10.13125/CH/5837
application/pdf
2533-1825
5837
2, special
en
urn:nbn:it:unica-29809
Maria Catena Silvestri
https://creativecommons.org/licenses/by/3.0/
Critical Hermeneutics
bibliotherapy, rehabilitation, prison
The Efficacy of Bibliotherapy in Rehabilitation Context
Text.Serial.Journal
https://ojs.unica.it/index.php/ecch
7
Articles
2024-01-10
2023-06-28
2024-01-11
2024-01-11
165-178
1
Maria Catena Silvestri
2023
10.13125/CH/5837
165
University of Messina
2533-1825
2, special
bibliotherapy, rehabilitation, prison
178
urn:nbn:it:unica-29809
The Efficacy of Bibliotherapy in Rehabilitation Context
https://ojs.unica.it/index.php/ecch/article/download/5837/5804
7
Critical Hermeneutics, 7(2), special, 2023                        Received: 28/06/2023
Biannual International Journal of Philosophy                       Accepted: 09/01/2023
http://ojs.unica.it/index.php/ecch/index                          Published: 10/01/2024
ISSN 2533-1825 (on line); DOI 10.13125/CH/ 5837




                    The Efficacy of Bibliotherapy in
                           Rehabilitation Context


                       Carmela Mento - Francesco Pira
             Valentina Gueli Alletti - Maria Catena Silvestri
                               University of Messina - IT




Abstract

The aim of the present study was to explore the effectiveness of
bibliotherapy in rehabilitation settings. The term bibliotherapy, coined
in the 1930’s by the psychiatrist William Menninger, conveys the
importance of reading as a tool for cultural promotion and growth, as
a means through which to acquire knowledge, enhance one's cognitive
and emotional abilities, develop strategies for managing discomfort, as
well    as    a   psychoeducational           and   cognitive   technique     in   the
psychotherapeutic field. A study carried out on Pubmed showed that
recent research on bibliotherapy, in particular experimental research,
would be lacking and requires a humanistic medical approach, drawing
on the knowledge and methods of psychology and cognitive literary
studies, as well as clinical disciplines to broaden our understanding of
how the dynamic processes of interpretation mediate between the
textual and characteristic structures of mental health and illness. This
narrative review was conducted on PubMed database and used two key
terms “Bibliotherapy” AND “rehabilitation” AND “prison”. Studies in line
with this specific issue were included. The search of PubMed database
provided a total of 470 items recruited online; of these 464 studies
C. Mento, F. Pira, V. Gueli Alletti, M. C. Silvestri, The Efficacy in Rehabilitation Context




were excluded according to inclusion and exclusion criteria. After the
screening, a total of 6 studies assessing the bibliotherapy in
rehabilitation setting, met the inclusion criteria and were included in
the narrative review. Bibliotherapy as a self-help approach also in
psychotherapeutic treatments can activate the desire to seek changes
in attitudes and behaviour, to acquire knowledge of symptoms, and the
value of self-care. A psychological intervention self-administered
through ACT bibliotherapy with minimal therapeutic support can
improve the physical and emotional functioning of adults with chronic
pain. If studies report the efficacy of parent-mediated bibliotherapy in
situations of childhood anxiety, nocturnal fears, specific phobias, in
adolescence chatbot-delivered self-help depression intervention was
proven to be superior to the minimal level of bibliotherapy in terms of
reduction on depression and anxiety. Bibliotherapy interventions may
be helpful to fight against weight gain and potentially facilitate smoking
cessation.

