Bibliotherapy for Suicidal Teenagers – Is It Beneficial?

What is Bibliotherapy?

The term “bibliotherapy” is defined as “a process of dynamic interaction between the personality of the reader and literature – an interaction which may be used for personality assessment, adjustment and growth” (Russell and Shrodes, 1950). Its history originates from World War I when wounded soldiers were given books with emotional content to read in order to calm them down and help them express their feelings. Bibliotherapy simply means “to experience healing through reading,” and it can be used alone or as an adjunct to therapy with a counselor. Readers identify with the characters in a book and realize that they are not alone with the problems they experience in their lives, then when readers become emotionally involved in the story they find it easier to express their own emotions, learn to problem solve and gain alternative perspectives.

Bibliotherapy has evolved into two distinct approaches, “didactic text” and “imaginative literature.” Didactic texts refer to the standard self-help books that most adults tend to buy in order to work through their problems without having to attend a doctor’s office, pay for it, and be labeled in the process. Yet “imaginative literature” refers to using fiction, fables, and drama to understand the human condition.

The popularity of self-help books indicates that individuals use reading as a form of self-development and healing, and while many are able to seek professional help through psychiatric agencies, a great many more either cannot access psychiatric services for financial reasons, or do not wish to, and that is where self-help texts come into their own. In many countries “resorting” to visiting a counselor or therapist is still taboo, and although it is accepted in the US, the process of financing treatment involves being labeled with a diagnosis, which can deter people from seeking help. Self-help books are an obvious avenue to take for those who suffer emotional pain in their lives yet don’t wish to become engaged with the authorities, but only if the person wants to read.

Obama’s plans to raise education standards in the US

President Obama has expressed his concern at the poor academic rates in science and mathematics, citing that the US is 21st in the world for science and 25th for mathematics, and he shared his concern that the standard of education among the young will seriously hamper the next generation of adults, and subsequently America’s future on the world stage. His launch of the “Change the Equation” program, designed to focus on science, technology, engineering and mathematics and the need to cultivate “widespread literacy” seems a step in the right direction. The 2007 National Assessment of Educational Progress showed that 69{1d2611b7b2358db1a5d290a72f211c932ff29d0dc596ec3bc444512a63e05c32} of eight graders were below proficiency levels for reading, which confirms the pervasive lack of literacy among the young, and therefore the lack of motivation to excel in the fields of science and mathematics.

I believe that there is a serious problem with President Obama’s “Change the Equation” plan, although his intentions are doubtless admirable. I am well aware of the effect of trauma on cognitive functioning, and see it all the time at work with teenagers admitted to a Behavioral Health Care facility. The majority of teenagers admitted to our long-term units reflect the statistics cited above, and they act out in order to avoid staying in school/class. Many have low self-esteem and are too afraid to try, despite having an average IQ, and when put out of class for their behavior it confirms their perception that they are a failure in school and therefore in life. When teenagers are preoccupied with problems that may be going on at home, or even just the transition from child to adult through normal adolescence, it is hard for them to concentrate. If a teenager is worried about what awaits her/him at home, or whether there will be any food that night, how are they able to concentrate when they are preoccupied with basic survival issues? Even the brightest child will be preoccupied and will therefore underachieve when their focus is related to what is going on in their lives outside the classroom. So although President Obama rightly acknowledges that the education standard in America needs to be addressed, he omits the basic building blocks that will underpin his “Change the Equation” plan to improve American youths’ education. The adolescents and children’s problems need to be addressed first. Only then will they be motivated enough to engage in his plan. People may think, “Who cares about the kids who can’t be bothered?” but what about the “No child left behind” program and all that untapped talent. Think about where society is going without basic education… we need our children to be able to read, and thus then be able to learn and grow into responsible citizens and leaders.

Research shows that there is a higher proportion of either illiterate or poor readers among adolescents in Juvenile Detention Centers, and not being able to read compounds their problems, but in my experience with the same type of teens, who are often court ordered to come to our facility as opposed to jail, they can read a little; they can read the basics. They can’t cope with elaborate vocabulary and can’t recite the rules of grammar, but they can actually read. One would assume that something has gone wrong during their early grades that they don’t progress to further reading proficiency. So what we need to do is to hook their motivation to read by giving them something that they want to read, something that captures their imagination and sucks them into the world of books. How?

Text books and sanitized fiction versus therapeutic novels

There are many factors to consider when trying to engage teenagers who either aren’t interested in reading because it bores them or because they are preoccupied with their problems. Reading is often associated with school, text books, grades and tests. As adults, you and I know what adventure, relief and wonder there can be in immersing oneself in a book. Rohl Doul, J.K. Rowling and Stephanie Myer have redefined reading for young people and are the future’s great writers, but even those books don’t always capture the interest of those teenagers who are hurting, or have to deal with such adverse situations that books hold no interest to them. So the key factor is surely what the books are about and how they are written.

