The Need for Youth-Based Bibliotherapy and CBT

Recommended APA 7th Edition Citation:

Grinev, L. (2024, April 5). The need for youth-based bibliotherapy and CBT. In Articles. WellnessToday180. https://wellnesstoday180.net/blog#articles

Cognitive-behavioral therapy (CBT) is a form of psychological treatment that uses core principles to change thinking patterns for a range of problems (American Psychology Association, 2017). Cost-effective CBT approaches, such inciting reflections and self-development through characterization, journaling, and poem reading and writing (Peach, 2023), can be effective among clinical and general populations, including youth, to combat various mental problems (Nakao et al., 2021). Empirical validation and endorsements of the effectiveness of CBT across a range of disorders and age groups can be seen in Dobson et al. (2019). Altogether, CBT is remarked as the current gold standard of psychotherapy (David et al., 2018) and can be easily implemented in bibliotherapy (Peach, 2023).

Currently, 1-in-5 youth, those aged 13-18, in the United States of America (U.S.) live with a mental illness (Centers for Disease Control and Prevention [CDC], 2023). Mental illness can cause declines in a youth’s emotional, psychological, and social wellbeing or ability to handle stress, relate to others, or make healthy choices (CDC, 2023). Hence, there is a need to distribute engaging and relatable prose-based materials, such as those including storylines that incorporates diverse and multicultural fictional characters, to youth, healthcare providers, and educators to help youth understand their disorder and needed actions to increase their wellbeing. These prose-based materials should use approaches rooted in CBT and bibliotherapy that encourages youth to engage in creative processes and relational reflections through characterization, journaling, and poem reading and writing to facilitate a youth’s wellbeing against mental illness (Peach, 2023).

Theoretical Background

Cognitive behavioral therapy (CBT) arose out of two models. On the one hand, Dozois et al. (2019) stated that the models used for CBT are the radical behavioral approach, which highlights interventions from classical and operant conditioning towards behavioral changes, and facets of the information-processing model of cognition, where cognitive phenomena are considered towards behavioral mechanisms to promote self-control and -regulation (Dozois et al., 2019). On the other hand, Nakao et al. (2021) similarly told how CBT began as a combination of rational emotional therapy and cognitive therapy as far back as the 1950s. Regardless, CBT became the first psychotherapy to use a health-related, evidence-based framework with stringent criteria, such as active comparator and randomized trials, according to Dozois et al. Altogether, cognitive restructuring, coping-skills therapies, and problem-solving therapies then became the three major divisions of CBT, according to Dozois et al. Additionally, Nakao et al. also listed acceptance and commitment, dialectical behavioral, and mindfulness-based cognitive therapies, functional analytic psychotherapy, extended behavioral activation, and psychosomatic medicine as forms of CBT. 

Literature Review

Beginning with David et al. (2018), their article was a scoping review (i.e., empirical synthesis) over the effectiveness of CBT. Out of the accounts mentioned by David et al., CBT had high or strong comparisons over pill placebo and treatment as usual (TAU) at 54% out of 34 depression trials, 20% out of 25 anxiety trials, and 17% for trials covering depression and anxiety. In most cases, David et al. presented that CBT often meets the gold standard of equivalence in effectiveness/efficacy by falling in an interval of -0.25 to +0.25. In other words, CBT is not an inferior design (David et al., 2018). Still, concerns for the effectiveness/efficacy of CBT surround target symptoms, general psychiatric symptoms, integrating large mainstream information processing paradigms and larger pictures of science (i.e., cognitive neurogenetics), and the continuous need for cumulative and critical research (David et al., 2018). Nevertheless, CBT meets international psychosocial treatment standards of the National Institute for Health and Care Excellence and the American Psychological Association (David et al., 2018).