Keywords: bibliotherapy, rehabilitation, prison



1. Introduction

Bibliotherapy, or book therapy is a method of therapy that uses the
reading of books. Through analysis of the subject, the therapist is able
to select a book suitable for the user's situation. By reading, the
individuals implement a process of introspection which induces them
to reflect on themselves (Veillette et al., 2019). The hypothesis that
reading could lead to beneficial effects dates back to Ancient Greece.
Apollo, the son of Zeus, is the god of poetry. At the same time, he was
also the God of medicine. Indeed, in Greek culture these two elements
are placed in a direct relationship (Dalla Valle 2005). Three stages of
the bibliotherapeutic process have been found: identification, catharsis




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and introspection. Identification is what happens to readers when they
perceive strong affinities and similarities with a character. During
catharsis, a change of thinking. Finally, through introspection, change
becomes fixed, stable and permanent (Dalla Valle, 2005). According to
literature bibliotherapy, is an important strategy to help individuals
cope with and process difficult experiences. In a study by Watson et al.
(2020), authors used bibliotherapy as coping strategies for children in
their grief. Interesting is the study by Veillette and colleagues (2019),
in which through bibliotherapy they managed chronic pain in a sample
of patients. Previous studies, for example, Vetri et al., (2022), used
bibliotherapy to manage children of parents with a mental illnesses,
and bibliotherapy was positively perceived by families. The results of
this study suggested that for children and parents bibliotherapy is an
effective tool for psychological support. In particular, this tool is
important to support resilience capability. Moreover, bibliotherapy, has
emerged as an effective treatment for anxiety symptoms (Radtke et
al., 2023). The intervention provided by bibliotherapy for depression
has also been shown to be helpful in treating depression (Liu et al.,
2022). Bibliotherapy is about using the narrative properties of the
human mind. A narrative is built on the patient through the reading of
the books, the themes include specific experiences on emotions,
feelings and how the subjects perceive the world and reality (Kasperek-
Zimowska et al., 2021). In the past, Tomasik (1994) defined
bibliotherapy as an intentional activity that uses the book for
rehabilitative, resocializing purposes, suitable for all patients, with
different psychopathologies and coming from different social and
cultural classes, suitable for different ages. Pardini and colleagues
(2014) used bibliotherapy for the treatment of depressive symptoms
in jail and prison, in the prison sample, these findings indicated that
the   treatment   with   bibliotherapy    reduces       depression,       anxiety,
psychological distress, and improved quality of life in prison.



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In the light of this, the aim of this work is to explore the positive effects
on the psyche of bibliotherapy.



2. Materials and Methods
2.1. Research Strategy
The main purpose of this narrative review is to map empirical research
concerning the efficacy of bibliotherapy in rehabilitation settings.
      There are different approaches to collecting and gathering
empirical evidence in literature. Narrative review is the most common
type of literature review and given the paucity of studies in literature
about this topic, we chose the narrative review, as it has a less
systematic methodology. Usually, in narrative reviews, there is usually
no specific research question or defined search strategy, unlike
systematic reviews. So we simply studied and developed the concept
in a qualitative way given the paucity of studies present in the scientific
panorama. Systematic reviews, on the other hand, are characterized
by a methodical and replicable methodology and presentation. They
involve a comprehensive search to locate all relevant published and
unpublished works on a topic; a systematic integration of research
results; and a critique of the extent, nature, and quality of evidence as
it relates to a particular research topic (Siddaway et al., 2019).
      This narrative review was conducted to PubMed database and used
two key terms “Bibliotherapy” and “rehabilitation”. We included studies
in line with this specific topic. This approach allowed us to include
studies and highlight the importance of this topic.
      The criteria for inclusion and the methods of the review have been
pre-specified in a protocol. In detail, exclusion criteria included were
as follows: (a) comments, commentaries, opinions, letters to editors,
interviews, specific editorials, conference abstracts or posters, book
chapters and books; (b) lacking details or quantitative information.




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Resources with these characteristics were not included in this review.
        The search of PubMed database provided a total of 470 quotations;
no additional studies meeting inclusion criteria were identified by
checking the reference list of the selected papers. Of these 464 studies
were excluded according to inclusion and exclusion criteria. After the
screening, a total of 6 studies assessing the bibliotherapy in
rehabilitation setting, met the inclusion criteria and were included in
the narrative review. Search was carried out from January 2018 to
January 2023, to give a recent view on the topic.