Teenagers, especially suicidal teenagers, who I studied for my PhD research, are in such distress that they have no attention span to read the classics or even text books designed to be self-helpful. They are “dry” and written by adults who adolescents tend to perceive know nothing about them and their pain. Of course this is wrong and many authors of teenage self-help books are driven to help the kids they seek to reach and do a good job, but kids are very perceptive and they don’t want to listen to adults because the adolescent’s task is to be self-focusing and egocentric, that’s a normal part of Erikson’s stages of development (Identity versus role confusion, aged 12 – 18). Adults are often seen as the “enemy” and they will refuse to listen to even the soundest advice, “Because you don’t know how I feel.”

So, the way forward is to get into the teenagers’ psyche, live their problems and write about their thoughts and feelings as if you were that teenager suffering at that moment, their moment, their thoughts and feelings, and also curtail one’s literacy tendency to go overboard with fancy words, metaphors and similes, which as a writer is very challenging and unfulfilling. I have seen teenagers who have never read a book before beg for more of this type of book. They need simple language written in large type so that they don’t feel disempowered by big words and elaborate speech. They need to identify with the main character and actually “live” the character’s life. When they do that the readers are then able to “be” the main character, to experience all his/her feelings and thoughts, and learn from the other characters in the book because they are the same age as the reader and suffer the same pain. Teens listen to other teens – they buck against adults – that’s normal behavior during adolescence.

If a teen is in dire need of help and they are given a book to read that they perceive to be a text book, they will fail to gain any help no matter how efficacious the text and the authors’ intentions are, and we professionals will fail to throw the suicidal teenager a lifeline. The lifeline we need is a book where they can associate with the main character’s thoughts and feelings, and which reflects their own. Not only do they realize that they are not alone, but they learn how to manage their feelings and to empower themselves. This is a vital aspect of Social Work education and therapy/ counseling training, for it is “empowerment” that drives these disciplines. Most of the teenagers I’m referring to have virtually no support, and so the reality is that we need to empower them to be able to take care of themselves in the future and not succumb to a “Life Script” of underachievement and dependency.

As educators or care givers in such fields as education, social work, counseling and nursing, we are in a unique position to be able to help the distressed and suicidal teenagers in our care. As professionals, we need to encourage children to continue to read beyond the basics and that means thinking outside the box and providing them with material that will not only encourage them to read but will grab their attention – teenage bibliotherapy that deals with the everyday situations that adolescents have to deal with, not sanitized or neatened around the edges (Did Dickens sanitize his novels and refuse to show what life was really like in his time?). Let the reading materials mirror what many teenagers experience at home when no one is watching, when they think no one cares, and the only way out for them is suicide.

So is bibliotherapy beneficial for suicidal teenagers?

This article seeks to ask whether bibliotherapy is beneficial for suicidal teenagers and several issues have been identified. Suicidal teens present a variety of reading levels, therefore any bibliotherapy text intended to help them has to be very simple, with large font, so that even the poorest readers can benefit from them.

In my years of experience working with troubled teenagers both in the US and the UK I would say emphatically that bibliotherapy has a valuable place for teenagers, but it is the approach that is the issue at hand. Suicidal teenagers would be very unlikely to benefit from the “didactic” approach, being too distressed to read what would appear to them to be a text book. This is because distress diminishes cognitive functioning, and to benefit from “didactic texts” the reader’s ability to process cognitively has to be intact. Suicidal teenagers, especially those who have just endured stomach pumping, and therefore reinforcement of their failure (their suicide attempt didn’t succeed) are in shock and are unable to think effectively. However, if they can identify with the main character on page one of a fictional therapeutic novel (bibliotherapy’s “imaginative literature” approach) they can indeed benefit from this form of therapy. Once “hooked” into the main character’s psyche, the suicidal teenager embarks upon a therapeutic journey, one that fulfils the principles of bibliotherapy: “identification, projection, introjections, catharsis and insight” (Silverberg, 2003).

Thus it seems that the answer to the question, “Can bibliotherapy be beneficial for suicidal teenagers?” is yes, but only with books that capture the imagination and hook the reader in immediately so that they realize that they are not alone, that others have felt the same pain and have found ways to cope.


Russell, D.H., and Shrodes, C. (1950) Contributions of research in bibliotherapy to the language arts program. Sch Rev. 1950; 50:335

Silverberg, L.I. (2003) Bibliotherapy: The therapeutic use of didactic and literacy text in treatment, diagnosis, prevention and training. JAOA, Vol 103, No 3, March 2003