2. Reading to children is central to their development.
“Books provide a safe medium for children to explore different
concepts, feelings, and attitudes while allowing them to better
understand their environment, community, and societal
expectations. Reading to children increases self-esteem, gives
comfort, and may aid children in coping with difficult
situations.”
3. Bibliotherapy is:
The use of written materials to gain understanding and engage
in problem solving relevant to the person’s therapeutic needs
What is Bibliotherapy?
Central to Development
Safe Outlet to Explore Concepts and Emotions
Why Bibliotherapy?
Communication
Stimulates Discussions and Conversations
Addresses innermost feelings
Provides Insight
Normalizes the Hospital Environment
Strengthen relationships
Healthcare Workers
Family
4. History
The term ‘‘bibliotherapy’’ was first used by S. M.Crothers in 1916 to describe the use
of books to help patients understand their health problems and symptoms.
Origin
The word is derived from the Greek words biblion (book) and oepatteid
(healing).
5. Can address/express
compassion, criticism, tension, relief, sadness, happiness, fear, c
ourage, rage, pain, anguish, and death
Children express their worries and fears differently than adults
Lack of verbal skills can inhibit the ability to express feelings and
emotions
Lack of family discussions concerning feelings
Parents’ stress reactions
6. Stages of Development and Literature
When Using Reading as a Resource to Minimize the
Stress of Hospitalization, it is Necessary to Consider
Aspects of Development
Pre-Schoolers (3-6 years) Experience a rapid development of
their vocabulary and language skills, and understand their
experience by using symbols, including language
School-Aged Children (6-8 years) Are improving their
reading and like to know about concepts and skills
Pre-Adolescents (8-11 years) Enjoy realistic fiction and books
that describe real life events, since they are learning to make
choices and developing personal values
Adolescents (12-18 years) Enjoy novels and fiction, fantasy, or
even individual non-assisted readings
7. Selection of a Book
Criteria:
Must not give a false sense of hope
Must provide correct information about a presenting
problem
Age appropriate
Assess the Child’s Development, Coping Response, and
the Attitude of the Child’s Parents
8. Transformation of Children’s Beliefs
Themes
Separation
Escape from a Difficult Situation
Recovery
Small Individuals who are Important
Control
Rescue by a Powerful Stranger
9. Determining a Theme
Stage of Cognitive Development
Stage of Personality Development
The Impact of the Medical Condition on the Child’s Life
The Psychological Defense Mechanism the Child Uses
The Child’s Dominant Affectual State
The Attitudes of the Family Members toward the Child
and the Illness
10. Didactic
Instructional and educational, similar to textbooks. A
didactic text can be found for nearly any topic a clinician may
wish to address with the patient-reader, including personality
conflicts, and coping with stress (eg, self-help books). The
purpose is to facilitate a direct change within the individual
through a cognitive understanding of self.
Imaginative
Refers to the dramatic presentation of human behavior
through fiction, poetry, drama, biography, and
autobiography.
11. Stages of Therapeutic Involvement
1. Involvement
At this point, patients begin listening to the story and
demonstrate interest in what is happening. They get “caught
up” in the narrative
2. Identification
Patients best identify with characters of the same age and
who are experiencing similar circumstances
3. Catharsis
Patients are pulled further into the process of recognizing
and vicariously experiencing the character’s feelings. As the
character successfully resolves problems, patients release
emotional tension associated with their own problems
12. 4. Insight
Patients think about what happened in the story and apply it
to their own lives. Patients begin resolving the struggles they
may be personally experiencing
5. Universalism
Patients move beyond the egocentric trap of only seeing their
own problems and the perception that no one else
understands or shares their pain. They gain a broader
perspective of their own challenges and are able to
understand that others may have similar problems.
13. Stages of Bibliotherapy
Identification
Selection
Presentation
Follow up
14. Conditions to be Met
Rapport, Trust, and Confidence to Have Been
Established
The Patient and Child Life Specialist have Begun to
Address Goals/Interventions
Some Preliminary Exploration of the Problem has
Occurred
15. Reading Goals
Creating your Own Goals
Examples of goal
Provide a sense of pleasure and enjoyment through
humorous read-alouds
Provide normalization by facilitation of imaginative
separation from the hospital environment through pre-
occupation with read-alouds
Program Design Aligns with Child Life Goals
16. Entrancement During the Reading
Strong Emotional Responses
Show evidence of their experience in relation to their disease and
care, their acceptance and understanding. This information is
relevant to plan comprehensive and humanized care.
Preoccupation with the Story’s Theme
Cascades of Questions
Testimonials
Examples: The child’s comments and questions, such as “that
mouse is hurt just like me” and “is he scared too?” seemed to
indicate strong identification with story characters in children read
aloud to in a research study.
In the same study, several stories which had characters who
survived a catastrophe, generated in some children hope and smiles
and questions about their own convalescence and recovery.
17. Use of Timing
Questioning Strategies
Questioning strategies during and after reading should
not be judgmental; rather, the focus is on the feelings of
the main characters
Facilitators must allow the stories themselves to shape
the questions
For example, “In the book, Onion John, how do you think
Onion John felt when Andy was able to understand what he
said?” or “In Sam, Bangs, and Moonshine, how do you think
Sam felt when her friend and her pet were in danger?”
21. What is the main idea of this story?
Why do you think the story has the title “ ”?
What would be another good title for the story?
Why does a character (take a particular action)?
What caused______to______?
What effect did _______ have on _______?
What character can you connect with most in the book?
What issue in the book the most interesting? Upsetting?
Familiar? Ridiculous? Confusing?
What are the problems the main character faces and how
are they solved?
22. What events and people cause the main character to
change?
What have you learned in the book that will be helpful
to you in the future?
What do you think the author wants you to know or
learn?
What impact has the story made on you?
What caused….?
Why do you think…?
23. To Assist in Determining the Appropriateness of a
Post-Reading Activity, Ask These Questions:
Will the activity help students connect with the story?
Will the activity help students connect with the story?
Will the activity help students in making conclusions
aligned with the story?
Will the activity promote emotional growth and
healing?
24. Use of Ipad, Ipod/Iphone, or Kindle (can use kindle
Application for the Apple Technology
Use of YouTube:
http://www.youtube.com/watch?v=zwwGBVa1j9A
The Next Place
http://www.youtube.com/watch?v=Scj3A1cLVzY
You are Special
http://www.youtube.com/watch?v=RnYW6YH_8w4
Alexander and the Horrible, No Good, Very Bad Day
4. During this stage students feel supported by others and lose their sense of isolation and alienation. Freeing up these inhibitions, patients are in a better position to access personal resources and coping skills