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Bibliotherapy: A Review and Analysis of the Literature

Ronald S. Lenkowsky
J Spec Educ 1987 21: 123
DOI: 10.1177/002246698702100211

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 BIBLIOTHERAPY: A REVIEW AND ANALYSIS OF
THE LITERATURE 1

Ronald S. Lenkowsky, EdD

Hunter College

Bibliotherapy, the use of reading to p r o d u c e af- demonstration o f the efficacy o f bibliotherapy

fective change and to promote personality and cautions against special education utiliza-
growth and d e v e l o p m e n t , is e x a m i n e d through tion without controlled study. Until such re-
a c o m p r e h e n s i v e analysis o f the literature. A search b e c o m e s available, the special educator
conceptual framework with which to review the s h o u l d proceed slowly in use o f this interven-
available data is suggested. This framework tion. H o w e v e r , understanding o f the principles,
looks at bibliotherapy in four ways: as self- philosophy, a n d practices o f bibliotherapy is
actualization therapy, a strategy for attitudinal seen as valuable for those personnel working
change, a m e t h o d for self-concept improve- with children w h o m a y profit f r o m the e x p o s u r e
m e n t , and an instructional/didactic tool. T h e to reading materials directed to their specific
literature analysis reveals litde systematic problems.

Recently, bibliotherapy has been offered as an intervention for special educators

to help exceptional children better understand themselves and their feelings and
as a counseling strategy within the classroom to meet social and emotional needs
(Lerner, 1985; Ysseldyke 8c Algozzine, 1984). Bibliotherapy is defined as an at-
tempt to help a child understand himself or herself and cope with presenting
problems by providing literature relevant to that child's personal situation and
developmental needs at the appropriate time (Russell, 1958).
Bibliotherapy arose from the concept that reading could affect an individual's
attitude and behavior and is thus an important influence in shaping, molding,
and altering values. The underlying assumption is that this effect denotes change
in attitude or behavior, and that this change is specific and predictable (Russell 8c
Shrodes, 1950).
Bibliotherapy has been a part o f the literature o f the social sciences for well
over a half century (McKinney, 1975). Originally, the field was dominated by
institutional/medical applications o f the theory as a therapeutic treatment offer-
ing emotional relief to patients suffering both acute and chronic impairments.
The next phase, counseling/clinical, was popularized by the psychodynamic
utilization o f bibliotherapy by a trained therapist to help children prevent or
solve personal problems, or improve self-concept. In this way, the literature o f
the 1950s and 1960s characterizes bibliotherapy as a specific, progressive,
planned therapy that includes three main components: identification, catharsis,
and insight. Identification with characters, situations, or elements o f a story en-

'This manuscript was accepted for publication under the editorial direction of Lester Mann.

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ables the reader to view his or her problem from a new and different perspective
and thus gain hope and tension release (catharsis). Such tension reduction allows
the reader to gain insight into his or her own motivations and actions and allows
for positive change in attitude and behavior (Lenkowsky 8c Lenkowsky, 1980).
In the last two decades, bibliotherapy has expanded to include self-
actualization, self-help and education, and problem-solving applications, often
termed limited-contact therapy approaches (Glasgow 8c Rosen, 1978), as well as
more didactic and instructional techniques (Rubin, 1979). Unfortunately, this
expansion has resulted in confusion in contemporary bibliotherapy—a poorly
articulated, barely coherent field. "It is instead a multifarious collection o f
techniques and practices in which literature is used in some fashion to structure
or organize interpersonal interactions (Berry, 1978, p. 2) or to affect intraper-
,,

sonal feelings and actions (Roy, 1979). As a result o f this expansion and overlap
in interpretation, definition, and utilization, understanding and evaluating the
efficacy o f bibliotherapy is difficult.
The purpose o f this review and analysis o f the current literature is to organize
and report on bibliotherapy in a coherent fashion. This will be accomplished by
suggesting a conceptual framework through which aspects o f bibliotherapy may
be examined and through which analysis of specific objective may be prepared.

