From school libraries to healthcare clinics, bibliotherapy is emerging as a supportive tool for mental wellbeing. Advocates emphasize its potential, especially when tailored to individual needs. The key factors include matching the right book with the right person and ensuring thoughtful engagement.
Below are core developments in the practice:
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Bibliotherapy programmes like Reading Well have facilitated over 3.9 million book loans in the UK since 2013
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Tailored fiction and non-fiction recommendations are used to support conditions like depression, anxiety, and chronic stress
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Self-help books have shown efficacy similar to conventional therapies in specific cases, like eating disorders
Personal healing through fiction
In 2017, during a turbulent divorce and ongoing depression, Connecticut-based teacher and librarian Elizabeth Russell discovered creative bibliotherapy online. After reading about Ella Berthoud, a Sussex-based bibliotherapist and co-author of The Novel Cure, Russell reached out for a tailored reading session.
Berthoud conducted an in-depth interview and recommended novels that mirrored Russell’s struggles, such as George and Lizzie by Nancy Pearl. Russell found deep resonance in these stories. “It opened up something in me that needed to be opened and needed to heal,” she explained. The emotional journeys of fictional characters allowed her to feel less isolated and provided new ways to reflect on her experiences.
This kind of personal engagement with literature is central to creative bibliotherapy, where emotional impact often stems from readers’ ability to relate to characters and scenarios in books. The results are not universal, but individual cases like Russell’s suggest significant potential.
NHS involvement and the rise of The Reading Agency
In the UK, the National Health Service has begun incorporating bibliotherapy tools through partnerships with organisations like The Reading Agency. Their flagship programme, Reading Well, provides curated book lists for those facing specific challenges such as depression, dementia, and anxiety.
Gemma Jolly, head of health and wellbeing at The Reading Agency, explains that each title is selected based on expert input and real user experiences. By 2022, the programme had already impacted millions, with 81% of surveyed users stating that the recommended books improved their understanding of personal health needs.
Doctors like Andrew Schuman, who advise bibliotherapy charities, also promote fiction as a supplementary resource. Schuman co-authored a 2016 Lancet paper advocating literature’s ability to "relieve, restore, and reinvigorate the troubled mind". However, Schuman stresses that fiction is not a treatment on its own and should not replace professional care.
Challenges and risks - when fiction goes wrong
Despite its promise, bibliotherapy is not a one-size-fits-all solution. Experts like James Carney from the London Interdisciplinary School caution that the effectiveness of bibliotherapy depends heavily on the individual, the book, and the context. Research has shown that in some cases, fiction can even worsen symptoms.
In a 2018 study conducted by Emily Troscianko, nearly 900 participants with a history of eating disorders reported that reading fiction involving similar conditions frequently worsened their mental state. Surprisingly, some even actively sought out such books, highlighting a troubling feedback loop. Troscianko warned that for those with narrow, obsessive mindsets, literature can reinforce harmful patterns.
Carney also pointed out potential harm in literature that glamorizes addiction. In clinical practice, Schuman avoids recommending fiction to patients in crisis or those with severe psychiatric symptoms. Missteps in book selection could damage the therapeutic relationship or worsen a patient’s outlook.
Group discussions, emotional engagement and practical frameworks
New studies suggest that the way people engage with books matters as much as the content itself. In one experiment led by Giulia Poerio at the University of Sussex, senior readers who deeply connected with audiobook content experienced measurable boosts in wellbeing. Those who were emotionally absorbed by the narrative felt more meaning in their lives, even two weeks after reading.
Carney also found that literature becomes more impactful when followed by group discussions. Sharing reactions to books helps readers process complex emotions safely. "Fiction gives you a way to rehearse all these difficult, challenging social scenarios," he says.
Comparison of bibliotherapy outcomes
| Method | Target Group | Reported Benefit | Noted Risk |
|---|---|---|---|
| Self-help books | Adults with anxiety/depression | Similar efficacy to psychotherapy | Content may not suit all readers |
| Fictional narratives | Readers with mild stress | Boost in empathy, emotional insight | May trigger symptoms in vulnerable readers |
| Audiobook programmes | Seniors | Increased sense of meaning and wellbeing | Ineffective without emotional engagement |
| Group literary discussions | General public | Enhanced social bonding, deeper reflection | Requires facilitation and guidance |
While bibliotherapy cannot replace professional treatment, it offers a flexible and personal method to complement traditional approaches. Tools like curated reading lists, literary consultations, and community reading groups allow people to explore emotional health through stories.
As Elizabeth Russell’s story shows, the right book at the right time can help people feel understood, supported and less alone. For some, fiction is more than a story – it’s a lifeline.
Source: BBC