The effectiveness of creative bibliotherapy for internalizing, externalizing, and prosocial behaviors in children: A systematic review

“Stories have the potential to help children find meaning and master social, emotional, and cognitive tasks (Bettelheim, 1976, p. 66): “When all the child's wishful thinking gets embodied in a good fairy; all his destructive wishes in an evil witch; all his fears in a voracious wolf; all the demands…”

“It has been shown to be effective for adults with depression, panic disorder, and certain sexual dysfunctions (Fanner & Urquhart, 2008; Marrs, 1995) as well as for those with anxiety when compared to no treatment (Mayo‐Wilson & Montgomery, 2007).”

“Briefly, a process of reframing negative thoughts underpins CBT: identifying unhelpful cognitions, challenging their meaning, and eliciting more realistic thoughts and assumptions (Hunot et al., 2013).”

“…schoolbased interventions were included either Meirelles dos santos and giglio (2012) too few school-based studies on outcomes of interest included Montgomery and Maunders (2015) too few school-based studies on outcomes of interest included ozabaci (2011) too few school-based studies on outcomes…”

“Overall, they reported positive outcomes, with small to moderate effect sizes—validating that bibliotherapy is effective in addressing a wide range of children’s internalizing and externalizing behavior problems (Montgomery & Maunders, 2015).”

“For example, a systematic review study conducted by Montgomery and Maunders (2015) reported that therapeutic reading activities are effective in reducing various mental problems including internalizing and externalizing problems and increasing adaptive prosocial behaviours in children.”

“…identification and utilization of supportive adults, improved parental and peer relationships, reduced social isolation, respect and acceptance of others, and improved socially accepted behaviors (Heath et al., 2005; Montgomery & Maunders, 2015; Pehrsson & McMillen, 2005; Stewart & Ames, 2014).”

“Emotional reading processes (Montgomery & Maunders, 2015) will help allow identification of these unhelpful, intrusive cognitions.”

“For example, through narratives we might find ourselves in unique situations that we would normally never be able to experience, opening the door to a whole range of new (social) experiences and accompanying knowledge (Hakemulder, 2000; see also Montgomery & Maunders, 2015).”

“Unlike in other more creative iterations of bibliotherapy (e.g., Mayaba & Wood, 2015; Montgomery & Maunders, 2015), in this quasi-experimental study, the fieldworkers did not engage children in any form of follow-up activity that would potentially prompt reflection on or internalization of…”

“A rare systematic review of causal evidence for creative bibliotherapy in the context of children’s behavioural development [13] found a small to moderate effect, and a more recent review for post-traumatic stress disorder [14] found promising trends in some low-quality and qualitative studies, though the authors loca…”

“Paralleling this, studies focused on individual reading argue for positive impacts on adolescent aggression [21, 22], expressiveness in ill children [23], self-confidence and functioning [5], interpersonal empathy [24, 25], and theory of mind [24] However, results do not seem to generalise, with a meta-analysis by Mon…”

“In early childhood, recommendations for bibliotherapy [86,87] and online programs [ In early childhood, recommendations for bibliotherapy [86,87] and online programs [88] can be effective and may be sufficient for mitigating current and future To be successful, DPSTs likely require front-end staff…”

“Furthermore, Montgomery and Maunders (2015) conducted a systematic review of 46 studies on the effectiveness of creative bibliotherapy in children regarding internalising, externalising, and prosocial behaviours, as well as peer relationships, child-parent relationships, educational achievement, and reading ability.”

“…them had not considered the role of other factors such as group participation, and had reading as their sole independent variable; and no study had mentioned the type of bibliotherapy used; however, all studies were somewhat based on the cognitive-behavioral approach (Montgomery and Maunders 2015).”

“However, Montgomery and Maunders note that ‘Although no definitive model of creative bibliotherapy emerges from the included studies, all interventions reflected to some extent the evidence-based steps of CBT’ [10].”

“…need to engage deeply, both cognitively (e.g., via concentration, attention, inference-making) and affectively (e.g., via introspection, reflection) with the books that they read (Barnes, 2018; Kumschick et al., 2014; Mar et al., 2006; Montgomery & Maunders, 2015; Poerio & Totterdell, 2020).”

“Although there is some limited evidence that bibliotherapy has mild to moderate effects on externalizing, internalizing, and prosocial behaviors (Montgomery & Maunders, 2015), there continues to be a lack of systematic research exploring its impact on therapeutic outcomes across populations.”

“Other quantitative measures of change are rare, but a systematic review 9 found a small to moderate effect on internalizing, externalizing, and prosocial behaviours amongst children from studies with a range of methods involving stories, poems, or films, plus various forms of interpretive support.”

