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Bibliotherapy gains traction as mental health tool
In recent years, the practice of using books-particularly fiction-to improve mental wellbeing has surged in popularity. Known as bibliotherapy, this approach offers tailored reading recommendations to help individuals navigate personal challenges, from divorce to depression. However, experts warn that its effectiveness depends heavily on the book, the reader, and the context.
A personal journey
Elizabeth Russell, a Connecticut-based teacher and librarian, discovered bibliotherapy during a particularly difficult period in 2017. Amid a painful divorce and long-term depression, she stumbled upon the concept of creative bibliotherapy, where fiction is prescribed to address emotional struggles. Intrigued, Russell reached out to Ella Berthoud, a UK-based bibliotherapist and co-author of The Novel Cure.
After a detailed discussion about her reading habits and personal challenges, Berthoud sent Russell a curated list of novels featuring characters facing similar marital dilemmas. One recommendation, George and Lizzie by Nancy Pearl, resonated deeply. Russell credits the experience with helping her process her emotions and reducing feelings of isolation. "It opened something in me that needed healing," she recalls.
The rise of bibliotherapy
Bibliotherapy, which includes both fiction and self-help literature, has gained momentum in the UK and beyond as a complementary tool for mental health. Advocates argue that immersive storytelling can help readers process emotions, develop coping strategies, or provide temporary escape from daily stressors. As two researchers noted in a 2016 The Lancet paper, literature can "relieve, restore, and reinvigorate the troubled mind," offering a low-cost alternative amid gaps in affordable mental health care.
However, not all experts are convinced. James Carney, a computational cognitive scientist at the London Interdisciplinary School, cautions against viewing books as a universal remedy. "For certain conditions and personalities, it can help," he says, "but the idea that books are a one-size-fits-all solution is simply false."
Mixed evidence and potential risks
While self-help books have demonstrated benefits-such as reducing anxiety and depression in some studies-the evidence for fiction-based bibliotherapy is less clear. Research suggests reading can boost empathy, reduce stigma, and improve self-confidence, but its effectiveness in treating specific mental health conditions remains uncertain.
Emily Troscianko, a literary scientist at the University of Oxford, highlights the lack of rigorous studies proving that identifying with fictional characters leads to tangible improvements. "The idea that books provide a cathartic release is simplistic," she says. "Human experiences are complex, and literature's effects are equally nuanced."
Worse, some books may exacerbate symptoms. A 2018 study by Troscianko and the UK eating disorder charity Beat found that fiction featuring characters with eating disorders often worsened readers' symptoms. Similarly, Carney warns that novels glamorizing addiction could trigger individuals struggling with substance abuse.
Programs and precautions
Despite these concerns, bibliotherapy programs continue to expand. The UK's Reading Well initiative, run by the non-profit The Reading Agency, curates book lists for conditions like dementia and depression, reviewed by experts and individuals with lived experience. Since 2013, the program has facilitated over 3.9 million book loans through partnerships with local libraries.
Gemma Jolly, the organization's head of health and wellbeing, emphasizes that recommendations are tailored to avoid harmful content. For example, the program excludes fictionalized accounts of eating disorders for adults, though teen lists include personal stories based on professional feedback. "Books aren't a solution for everyone," Jolly says. "It's about offering an additional tool that might work for some."
How to engage safely
Experts agree that the benefits of bibliotherapy depend on how readers engage with books. Giulia Poerio of the University of Sussex found that seniors who deeply connected with audiobooks reported lasting improvements in wellbeing, while those who remained disengaged saw no benefits. Carney suggests discussing literature in groups to enhance its impact, as shared reflection can make fictional scenarios feel more real and meaningful.
For those interested in trying bibliotherapy, Carney recommends joining book clubs, while Jolly advises exploring public libraries to sample different genres. If a book feels unhelpful or intrusive, experts urge readers to stop immediately. "If it's helping you, keep going," says NHS physician Andrew Schuman. "But if it's not, there's no obligation to continue."
A tool, not a cure
For Russell, bibliotherapy has been transformative. She has since returned for multiple sessions with Berthoud and even gifted vouchers to friends. She also uses the approach with her students, selecting books that address themes like immigration and loss. "The biggest takeaway is realizing you're not alone," she says. "It's a reminder that others have walked this path too."
Note: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for concerns about mental health.