A CONCEPTUAL FRAMEWORK
Sclabassi (1973) suggests that bibliotherapy be approached in terms o f the o b -
jectives o f a particular application without reference to general theoretical con-
structs or semantic differences, which may only confuse understanding. It makes
sense to employ this schema and to examine current investigations from such a
perspective. Bibliotherapy may thus be reviewed from the following four
applications.
Self-Actualization, Problem-Solving Utilization encompasses objectives that reflect
efforts to impart information and knowledge for self-improvement, self-
actualization, and self-knowledge. They are designed to promote self-
understanding and successful problem solving.
Social Utilization includes the objectives o f affecting attitudes, social acceptance,
social standing, and o f reinforcing one's sense o f social awareness and sen-
sitivity.
Psycho-therapeutic Utilization incorporates objectives o f developing emotional
and psychological insight and growth, improving self-concept, and redirecting
inappropriate behaviors and impulses. These objectives "are concerned with
universalization-dispelling feelings o f being different; providing vicarious expe-
rience without immediately exposing one to the dangers o f actual experience;
and allowing opportunity to discuss problems without initial embarrassment o f
explicit self-revelation" (Sclabassi, 1973, p. 72). This technique requires leader-
ship and direction from the "bibliotherapist."
Educational/Didactic Utilization includes objectives such as teaching others how
to use bibliotherapy, what books or alternative materials to employ, what in-
structional techniques are most beneficial, or relating experiences using the pro-

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cess. Underlying most o f the literature on this level is the conviction that the
basic tenet o f bibliotherapy, that reading promotes change, is unchallenged.

ANALYSIS OF CURRENT RESEARCH BY OBJECTIVE

Self-actualization, Problem-solving Utilization. Does bibliotherapy significantly
contribute to self-knowledge, self-actualization, and so forth? There is some sup-
port for bibliotherapy as an effective intervention in the broad area o f "self-help"
and problem solving. Miller (1982), in an investigation o f the approach in the
treatment o f alcohol abuse, found that bibliotherapy provides critical conditions
that allow a person to change by providing material for contemplation, m o -
tivational ideas and information, and specific, active strategies for such change.
He also termed bibliotherapy useful in maintaining gains and in eliminating
many problems that arise from resistance to standard therapy and therapists.
Further, bibliotherapy has been found to be as effective as any other strategy
(Miller, Taylor, 8c West, 1980), but much more cost effective (Miller 8c Taylor,
1980). This type of bibliotherapy has also been effective in treating phobias
(Kolko 8c Milan, 1980), obesity (Pezzot-Pearce, LeBow, 8c Pearce, 1982), sexual
dysfunction (Trudel, Saint-Laurent, 8c Proulx, 1985), and agitation and depres-
sion (Boorstein, 1983).
However, other experiments in self-improvement have not produced results
supportive o f bibliotherapy. Libman (1984) found that bibliotherapy is not as ef-
fective as other therapy methods for treating sexual dysfunction. Similarly,
Bornstein (1984) found marital conflict unimproved by the process, while Seibel
(1979) reported little impact on cessation o f cigarette smoking. In these instan-
ces, the inability to provide sufficient motivation is suggested as a possible reason
for failure. In addition, some have found that bibliotherapy did not maintain
gains made by other therapy formats (Spevak 8c Richards, 1980), and it was effec-
tive in weight control only if combined with other forms o f therapist assistance
(Black 8c Threlfall, 1986).
Perhaps the best conclusion to reach concerning bibliotherapy and self-
actualization, problem solving utilizations is that the evidence is mixed. Neither
justification, nor rejection o f its use, is substantiated. Stevens and Pfost (1982) in
their review o f literature suggested the need for continued research and the need
for caution in the use o f self-directed bibliotherapeutic interactions. The scope o f
interpretation o f what bibliotherapy is appears too broad for its original
intent.

Social Utilization. Does bibliotherapy improve attitudes, social skills, social

awareness, and so forth? Conflicting data are found on the effect of bibliotherapy
in the area o f social skills. Schwartz (1981), Schrank (1982), and Schrank and En-
gels (1981) all reviewed the research o f the last two decades and concluded that
bibliotherapy may help children solve personal and social problems or improve
attitudes toward others, although little demonstration o f improvement in self-
concept is clear. Heitzmann and Heitzmann (1975) agreed that, although not
precise, bibliotherapy may be o f benefit in social change. DiSturco (1984)

