Does Creative Bibliotherapy delivered in schools improve mental health-related outcomes for 5-16 year olds? A systematic review.

Abstract

Background: There is an increasing need for effective interventions for child and adolescent mental health promotion, with mixed evidence to date on what works. Creative Bibliotherapy has promise as a pragmatic, school-based approach.

Methods: We undertook a systematic review of experimental or quasi-experimental studies of Creative Bibliotherapy designed to be delivered by teachers in schools to improve any mental health related outcome for children aged 5-16.

Results: Of 3405 unique reports retrieved, 23 met the inclusion criteria. The majority were student research dissertations (n = 12); conducted in North America (n = 17); conducted in children aged 12 or under (n = 17). Of the 13 (57%) which reported positive impact on mental health outcomes, authors described the selection of diverse and appropriate materials; structured interaction; and trained delivery by school-based practitioners as important to success. These were neither necessary nor sufficient conditions. Few studies were well defended against risk of bias.

Conclusion: There are promising indications that Creative Bibliotherapy in schools can improve mental health and its contributors but, to date, no strong evidence. Much of the literature pre-dates widespread adoption of reporting guidelines, and few designs were robustly defended against bias. Whilst interventions such as Creative Bibliotherapy fit uneasily within experimental evaluation paradigms, many interventions identified in this review could be evaluated with stronger trial designs to identify both positive and negative effects, and (more importantly) the contexts and conditions under which they are likely to improve children's mental health.