) “The process of dynamic interaction between the personality of the reader and literature under the guidance of a trained helper” (Shrodes, 1950)

Alternative Terminology Bibliocounseling Bibliopsychology Bookmatching Literatherapy Library therapeutics Guided reading Biblioguidance

Distinction found most useful is practice based-- Clinical Bibliotherapy is implemented by trained helping professionals dealing with significant emotional or behavioral problems Developmental Bibliotherapy may be used by teachers and other lay helpers to facilitate normal development and self- actualization with an essentially healthy population

Historical Perspectives The Library at Thebes… “The healing place for the soul” Aristotle proposed the notion of emotional catharsis (Poetics) Freud owned the intellectual debt to creative artists suggesting that they, not he, had first ‘discovered’ the unconscious. Freud further suggested that in the therapeutic process creative artists are “valuable allies…”

History: The Early 1800’s- A movement toward the moral & humane treatment of the insane. Institutions founded and administered by the early Friends (Quaker) Societies embraced this approach. Reading became one of the most commonly used therapeutic interventions, second only to physical exercise.

History: Mid-19 th C Several major medical hospitals established patient libraries. Reading materials intended to: distract their patients connect them to the outside world during lengthy stays engage them with positive ideas give them hope and consolation

History: Early 1900’s American Library Association active in establishing libraries for hospitals and other therapeutic institutions Belief in the “value of patients’ library service as an adjunct to the treatment & recovery of the patient…” Early standards for patients’ libraries were endorsed by the American Hospital Association and the American College of Surgeons

History: The World Wars WWI was a major impetus for establishment or expansion of patients’ libraries in general medical hospitals in Britain & America. Librarians/volunteers used reading to help soldiers recover from the physical & mental trauma of war. US War Service (WW II), run by ALA, boasted of library service to more than 3,981 military service points as far away as Siberia and China.

Shifting Practice US Regional/national surveys (1980s), found Bibliotherapy used extensively by psychologists, psychiatrists and counselors Survey of users in Britain (Forrest, 1998) identified 4 main groups: psychologists (57%), librarians (20%), nurses (11%), and social workers (10%)

Current Use: In many helping professions with all ages and populations School counselors (Gladding & Gladding, 1991) Social workers (Pardeck & Pardeck, 1998) Mental health nurses (Farkas & Yorker, 1993) Teachers (Kramer & Smith, 1998)

Range of Issues Addressed~ aggressiveness (Shechtman, 1999, 2000), adoption/ foster care (Pardeck, 1993; Sharkey, 1998), diversity awareness/ valuation (Pardeck & Pardeck, 1998a; Tway, 1989), death & dying (Meyer, 1994; Todahl, Smith, Barnes, & Pereira, 1998), chemical dependency (Pardeck, 1991), divorce (Early, 1993; Kramer & Smith, 1998; Meyer, 1991), obsessive-compulsive disorder (Fritzler, Hecker, & Losee, 1997), giftedness (Hebert, 1995), conflict resolution (Hodges, 1995), child abuse/ neglect (Jasmine-DeVias, 1995; Pardeck, 1990), nightmares (Barclay & Whittington, 1992), ethnic identity (Holman, 1996), depression (Ackerson, Scogin, McKendree-Smith, & Lyman, 1998), separation & loss (Bernstein & Rudman, 1989), family violence (Butterworth & Fulmer, 1991), homelessness (Farkas & Yorker, 1993), self-destructive behavior (Evans et al., 1999).

Benefits can include: Increased self-awareness Clarification of emerging values Development of one’s own ethnic/cultural identity Greater empathic understanding of others Increased appreciation of different cultures, viewpoints and lived experiences Improved coping skills as learn about alternative responses to problems Reduction of negative emotions such as stress, anxiety and loneliness Enhanced self-esteem, interpersonal skills and emotional maturity

Hypothesized Therapeutic Mechanisms Shrodes (1950), utilized a psychodynamic model, which focused on identification (or universalization), catharsis (or abreaction) and insight (and integration) as the key steps for therapeutic benefit. Many writers since then have relied on these same constructs.This model is more typically applied when fiction is used than when non-fiction/ self-help books are the tools; then the model is often a cognitive- behavioral one.

Laura Cohen’s (1994) research approach is unique Research focused on therapeutic mechanisms from the readers’ perspective Well-functioning, non-clinical adult population who believed that reading helped them through situations such as depression, miscarriage, alcoholism, grief, and/or physical illnesses. Participants selected materials that ranged from poetry and fiction to motivational and self-help Identification with the character/situation in selected literature was acknowledged by virtually all readers as the key to experiencing positive effects from reading, regardless of genre. Other benefits described by readers validated both the emotional-dynamic and cognitive models.

Emotional Benefits Relieving feelings of isolation by learning that others shared their experience (universalization) Gaining comfort or reassurance Finding hope from hearing how others had dealt with similar situations in a positive fashion (an expectation for a good outcome) Being motivated to act differently Temporary escape from pressing problems Emotional release or relief (catharsis)

Cognitive Benefits Increasing understanding of their feelings and ideas (insight and integration). Gaining knowledge such as facts, advice/ recommendations, or other information which helped them make decisions and/ or talk effectively with gatekeepers such as health care providers.

