An investigation of experiences of reading for mental health and well-being and their relation to models of bibliotherapy

Brewster, Liz and Cox, Andrew and Sen, Barbara (2012) An investigation of experiences of reading for mental health and well-being and their relation to models of bibliotherapy. PhD thesis, Uni of Sheffield.

Abstract

Bibliotherapy is the use of imaginative or self-help literature as an intervention for mental health problems. It aims to provide psycho-social support and treatment and is used with individuals or in a group. Bibliotherapy has come to prominence in the UK over the past decade. Bibliotherapy schemes mainly operate in partnership between the public library and the NHS. Previous research on bibliotherapy has focused on the quantitative effectiveness of the intervention or anecdotal report of individual successes. Evaluation of current schemes and qualitative investigation of the views of those experiencing bibliotherapy have been neglected in previous research, providing the rationale for this thesis. The thesis argues that because there have been shortcomings in previous research, there are differences in the understanding between those managing bibliotherapy schemes, and those using the schemes. The thesis has a dual research design; it critically analyses the emergence of the main models of bibliotherapy in the UK, deconstructing them using an Actor-Network Theory framework. Document analysis, interview data, and descriptive statistics contribute to these findings. Analysis concludes that the focus of these models is not always user-centred, with other factors driving the implementation of the intervention e.g. cost-effectiveness and health policy requirements. The type of text used is a key element of the intervention. The thesis also takes a qualitative, ethnographic approach based on Interpretive Interactionism to investigate the experiences of people with mental health problems who use bibliotherapy. Data was collected via an interview and observation study. It concludes that there are diverse uses of bibliotherapy. Building on the gaps between the application of bibliotherapy and the experience of using it, the central finding of the thesis is the emergence of four user-centred models of bibliotherapy, focused on the outcomes of bibliotherapy rather than the text used. These proposed models reflect the emotive, escapist, informational, and social outcomes of using bibliotherapy as a form of support for mental health problems.