2.2. Identifying the research question
Studies about the topic of bibliotherapy in rehabilitation settings have
been included.
A variety of studies was included: qualitative information on this topic.
Studies in languages other than English, were excluded, as well as
studies not in line with this topic. Moreover, exclusion criteria were
review articles, books, reviews, editorial comments, and case
reports/series.
(See: Insert table 1).


3. Results
The studies examined showed the efficacy of bibliotherapic approach
in a variety of mental illnesses. Although studies present in literature
are outdated, it is an important issue, as it allows subjects to rewrite
their own story. Bibliotherapy positively influences psychiatric patients’
emotions, for example, it can normalize them, having an impact on
their     functioning   and    interpersonal   relationships.       Certainly      in
psychiatric rehabilitation there are several effective methods of
intervention,      such       as   psychoeducation,          pharmacotherapy,
psychotherapy, but bibliotherapy, as previously described if integrated
with these other methods is effective, bringing better and faster



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outcomes. This technique was found to be effective to reduce
depression and anxiety. Bibliotherapy is a concept with few boundaries
that leaves room for ideas and creativity. Bibliotherapy is a discipline
with blurred boundaries, adaptable to any reality, bearer of those
potentialities known by professionals who work with books.
(See: Insert table 2).


4. Discussion and Conclusion
The current study explored the effectiveness of a bibliotherapic
intervention supported by therapists for various psychopathologies.
The specificity of the application of bibliotherapy in clinical settings with
a rehabilitative and psychiatric nature, is based on the narrative
character of this approach. It allows to help patients adequately
express their emotions, process and manage them, re-telling their own
personal stories, through identification with the characters of a specific
story. Patients learn to know each other, to know their thoughts, their
emotions (Szabo et al., 2018). Generally, materials are about literary
texts related to the topic to be covered. It is dedicated to patients with
emotional or behavioural problems and its main purpose is to generate
insights and alter psychological situations of patients, including thought
disorders (Rubin 1978). Bibliotherapy provides a variety of content, can
activate emotional experiences, helping patients reading books, to
build self-knowledge, thus contributing to an adequate representation
of the world and of oneself. It refers to yourself and improves the
expression of your thoughts. The therapeutic role of the book is
achieved by helping patients to become aware of their own emotional
experiences and to have access to them. Also, bibliotherapy can be an
effective universal prevention tool for promoting mental health
(Kasperek-Zimowska et al., 2020). Given that, the results present in
literature underline the importance of the combination of narrative and
activities suited to developmental level of primary school children, as



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books capture their attention and facilitates learning. Results in
literature therefore underline the importance of the combination of
developmentally appropriate narrative and activities of primary school
children (Vetri et al., 2022).
     This model of intervention should not be understood as an isolated
one, but should be included within a team work, together with other
clinical practices to manage psychiatric patients. The studies reviewed
emphasize the importance of the combination of narration with other
clinical rehabilitation interventions. Books captures their attention and
facilitates learning, and the use of adapted tools can promote patients'
understanding of content, metacognition, facilitate debate about
sensitive issues, normalize their experiences and strengthen their
interest. These cognitive, emotional and relational aspects are very
important in design rehabilitation, especially in psychiatric, inpatient or
prison rehabilitation settings where the patient can work on enhancing
residual skills or affective regulation and metacognition deficits, as well
as implementing personal cultural and literacy levels.
     This topic has been little studied empirically, so this study aims at
presenting the results of mentioned studies, albeit with different
methodologies, and offers some interesting insights for healthcare
professionals (e.g., doctors, psychiatrists, and psychologists). However,
our results have brought us to recognize the effectiveness of this
method of intervention in clinical and rehabilitation settings, and
further investigations are needed.
     The limitations of this study are about the limited literature
produced so far. Another important limitation is the heterogeneous
nature of these studies in which methodological uniformity is lacking.




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Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest regarding
research, authorship, and/or publication of this article.