Effectiveness Assessment is hampered by: Working in two areas that are complex and often difficult to define operationally--reading and therapy The lack of good assessment tools Unclear categories for types of bibliotherapy interventions --Wide range of activities that are included under the heading of bibliotherapy Poorly specified outcomes Lack of research done to date on the moderating effects of personality type, reading ability, and education levels is problematic.

Cautionary advice Zaccaria and Moses (1968) [Bibliotherapy] “is not a panacea… neither can it be used with all individuals”. Shrodes (1950) emphasizes …“For no two persons can there be an absolute equivalence of symbols, for no two people have identical psychological fields.” (p.85) Above all, the recommender must be well acquainted with the content of the materials they intend to recommend or use.

More cautions Helpers must be familiar enough with the reader/listener, to anticipate the state of reader/listener readiness for the reading materials. Helpers are sensitive to cultural, ethnic and religious messages in material. Helpers ensure that factual material is accurate and up to date. Helpers ensure that stories deal with characters and situations similar enough to facilitate some level of identification. increase empathy and understanding for those from different backgrounds. to provide needed distance from painful emotions.

Bibliotherapy Modalities Recommend a book for self reading Reading to the client in a session Reading and reacting to the readings Reading to a group of clients in a group therapy session Reading and writing and journaling Reading for information Story starters or discussion starters Reading and reacting with art, poetry, drama Reading and books in guidance

Categories for Evaluation General Info General Format and Structure Subject Matter Reading Level and Suitability Book Length Text and Pictures Developmental level Diversity Factors Usage: Context Environment Situation Therapeutic Use Additional Considerations Overall Impression

General Format and Structure In this section the reviewer evaluates the material from an overall perspective—the “Gestalt” of the text If it is a fictional book, then the reviewer assesses factors such as plot cohesiveness, character development, universality of the story line, and general quality of the text.

Subject Matter In this section the reviewer evaluates the material from the perspective of subject matter. Whether it is fiction or non-fiction there is usually a subject (or multiple subjects) addressed in the material. Specific topics are identified. The reviewer assesses factors such as relevancy of material, ability to engage the reader, and fit between reader interests and subject. The question posed-- “Is this a good subject fit for the client?”

Reading Level and Suitability In this section the reviewer evaluates the material from the perspective of reading level and suitability of the material. Some materials identify an appropriate reading or age level, some do not. So it is up to the counselor to make their “best guess” as to the appropriateness. It also depends on how the material will be applied. If the clinician is reading to the client, it matters less if the material is an exact match to the client’s skills. Rhyming and other stylistic devices may influence how the helper chooses to use the material

Book Length In this section the reviewer evaluates the material from the perspective of how long will it take to use this material with a particular client. Counselor looks at book format and length. Counselor must decide how text is used. Session to session Home reading One time read, etc. Individual client characteristics will also influence how long it will take to use the book in certain ways

Text and Pictures In this section the reviewer evaluates the material from the perspective of print and illustrations. Counselor looks at congruence between text and illustrations. What is the mood created by the combination of print and pictures. Counselor looks at quantity and quality of illustrations. Once an implementation strategy is identified, ask, “Will this combination of text and images create a therapeutic effect for this particular client?”

Developmental Level In this section the reviewer evaluates the material from the perspective of developmental level; consider the client from a holistic perspective, including age and grade Additionally, the counselor looks at the therapeutic readiness and stage of counseling for the client The counselor evaluates fit or match of the text, character, and subject matter with the client The counselor evaluates the appropriateness of the text’s usage with populations who may be at multiple developmental levels

Diversity Factors In this section the reviewer evaluates the material from the perspective of diversity and social issues. The counselor looks at the factors of respectful presentation, cultural appropriateness, world view expansion, and needs of the client. The counselor evaluates the text to ensure that stereotyping does not exist. The counselor examines the relevancy and current nature of the material presented. The counselor evaluates the administrative and political impact of literature usage.

Use: Context, Environment and Situation In this section the reviewer evaluates the material from the perspective of the context, environment or situation in which it will be used. The reviewer considers the setting Home Healthcare Mental health School-education Social services Library The counselor considers the client population.

Therapeutic Use: In this section the reviewer evaluates the material focusing on how the text will used. The reviewer considers the application of the text: Choral reading, Reading to the client or the group or the class Reading with the client, Reading and reacting Art, writing, story telling Other The counselor considers the impact on client growth. The question considered might be “what will this do for the therapeutic movement of my client”?

Additional Evaluation Considerations: In this section the reviewer takes a final look and evaluates the material from the retrospective stance. The reviewer considers overall implications, benefits, trauma, administrative and political-cultural factors. The reviewer offers advice to others who may consider this book for therapeutic use. The reviewer gives a “ballpark” figure of the projected therapeutic value of the text.

Be sure to check out the Bibliotherapy Education Project website and resources at: Paula McMillen: Dale-Elizabeth Pehrsson: