Bibliotherapy the write stuff can be good for you

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Bibliotherapy the write stuff can be good for
you!

• Rowena Perry BA Hons, PGDipLib, MCLIP
• Library Manager
• Health Informatics Shared Service
• Prospect Park Hospital
• Reading

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What is bibliotherapy?

• The use of a self-help book to treat a
  disorder.highered.mcgraw-hill.com/sites/007298636
  0/student_view0/chapter19/glossary.html
• However not just any old self-help book will do

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What is an information prescription?

• Information prescriptions will contain a series
  of links or signposts to guide people to sources
  of information about their health and care for
  example information about conditions and
  treatments, care services, benefits advice and
  support groups. http//www.informationprescription
  .info/
• From 2008, information prescriptions will be
  given to everyone with a long-term condition or
  social care need, in consultation with a health
  or social care professional. (The Department of
  Health white paper 'Our health, our care, our
  say' published in January 2006)

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Piloting the project

• There are 20 pilot sites mainly NHS Trusts
  sometimes working with for eg the RNIB plus some
  local authorities
• The work they are doing includes
• identifying content sources that people should be
  signposted to
• establishing directories of content and compile
  the links that will point to the content
• generating a template to determine how a
  personalised information prescription is created
  and formatted for a specific point on a care
  pathway

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What are books on prescription

• GPs or other clinicians prescribe from a list of
  clinician evaluated self-help books
• The patient takes the prescription to their
  local public library and borrows the book from
  there
• The most effective schemes involve follow-up or
  at least contact by a clinician
• One of the first schemes started in Cardiff in
  2002 and bibliotherapy is now funded by the Welsh
  Assembly for the whole of Wales

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What is useful?

• Good quality self help books
• Generally these are based on Cognitive
  Behavioural Therapy techniques - CBT is commonly
  based on the idea that how we think (cognition),
  how we feel (emotion and affect), and how we act
  (behaviour) all interact and go together. Source
  http//en.wikipedia.org/wiki/Cognitive_behavioral_
  therapy

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• For eg
• Books in the series Overcoming published by
  Constable and Robinson
• Mind over mood by Dennis Greenburger and
  Christine Padesky
• Woman in your own right by Anne Dickson
• Head Injury a practical guide by Trevor Powell

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Beware of SHAM

• The Self-Help and Actualisation Movement.
• For eg Men are from Mars, Woman are from Venus
  hardback, paperback, CD, audio cassette,
  calendar, book of days
• Men Are from Mars, Women Are from Venus, Children
  Are from Heaven How to Have Strong, Confident
  Children
• Mars and Venus Starting Over A Practical Guide
  for Finding Love Again After a Painful Breakup,
  Divorce, or the Loss of Loved One (also available
  in large print)

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When is it useful?

• When a patient has a mild or moderate mental
  health problem eg
• Depression
• Panic disorder
• Obsessive Compulsive Disorder
• Anxiety
• It is not suitable for more serious conditions
  such as
• Personality disorder
• Schizophrenia

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Are there other types of bibliotherapy?

• Creative bibliotherapy uses fiction,
  non-fiction and poetry and can lead on to
• Creative writing
• This is more intensive and requires skilled staff
  (ie those with training/experience in working
  with people with mental health problems) to lead
  it
• There are additional benefits for example
  improving confidence, self - esteem and
  inter-personal skills by reading, discussing and
  debating in small informal groups.

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Who doesnt it suit?

• Those who have literacy issues reading age of
  books can be high and chapters long
• The visually impaired
• Those who are so unwell that they lack the
  motivation to undertake self-help
• Some conditions are too critical/ complicated/
  severe
• It wont suit some people but it can help many

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A word about EBM

• What is evidence based medicine?
• Evidence-based medicine is the conscientious,
  explicit and judicious use of current best
  evidence in making decisions about the care of
  individual patients. The practice of
  evidence-based medicine means integrating
  individual clinical expertise with the best
  available external clinical evidence from
  systematic research.
• Source http//www.cebm.net/

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Wheres the evidence I?

• den Boer P C, Wiersma D, van den Bosch R J.
  (2004) Why is self-help neglected in the
  treatment of emotional disorders a meta
  analysis. Psychological Medicine. 34 (6),p
  959-971.
• Bibliotherapy for clinically significant
  emotional disorders is more effective than
  waiting-list or no treatment conditions. No
  difference was found between bibliotherapy and
  psychiatric treatment of relatively short
  duration.

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Wheres the evidence II?

• Cuijpers P. (1997) Bibliotherapy in unipolar
  depression a meta-analysis. Journal of Behavior
  Therapy and Experimental Psychiatry. 28 (2),p
  139-147.
• Bibliotherapy was an effective treatment modality
  in unipolar depression, which was no less
  effective than individual or group therapy.

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Wheres the evidence III?

• Marrs R W. (1995) A meta-analysis of
  bibliotherapy studies. American Journal of
  Community Psychology. 23 (6),p 843-870.
• The overall results suggest that bibliotherapy
  has a moderate degree of effectiveness. It is
  possible that bibliotherapy is more useful for
  anxiety-related problems rather than those
  problems associated with controlling the need for
  immediate gratification.

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Why do it?

• Because it works and is cost effective?
• Because NICE say so? (NICE guidelines on
  depression, anxiety and eating disorders advocate
  the use of bibliotherapy as part of a stepped
  care programme.)
• It ticks lots of boxes both for the NHS and
  public libraries.

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• For a copy of the briefing paper please email
• Rowena.perry_at_berkshire.nhs.uk