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found that bibliotherapy has significant, positive effects on children's personal
and social development.
But, more current research fails to support the positive impact o f biblio-
therapy on social skill improvement or attitude change. Warner (1980) reviewed
the literature and found that much o f the research on bibliotherapy and attitude
or social change is incomplete, inconsistent, and does not support biblio-
therapeutic claims. She further indicates that even when improvement is found,
it is only short-term (Warner, 1980).
Tillman (1984), in his review o f bibliotherapy with adolescents, also found no
support for attitude change, or general social skills development, and concluded
that although some benefit o f the therapy may be seen, clear, substantiating
research is lacking.
Monti (1979) found that bibliotherapy does not affect social skills in psychi-
atric patients, while Kohutek (1983) concluded that bibliotherapy by itself will
not increase personal/social growth in prison inmates without other effective
therapy. Van Son, Landsheer, de Jong, and Groot (1983) discovered that social
skills were unimproved by bibliotherapy and decided that social behavior prob-
lems may be too complex to be treated by this method.
Finally, in studies of particular interest to special educators, Moss (1980) and
Beardsley (1979, 1981-82) reported that efforts to improve the attitudes o f
regular elementary school pupils toward disabled and handicapped children
were not successful through bibliotherapy. Both authors determined that
bibliotherapy does not change perceptions towards handicaps. Thus, although
some positive indications exist, it appears that the data d o not support biblio-
therapy as sufficient to improve attitudes and social skills. Controlled research is
necessary before social utilization objectives can be validated.

Psycho-therapeutic Utilization. Is bibliotherapy effective in providing emotional

release, alleviation of specific problems, or improvements in concept o f self?
Again, consistent research results are not observable in the use o f bibliotherapy
specifically oriented to self-concept improvement and emotional release. Robin-
son (1980) and Wallick (1980) reported improvement in feelings o f self-worth
and in achievement for special education students and an autistic child treated
with bibliotherapy, but without controlled research. Schizophrenics in a biblio-
therapeutic treatment program evidenced no gain in self-concept that could not
be obtained through other methods of therapy (Alexander 8c Buggie, 1967), and
yet another schizophrenic population evidenced no significant improvement in
self-concept (DeFrances, 1982). And, when specifically targeted towards reduc-
ing children's fears, bibliotherapy was not effective (Newhouse 8c Loker, 1983).
On the other hand, when used in conjunction with other thereapies, biblio-
therapy was helpful in offering emotional relief to a burn patient (Walker 8c
Healy, 1980) and bereaved mothers (Mahan, Schreiner, 8c Green, 1983). Im-
provement in feelings about self in a retarded population was reported by Kan-
trowitz (1967). As a preventative for developing self-concept difficulties in
children experiencing family change (death, divorce, moving, etc.), biblio-

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therapy was found effective as part o f larger treatment plan (Sheridan, Baker, 8c
de Lissovoy, 1984).
It is apparent that before bibliotherapy can b e certified br accepted as a
psycho-therapeutic practice, detailed clinical examination must be conducted.
As will be noted in examining the final approach toward bibliotherapy, there is
no lack of opinion on the psycho-therapeutic benefits o f bibliotherapy, but
perhaps self-concept, like attitude, is not readily definable, and any improve-
ment may be too uncertain for empirical verification.