Funding
The author(s) received no financial support for research, authorship,
and/or publication of this article.




Table 1: List of search terms entered into the PubMed search
engines for identification the studies for this review.




      Number            Search term
      1                 Bibliotherapy [all fields]
      2                  Rehabilitation [all fields]
      3                 1 AND 2
      4                 English [language]




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  Table 2. Characteristics of the studies included in the review.

REFERENCES                       SAMPL                 TYPE OF
                        AIM                                                      FINDINGS
(Autor, year)                    E                 MEASUREMENT


                                              -the Patient Health
                                              Questionnaire-9 (PHQ-
                                              9)

                                               -the Generalized
                                              Anxiety Disorder scale
                 This study
                                              (GAD-7)
                 aims to
                 compare                      -the Positive and                Bibliotherapy
                                 41
Liu   et   al., chatbot                       Negative Affect Scale            for     reduction
                                 Particip
(2022)           therapy to                   (PANAS)                          of depression
                                 ants
                 other                                                         and anxiety
                                              -the Client
                 psychological                Satisfaction
                 interventions                Questionnaire-8 (CSQ-
                                              8)

                                              -the Working Alliance
                                              Inventory-Short
                                              Revised (WAI-SR)

                                                                               This        study
                                              -Cognitive behavioural shows                     a
                 This research
                                              bibliotherapy                is significant
                 testes a new 7
Radtke et al.,                                delivered         via      an reduction         in
                 bibliotherapy   Childre
(2022)                                        unpublished chapter 9 cases                     of
                 for the fear of n
                                              (66p, a story book whit severe
                 dogs
                                              topics on dogs).                 diagnosed
                                                                               phobias




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  C. Mento, F. Pira, V. Gueli Alletti, M. C. Silvestri, The Efficacy in Rehabilitation Context




                                                                                             This study
                                                                                             shows that a
                                                                                             self-
                                                          -8 weeks bibliotherapy administered

                                                          -type: self-                       psychological
                     This work                            administered                       intervention
                     aimed to                             psychological                      via ACT
Veillette et al., evaluate the               140          intervention with                  bibliotherapy
(2019)               effectiveness           Adults       minimal therapeutic                and with
                     of                                   contact in the                     minimal
                     bibliotherapy                        treatment of chronic               therapeutic

                                                          pain / it is based on              support can

                                                          ACT                                improve
                                                                                             physical and
                                                                                             emotional
                                                                                             functioning




                                                                                             The book
                                                                                             strengthens
                                                                                             resilience of
                     This study                           -Answers collected                 elementary
                     evaluates an                         online                             school-aged
Vetri    et   al.,                           22
                     interpersonal                        - open-ended                       children
(2022)                                       Particip
                     based book                           questions after                    having a
                                             ants
                     psychotherapy                        reading                            parent
                                                                                             suffering from
                                                                                             mental
                                                                                             problems




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                                           Critical Hermeneutics, 7(2), special, (2023)




               This study                                                     Participants
                                             - Interviews concluded
               aims to                                                        generally had
                                             with an opportunity for
               explore                                                        positive
                                7            participants to review
Watson et al., children’s                                                     experiences
                                Particip     and       express        their
(2021)         experience of                                                  with a
                                ants         impressions         on     10
               facing a                                                       programme
                                             children’s            picture
               parent’s                                                       for preventing
                                             books
               suicide                                                        suicide

               This study
               creates
               bibliotherapic
               material
                                                                              This study
               database and
                                                                              shows how
               examines the                  -the Optimism
                                                                              bibliotherapy
               effectiveness                 Pessimism Scale
                                64                                            promotes
Zhang et al., of                             -the Memorial
                                Particip                                      optimistic
(2022)         bibliotherapy                 University of
                                ants                                          attitude and
               on subjective                 Newfoundland Scale of
                                                                              reduces
               well-being. It                Happiness
                                                                              negative
               focuses on
                                                                              emotions
               older adults
               living in
               nursing
               homes.




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