Is poetry therapy an appropriate intervention for clients recovering from anorexia? A critical review of the literature and client report

Quantitative methods for group bibliotherapy research: a pilot study

Background

Bibliotherapy is under-theorized and under-tested: Its purposes and implementations vary widely, and the idea that 'reading is good for you' is often more assumed than demonstrated. One obstacle to developing robust empirical and theoretical foundations for bibliotherapy is the absence of analytical methods capable of providing sensitive yet replicable insights into complex textual material. This pilot study offers a proof-of-concept for new quantitative methods including VAD (valence-arousal-dominance) modelling of emotional variance and doc2vec modelling of linguistic similarity.

Methods

VAD and doc2vec modelling were used on conjunction with qualitative coding to analyse transcripts of reading-group discussions plus the literary texts being discussed, from two reading groups each meeting weekly for six weeks (including 9 participants [5 researchers (3 authors, 2 collaborators), 4 others] in Group 1, and 8 participants [2 authors, 6 others] in Group 2).

Results

In-text-discussion similarity was inversely correlated with emotional volatility in the group discussions (arousal: r = -0.25; p = ns; dominance: r = 0.21; p = ns; valence: r = -0.28; p = ns). Enjoyment or otherwise of the texts was less significant than other factors in shaping the significance and potential benefits of participation. (Texts with unpleasant or disturbing content that strongly shaped subsequent discussions of these texts were still able to sponsor 'healthy' discussions of this content.).

Conclusions

Our methods and findings offer for the field of bibliotherapy research both new possibilities for hypotheses to test, and viable ways of testing them. In particular, the use of natural language processing methods and word norm data offer valuable complements to intuitive human judgement and self-report when assessing the impact of literary materials. We also share observations on facilitation protocols, interpretative practices, and how our group reading model differs from other trials of group reading for wellbeing.

Effects of a group poetry therapy program on stress, anxiety, ego-resilience, and psychological well-being of nursing students

This quasi-experimental, nonequivalent control group pretest-posttest study developed a 10-session group poetry therapy program for nursing students and examined effects on clinical training, job-seeking stress, anxiety, ego-resilience, and psychological well-being. Forty-nine nursing students were conveniently recruited (experimental group n = 24, control group n = 25). Program construction used the Analysis, Design, Development, Implementation, and Evaluation model and Mazza's poetry therapy practice model. Compared to the control group, the experimental group showed significant decreases in stress and anxiety and significant improvements in ego-resilience and psychological well-being immediately after intervention, maintained at 5-week follow-up. The program can be a beneficial intervention for individuals experiencing various degrees of stress.

Fiction-reading for good or ill: eating disorders, interpretation and the case for creative bibliotherapy research

Compared with self-help bibliotherapy, little is known about the efficacy of creative bibliotherapy or the mechanisms of its possible efficacy for eating disorders or any other mental health condition. It is clear, however, that fiction is widely used informally as a therapeutic or antitherapeutic tool and that it has considerable potential in both directions, with a possibly significant distinction between the effects of reading fiction about eating disorders (which may-contrary to theoretical predictions-be broadly negative in effect) or one's preferred genre of other fiction (which may be broadly positive). Research on creative bibliotherapy, especially systematic experimental research, is lacking and requires a medical humanities approach, drawing on knowledge and methods from psychology and cognitive literary studies as well as clinical disciplines to expand our understanding of how the dynamic processes of interpretation mediate between textual structures and characteristics of mental health and illness.

Literary reading and eating disorders: survey evidence of therapeutic help and harm

BACKGROUND

There is growing evidence for the efficacy of self-help bibliotherapy as a treatment for eating disorders, although little understanding of how specific linguistic characteristics may enhance or constrain its effects. Meanwhile, 'creative bibliotherapy' (the therapeutic use of fiction, poetry, or sometimes film, rather than self-help books) is widely practised, but even more poorly understood than the self-help variety: although a range of theoretical models exist, claims of the healing power of literature are far more commonly made than tested.

METHODS

An online survey including quantitative (forced-choice) and qualitative (free-response) items was designed and administered in collaboration with the charity Beat to investigate the connections between respondents' reading habits and their mental health, with a focus on eating disorders, and attracted 885 respondents. Responses to two sequences of questions, exploring the differential effects of fiction about eating disorders versus respondents' preferred genre of other fiction on the dimensions of mood, self-esteem, feelings about one's body, and diet and exercise habits, were analysed using a 2 × 2 repeat measures factorial ANOVA design for each of the four dependent variables.

RESULTS

Surprisingly, fiction about eating disorders was perceived by respondents as broadly detrimental to mood, self-esteem, feelings about their bodies, and diet and exercise habits, while respondents' preferred genre of other fiction was experienced as beneficial to mood and broadly neutral on the other three dimensions. The free-response data added detail to these core findings, as well as suggesting numerous other possible effects and mechanisms, drawing attention to the roles of positive and negative feedback structures and of highly selective interpretive filtering, and highlighting the dangers of 'self-triggering': using books to deliberately exacerbate an eating disorder.

CONCLUSIONS

The findings directly challenge existing theoretical models of creative-bibliotherapeutic mechanisms, which tend to insist on the importance of a close match between the reader's and the protagonist's situations. They point the way forward for a new programme of clinical research and practice by suggesting other ways to conceive of how embodied cognitive acts of textually cued interpretation may intervene in the psychopathology of an eating disorder - for good and for ill.