Educational/Didactic Utilization. Does the literature relate to teaching prac-

titioners how to apply bibliotherapy, provide rationale for its use, relate ex-
periences, and suggest materials and techniques? The largest body o f available
literature reports on the application o f bibliotherapy for preventative, remedial,
and/or developmental goals. These are subjective accounts, assuming—but not
verifying—that the therapeutic process originally postulated for bibliotherapy is
operational and effective. Gains observed are tied to a belief in the principles o f
the therapy and the benefits to be obtained for students in affective functioning.
For ease o f examination, the literature will be examined in three categories:
general application, specific problem application, and application to special
education.
In terms of general application, there are many articles explaining the interactive
therapeutic process inherent in bibliotherapy-identification and projection,
catharsis and abreaction, and insight, as well as articles describing variations o f
proper implementations for practitioners (Bodart, 1980; Bohning, 1981; Davi-
son, 1983; Garner, 1976; Hoagland, 1972; Howie, 1983; Lehr, 1981; Morgan,
1976; Nickerson, 1975; O'Bruba, 1978; Ouzts, 1984; Pardeck 8c Pardeck, 1984b).
It is suggested that bibliotherapy can be accomplished by social workers, li-
brarians, and teachers. Under the guidance of such bibliotherapists, specific
groups experience gains, including maintenance o f overall emotional health in
children and youngsters (Jalongo, 1983b; Pardeck 8c Pardeck, 1984c), adoles-
cents (Angelotti, 1985; Tartagni, 1976; Taubenheim, 1979), and adults (Anstett
8c Poole, 1983; Stolzenberg, 1979). Support for personality growth and change
has also been noted (Alton 8c Lanning, 1979; Morris, 1973). Available reading
materials are suggested for use in bibliotherapy projects, annotated biblio-
graphies provided, and caution and advice on literature evaluation for teachers
and others offered (Ashley, 1978; Galen 8c Johns, 1979; Greenlaw, 1982; Groff,
1980; Heitzmann 8c Heitzmann, 1976; Hippie, Yarbrough, 8c Kaplan, 1984;
Holbrook, 1982; Jalongo, 1983a; Pilon, 1972; Schwartz, 1981; Singer, 1977).
Several nonreading bibliotherapy methods are discussed, including audiovisio-
therapy (Axelrod 8c Teti, 1976), media therapy (Weinstein, 1978), poetry therapy
(Hynes, 1981), and tell-a-therapy (O'Bruba 8c Camplese, 1979).
With respect to specific problem application, descriptions of bibliotherapeutic pro-
grams applied to different types of problems are addressed in the literature.
These include children's problems related to divorce (Martin, Martin, 8c Porter,
1983; Monteith, 1981; Randolph 8c Gredler, 1984; Winfield, 1983), the dif-
ficulties of alcoholism or alcoholic parents (Cilliers, 1983; Manning 8c Man-

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ning, 1984), abuse (Carla, 1978; Pardeck 8c Pardeck, 1984a; Randolph 8c Gredler,
1985; Watson, 1980), aging (Hynes, 1979; Strunk, 1984), fear o f the dark
(Mikulas, 1985), death (Heath, 1986), being a child in a step-family (Mclnnis,
1982), health (Rubin, 1983; Threadgill, 1978), and coping with incarceration
(Cellini 8c Young, 1976). These publications advance bibliotherapy as effective in
particular situations and advocate generalization to problems similar to those
they have treated.
For applications to special education, Moody and Limper (1971) and Zaccaria
(1978) have prepared texts on the proper use o f bibliotherapy with handicapped
children, providing literature selections and evaluations, and recommending the
bibliotherapeutic process as effective for improving self-concept, feelings, and
productivity o f handicapped children. Bibliotherapy has been shown to ease
coping with psycho-social needs and problems o f daily living for blind children
(Roberts, 1984) and physically impaired children (Allen, 1980; Hopkins-Best 8c
Wiinamaki, 1985). The special challenges and needs o f gifted children have also
been approached through the process (Frasier 8c McCannon, 1981; Sisk, 1982),
while obvious attention has also been given to tension relief and adjustment for
emotionally disturbed children (Leedy, 1969; Olsen, 1975; Russell 8c Russell,
1979). Finally, bibliotherapy is presented as a method for helping learning dis-
abled children gain interpersonal competence, improve their concept of self,
and meet unique personal/social needs (Gerber 8c Harris, 1983; Lindsey 8c
Frith, 1981).
The objectives o f the fourth utilization are accomplished by the literature. The
examples o f action research, guided suggestions, and recommended generaliza-
tions demonstrate that many people are using the reading process in an attempt
to provide relief to children, adolescents, and adults. The absence o f systematic,
objective, comparative research, however, suggests that while many believe in
bibliotherapy and are using it, sufficient substantiated evidence o f how it works,
why it works, or if it works, is not yet available.

SUMMARY AND CONCLUSION

Bibliotherapy was, and continues to be, used by the helping professions to
treat children. For the bibliotherapist, it is a fundamental belief that reading will
influence thinking and behavior and that through structure, guidance, and coun-
seling, selected readings can be focused on specific needs. But, while the ma-
jority o f authors "feel" that bibliotherapy helps those clients they serve and are
advocates o f the technique, available objective evidence is unclear, if not uncon-
vincing, regarding such benefits. Special educators would be wise to consider
carefully any claims that using bibliotherapy in the classroom will provide
therapeutic assistance for the handicapped or exceptional child or will supplant
the need for other on-going therapies. Until more objective research is designed,
implemented, and compared, and sufficient representative studies completed,
bibliotherapy may best be considered as a possible instructional and values
clarification system, but not as a truly validated counseling intervention for spe-
cial education.

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