Then, Dozois et al. (2019) conducted an integrative literature review of CBT in which Dozois et al. clarified the significance of CBT as an approach that has protocols within the Diagnostic and Statistical Manual of Mental Illnesses (DMS-5) for various disorders. Because of CBT, clinicians also have transdiagnostic and modular approaches available (Dozois et al., 2019). Despite generally positive outcomes that individuals have under CBT interventions, Dozois et al. found that participants had dropout rates of about 15%, inability to receive anxiety remission around 45-50%, or a 40% likelihood of relapse. Dozois et al. recommended that further process-oriented research is needed to facilitate treatment improvements, especially treatments incorporating technology, particularly smartphone apps and websites, towards treatment effectiveness.

Additionally, a meta-analytic review by Nakao et al. (2021) reviewed 345 articles from 1987 to 2021 relating to biopsychosocial medicine. The search by Nakao et al. showed that the number of publications on CBT significantly increased between 2014 and 2021. The conclusions drawn by Nakao et al. support that CBT is effective for various mental problems, physical conditions, and behavioral problems with short-term interventions. 124 disease conditions clarified CBT effects in randomized controlled trials, and further efficacies of CBT were found for other major conditions (Nakao et al., 2021). More insights to better understand the long-term effects of CBT are needed through recommended follow-ups (Nakao et al., 2021). Nonetheless, CBT was found in non-patient and patient populations (Nakao et al., 2021), supporting the growing popularity of CBT among clinicians and individuals.

Lastly, Peach (2023) explored the influences of bibliotherapy on mental-health conditions through an exploratory qualitative study. Through reading, writing, and the use of texts, Peach exclaimed that bibliotherapy can promote client well-being, particularly through relaxation or increasing emotional expressions and recollections. As a result, participants in Peach reported proliferations in emotional processing and reflections, interpersonal engagements, and self-development. Altogether, Peach affirmed that self-directed creative literacy practices, including bibliotherapy, are beneficial toward managing mental health for young people.

Conclusion

Bibliotherapy founded in CBT practices is expected to positively promote well-being among young people with mental illnesses. The success of CBT-based bibliotherapy is possible by combining reading, writing, and use of texts (Peach, 2023) with cognitive restructuring, coping-skills therapies, and problem-solving therapies (Dozois et al., 2019). Otherwise, CBT-based bibliotherapy can be combined with acceptance and commitment, dialectical behavioral, and mindfulness-based cognitive therapies, functional analytic psychotherapy, extended behavioral activation, and psychosomatic medicine (Nakao et al., 2021) to improve the lives of young people with mental illnesses. Support for positive baseline effectiveness of CBT-based interventions can be drawn from David et al. (2018). Adding bibliotherapy to existing CBT-based interventions is expected to extend effective impacts against mental illnesses.

References

American Psychological Association [APA]. (2017). What is cognitive behavioral therapy? https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Centers for Disease Control and Prevention [CDC]. (2023, April 25). About mental health. https://www.cdc.gov/mentalhealth/learn/index.htm

David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychology, 9(4). https://doi.org/10.3389/fpsyt.2018.00004

Dobson, K. S., McEpllan, A. M., & Dobson, D. (2019). Empirical validation and the cognitive-behavioral therapies. In K. S. Dobson & D. J. A. Dozois (Eds.), Handbook of Cognitive-Behavioral Therapies (4th ed., pp. 32-63). The Guildford Press.

Dozois, D. J. A., Dobson, K. S., & Rnic, K. (2019). Historical and philosophical bases of cognitive-behavioral therapies. In K. S. Dobson & D. J. A. Dozois (Eds.), Handbook of Cognitive-Behavioral Therapies (4th ed., pp. 32-63). The Guildford Press.

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(16). https://doi.org/10.1186/s13030-021-00219-w

Peach, E. (2023). Creative mental health literacy practices: A qualitative study exploring how students use literacy to promote wellbeing and manage mental health conditions while at university. International Journal of Environmental Research and Public Health, 20(15). https://doi.org/10.3390/ijerph20156475