CLINICAL EDITOR’S COMMENTS:
Combining play therapy and bibliotherapy can bring powerful metaphors to life.
T
ake a moment and think about your favorite childhood book. Why is this book important or influential? Was it the
setting, the situation, the storyline, or maybe the characters? Was it the act of reading or being read to? How did it impact you? Could you relate to the book in some meaningful way? Books are powerful agents with relatable characters and relevant stories that can have a profound impression on our lives. This is why books are appealing, and more importantly, therapeutic, as Ava (pseudonym) helps us understand through the following case example.
Ava, an adolescent female, is the oldest of several siblings being raised by her grandparents. She was referred for therapeutic services due to a history of abuse and neglect. Ava reported experiencing a repetitive nightmare nearly every night. Despite initially not disclosing the details of the nightmare, we tracked the occurrence of the nightmare while practicing coping strategies to help her become the director of the dream and manage the associated feelings. Ava eventually shared that the nightmare was related to a traumatic event in her life concerning the murder of family pets in which a parent involved her. Ava reported that she would wake up seeing the images fresh from the nightmare. She felt extreme guilt and sadness. The first author took a book off of the shelf, Dog Heaven, by Cynthia Rylant (1995), and asked Ava if it would be okay to read her a book. Ava cried as the book was read. After finishing the book, therapist and client side-by-side in silence, Ava said, “Thank you,” as large tears rolled down her cheeks. Ava did not report having the nightmare again during her time in therapy. This was the moment the first author recognized the therapeutic power of a book and the significance of bibliotherapy.
The Healing Power of Books Bibliotherapy is a therapeutic technique that uses the healing power of books to help children navigate, learn from, and cope with a variety of life circumstances and a range of social, emotional, behavioral, and developmental concerns. Bibliotherapy can be used as an approach to facilitate a corrective experience or to aid children with emotional and behavioral difficulties or disorders. The goal is to broaden and deepen the understanding of a child’s particular concern or problem (Akinola, 2014) by relying on the analogy of the story to convey acceptance, meaning, or similarity.
Bibliotherapy can be used during different stages of the therapeutic process, including building rapport and a therapeutic alliance; assessment, intervention, and treatment; and termination. It provides the client with a degree of separation from the issue at hand that normalizes similar difficulties, encourages identification with the characters, offers coping skills and solutions to problems, and creates a sense of safety. Moreover, bibliotherapy can be utilized in individual, family, or group therapy and in a variety of therapeutic settings. In other words, it can be a universally effective treatment approach across a wide variety of client populations, settings, presenting problems, and throughout all stages of treatment.
There are four steps involved in bibliotherapy that contribute to the therapeutic process. The first three steps were developed from a psychodynamic premise (Shrodes, 1955) and include identification, catharsis, and insight. The goal in identification is to help the child identify with the information, storyline, and/or character(s) in the book. In step two, catharsis, the goal is for the child to become emotionally involved in the story and experience emotional release. Within the third step, insight, the client understands their own processes, and sees that they can experience positive change and growth based on the progress depicted in the story. Afolayan (1992) added universalization as a fourth step to this theoretical ladder, which occurs when the child realizes that they are not alone in their experience and can view their situation and future with a new lens of understanding and hope.
Combining Approaches Bibliotherapy can be used in conjunction with play therapy to provide children with a nonthreatening and fun therapeutic experience. Hasty (2010) believed the combination of these two therapeutic processes to be the dynamic duo of effective treatment modalities. Integrating books into play therapy capitalizes on a child’s language skills and social-emotional literacy to enhance the therapeutic process. Pehrsson (2006) considered the integration of bibliotherapy and play therapy a perfect companion set with the emphasis from bibliotherapy on reception and from play therapy on expression.
www.a4pt.org | March 2020 | PLAYTHERAPY | 25
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