By Lynn Cukaj, ATR-BC www.CreativeExpressionsConsulting.com
Art Therapy for Children, Teenagers, and Adults
The word bibliotherapy is of Greek origin: biblio meaning book and therapeia meaning healing (McCulliss, 2012). The term was first used in an editorial in 1916 where Samuel McChord Crothers, a Unitarian minister and essayist, recommended that people read to expand their level of self-understanding and other’s perceptions (Heath et al., 2017; McCulliss, 2012). The use of books has a long history of helping people to understand difficult problems and to gain knowledge on how to cope (McCulliss, 2012; Goddard, 2011). Through the use of books a mental health counselor will expose their young child clients to opportunities to hear about characters who are experiencing similar situations or problems. Thus, learn by the characters’ experiences how to problem solve through crises and gain resilience from traumatic experiences.
The following types of bibliotherapy have been proven successful in counseling:
Developmental: utilizing books to work through issues typical of adjustment problems in young children; for example, friendship, conflicts with peers, and bullying.
Clinical: addressing more serious mental health issues such as abuse, trauma, loss, and mental illness (Lucas & Soares, 2013, McCulliss, 2012)
Client-developed: the client creates their own ending to a story as if the client is the character and is addressing a specific area of concern (Lucas & Soares, 2013)
Bibliotherapy is not seen as a solution but is most effective as an adjunctive therapeutic tool (Lucas & Soares, 2013; McCulliss, 2012). Websites that can serve as a resource for searching for appropriate books are www.csefel.vanderbilt.edu and www.schoolsocialwork.net. Books used in bibliotherapy do not need to be therapeutic books but can be found in general children’s literature. Libraries and bookstores can be an excellent resource (Leggett, 2009).
Malchiodi and Ginns-Gruenberg (2008) defined bibliotherapy as the purposeful use of books in therapy. Bibliotherapy is further defined by Jacob and Guzman (2016) as the deliberate use of written materials for healing and development. Through the use of bibliotherapy a person deals with ones’ own feelings, thoughts, and memories, and then compares these to other people’s experiences (Suvilehto, 2016). Children who are struggling with feeling identification and expression will find comfort in characters who share similar struggles. Bruno Bettelheim (1976) analyzed fairy tales in terms of Freudian psychoanalysis. In his book, The Uses of Enchantment, he suggested that fairy tales help children solve certain intrapsychic issues such as separation anxiety and sibling rivalry. It is through this connection that a mental health counselor can help a child towards healing and growth. In addition, reading to children provides comfort, increases self esteem, and aids in helping them cope with difficult situations (Goddard, 2011).
Furthermore, Malchiodi and Ginns-Gruenberg (2008) presented guidelines for using books in therapy and emphasized how children’s books can enhance trauma intervention when used appropriately. The authors also recommended that books used in a therapeutic context: convey specific themes, evoke connection with the characters and communicate how others have confronted or solved problems. When using children’s books in therapy, Malchiodi and Ginns-Gruenberg (2008) urge therapists to consider the following guidelines: preview all books before using with clients; consider the relevance of the book or story to the child’s current situation; consider developmental needs: attention span, vocabulary and reading skills, and complexity of plot; choose books that provide comfort and reassurance; introduce why the book is relevant. The authors suggested taking a less direct approach and talking about the story’s characters versus talking about the child/children’s specific situation (pp. 171-173).
When choosing books, counselors need to be sure to keep in mind treatment goals such as focusing on reducing anxiety, improving self esteem, emotion regulation, social pragmatics, work on creative problem-solving, prosocial behaviors, and feeling identification and externalization of feelings (Brinton & Fujiki, 2017; Lucas & Soares, 2013). In addition to treatment goals, bibliotherapy can assist children in becoming more effective participants in society by helping improve personal and social judgment, enhance empathy, tolerance, respect, and acceptance of others (Lucas & Soares, 2013). These aspects to becoming a well rounded person are important to living successfully in a multicultural society.
Also, choice of book should consider the rhythmic aspect of the story. Counselors need to pay close attention to whether the book is developmentally appropriate and if the book is stimulating and engaging. Books that are engaging often have rhyming, repeated chorus, and opportunities for the child client to be active and “chime in” during the story. According to Brinton and Fujiki (2017), it is critical to select developmentally appropriate books, with clear emotional content, accessible language structure, strong story grammar, well-defined plot, and appealing illustrations.
However, the challenge of choosing books is to appeal to a wide age range and limited attention span. If a therapy group has a wide age range of children, the counselor needs to use or adapt books so that they are not too childish for tweens, yet accessible to lower functioning or very young children. Children’s books with illustrations that are visually engaging, have a “cartoonish” style, and are colorful are usually more appealing to younger children (Brinton & Fujiki, 2017). Lastly, books that stimulate the imagination and creative thinking are very beneficial for art making. Bibliotherapy is not simply reading but a combination of reading and reflecting with often combining the reflection with activities like creative writing, and art (Lucas & Soares, 2013). Likewise, Montgomery and Maunders (2015) reported bibliotherapy as an effective approach in “addressing a wide range of children’s internalizing and externalizing behavior problems” (p. 552). Jacob and Guzman (2016) found that the major benefits of utilizing bibliotherapy are “self expression, examination of one’s thoughts and feelings in relation to self and others, and discovery of new solutions to problems” (p. 100). Similar to bibliotherapy, where books are used for a therapeutic purpose, art therapy is where an art directive is utilized for a therapeutic intervention.
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Learn more about Art Therapy and Lynn Cukaj, Board Certified Art Therapist here: www.CreativeExpressionsConsulting.com
References
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