Tell Me A Story: Promoting resiliency in military children with a bibliotherapy intervention.

PURPOSE: Research demonstrates the complex effect of the military lifestyle on children of military members. Problem behaviors can manifest in military children as young as 6 years old (eg, physical violence). Some military children have better outcomes (ie, resiliency). These differences in outcomes are not fully understood; literature agrees that parent's interaction with their children predicts resiliency. Nurses can utilize resiliency interventions to improve the health and wellbeing of families. Tell Me A Story (TMAS), a bibliotherapy intervention, role models for parents reading with their children, using story as a platform to deal with issues in a safe way. The purpose of this pilot study was to determine if child resiliency increased and problem behavior decreased with TMAS participation. DESIGN AND METHODS: A community-based study examined the impact of TMAS intervention on parent's perceptions of their school-aged children's behavior. Participants were active-duty military parents, recruited on or near seven military installations in the continental United States. RESULTS: Child problem behavior showed a change from baseline, with sex and parental deployment factoring for improved or worsening behavior among children. Total and internalizing problem behavior scores increased after intervention if a parent was deployed. Girls experienced increased resiliency scores after TMAS intervention while boys experienced decreased scores. PRACTICE IMPLICATIONS: Overall, TMAS intervention is beneficial for behavior and resiliency for some children and provides research for future programming offered by nurses for military families.

Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials.

Cognitive behavioural therapy (CBT) is a well-established treatment for obsessive-compulsive disorder (OCD). However, few patients receive CBT, due to factors such as geographic limitations, perceived stigmatization, and lack of CBT services. Technology-delivered cognitive behavioural therapy (T-CBT) could be an effective strategy to improve patients' access to CBT. To date, a meta-analysis on the effectiveness of T-CBT for OCD has not been conducted. This study used meta-analytic techniques to summarize evidence on the efficacy of T-CBT for OCD versus control conditions and therapist-administered CBT. A meta-analysis according to Prisma guidelines was conducted on randomized controlled trials (RCTs) of T-CBT for OCD. Treatment was classified as T-CBT if evidence-based CBT active ingredients for OCD were included (psychoeducation, ERP, and cognitive restructuring), delivered through health technologies (e.g. self-help books, leaflets, and other forms of bibliotherapy) or remote communication technologies (e.g. the Internet, web-cameras, telephones, telephone-interactive voice response systems, and CD-ROMS). Studies using validated outcomes for OCD or depression were included. Eight trials were included (N = 420). Two trials were classified as at high risk of bias. T-CBT seemed to be superior to control conditions on OCD symptom outcomes at post-treatment (d = 0.82, 99% CI = 0.55-1.08, p = 0.001), but not on comorbid depression (d = 0.33, 99% CI = - 0.01-0.67, p = 0.020). Difference in the efficacy on OCD symptoms between T-CBT and therapist-administered CBT was not significant, despite a trend favouring therapist-administered CBT emerged (d = 0.45, 95% CI = 0.03-0.87, p = 0.033). Directions for research are discussed. Further RCTs are warranted to examine the efficacy of T-CBT for OCD.

All at once or one at a time? A randomized controlled trial comparing two ways to deliver bibliotherapy for panic disorder.

Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions (M = 17.8 min, SD = 4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen's d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.

[The meaning of bibliotherapy and expressive writing in child and adolescent psychiatry]. / Zur Bedeutung der Bibliotherapie und des expressiven Schreibens in der Kinder- und Jugendpsychiatrie.

Child- and adolescent psychiatry is a good field for the application of creative and playful therapies. Bibliotherapy and expressive writing are two examples of them. The effectiveness of both, for different types of disorders, has been proved in many studies. Up until today it was unknown just how prevalent these therapies are within child and adolescent psychiatry in the german speaking countries. The following article summarizes the results of a survey conducted in 122 child and adolescence psychiatric clinics in Germany, Austria and Switzerland to gain more information about their use. The survey takes into account the frequency of application of bibliotherapy and expressive writing therapies depending on age and type of disorder, preferences amongst patient groups, as well as specific approaches. More than half of the surveyed child and adolescent psychiatries are using at least one of the two therapies. They are used on an irregular and non-systematic basis and rather symptom- than diagnosis-orientated. Bibliotherapy and expressive writing are dynamic therapies which can be used in manifold ways. Reading and writing are two of the main pillars of our educational system and can be utilized within a therapeutic setting. Provided that the patient is not suffering from severe cognitive or mental limitations, the spoken and written word can leave deep imprints within the patient's, but also the therapist's, soul.

Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK.

AIMS AND OBJECTIVES: UK health policy advocates a patient-centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e-learning materials to provide therapeutic support). Part 2 of this two-part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. METHODS: An e-mail questionnaire survey of psychiatric library members of the psychiatric lending co-operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. RESULTS: At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. CONCLUSIONS: In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.

Who uses bibliotherapy and why? A survey from an underserviced area.

OBJECTIVE: To assess which mental health therapists use bibliotherapy, their reasons for doing so, and rationale for recommending specific titles. To review the book selected most often in several categories, using prepublished criteria for reviewers of self-help books. METHOD: We sent a survey to all therapists in a Northern Ontario community requesting information on therapist demographics, the respondent's practice, the use of bibliotherapy, and details of the book most often prescribed in various categories. RESULTS: Of 112 surveys, 62 were returned, for a response rate of 55%. Sixty-eight percent of respondents indicated that they used bibliotherapy. The most common reason for recommending books was to encourage self-help. There was a significant relation between greater counselling experience and increased use of bibliotherapy. Three of the 5 books reviewed were based on empirical theory; only 1 met all the guidelines. CONCLUSION: Most therapists recommend books to their clients, but there is little empirical evidence of efficacy. Counsellors should review the books recommended and discuss them with the client. Client opinion should be solicited and effectiveness measured.

Children in hospital: II. Reading therapy and children in hospital.

Following the survey of book and library services described in the first of these two articles (Health Libraries Review, 8, 210-219), a research project funded by BNB Research Fund in 1991 investigated the theory and practice of reading therapy with children in hospital. Hospital play staff had been identified as the therapists most commonly involved and a number of them were interviewed using advance notice questionnaires and structured discussion. The following aspects were investigated: definitions of reading therapy, children in hospital, the reading therapy process, materials used, evaluation, services to facilitate and promote reading therapy, training and the role of libraries and librarians. Recommendations relate to practice, to provision and listing of materials, to evaluation procedures and to training. The final conclusions relate to the role of librarians in the processes and development of reading therapy with children in hospital.