“…as an evidence-based practice, previous studies show that bibliotherapy had positive impacts on children’s and adolescents’ externalizing or internalizing behaviors (Montgomery & Maunders, 2015), social and emotional growth (Elley, 2014), and coping skills (Betzalel & Shechtman, 2017).”

“Thus, the evidence validating H 2 is in line with that from previous studies (Böckler et al., 2018; Laguna et al., 2020; Montgomery & Maunders, 2015) which highlight the effectiveness of interventions that use strategies cognitive, behavioural and emotional effects on altruism.”

“In a systematic review of eight studies on bibliotherapy, Montgomery and Maunders (2015) identified several common beneficial elements including the identification of unhelpful beliefs and behaviors, the challenging of the existing beliefs’ and behaviors’ meaning, and the development of new…”

“Our findings reflect those of one other systematic review of randomized studies of the impact of Creative Bibliotherapy on mental health-related outcomes in children aged 5–16, Montgomery and Maunders (2015) review of the impact on internalizing, externalizing and prosocial behaviors.”

“Previous researches have established that books can have a small to moderate positive effect on child mental health, especially self-help books [50].”

“…(Crothers, 1916) and is a highly effective, inexpensive, and convenient psycho- educational intervention applicable to many health- related scenarios, particularly for children (Amer, 1999; DeVries et al., 2019; Mendel et al., 2016; Montogomery & Maunder, 2015; Pardeck, 1990, 1992; Pardeck, 1995).”

“The theoretical underpinning for this choice included the apparent bene fi ts of more structured interpretive engagements discussed above, as well as Montgomery and Maunders ’ (2015) suggestion that engaging with narratives may have therapeutic ef fi cacy via the same forms of cognitive restructuring…”

“…skill-building, behavioral change, selfunderstanding, and understanding of others’ perceptions, may be a promising medium to facilitate elementaryaged students’ cognitive-emotional development, social responsibility, and social-emotional learning (Montgomery & Maunders, 2015; Prater et al., 2006).”

“Still, such creative-oriented CBT integrations remain limited, with a need for more transferable guidelines and interactive tools that consistently support both in-session work with clinicians and self-directed at-home practice [84, 96, 143].”

“In contrast, children who read more books displayed less externalizing and internalized problems [10].”

“Recent studies (e.g., [11]–[13]) bibliotherapy, utilizing narratives to identify, achieve catharsis, and gain understanding into the functions and roles of different components is an efficacious approach for treating internalizing and externalizing behaviours, including anxiety, fear, and loss.”

“Some picture books intentionally focus on health and social issues to promote such conversations (e.g., bibliotherapy; the use of books for therapeutic purposes) (Montgomery and Maunders 2015; Tympa and Karavida 2021).”

“…of similar literature research on the topic of bibliotherapy was conducted by authors Paul Montgomery and Kathryn Maunders in their paper “The Effectiveness of Creative Bibliotherapy for Internalizing, Externalizing, and Prosocial Be-haviors in Children: A Systematic Review”, published in 2015 (5).”

“Montgomery and Maunders (2015) observe that reading is therapeutic because it challenges and reframes negative thoughts in the same way that cognitive behavioral therapy does.”

“Por ejemplo, se ha establecido que el vínculo afectivo se tiene desde antes del año y la funcionalidad de ese vínculo es un factor protector que estimula unas adecuadas relaciones interpersonales (28).”

“The authors concluded that bibliotherapy has a small moderating effect on children and adults with externalising, internalising, or prosocial behavioural challenges (Montgomery & Maunders, 2015).”

“Furthermore, the review found that including minimum levels of therapist support in addition to self-help materials enhanced child and parent outcomes (Montgomery & Maunders, 2015).”

“Within school settings, bibliotherapy not only aids children in coping with di ffi culties (Heath, Sheen, Leavy, Young, & Money, 2005) but also acts as a preventive measure against the development of negative behaviors, fostering the reinforcement of prosocial behavior (Montgomery & Maunders, 2015).”

“The use of bibliotherapy has been shown to help children improve anxiety, adjustment, and fears (Hammond, 1990; Montgomery & Maunders, 2015).”

“Although there are several reports regarding the use of books for entertainment purposes, nothing similar happens in cases of psychotherapy (Montgomery & Maunders, 2015).”

“Furthermore, previous research has shown that bibliotherapy provides a context in which reading comprehension can be examined alongside psychological flexibility, emotional awareness, and narrative identification, providing additional context for interpreting the present findings [20, 79, 110].”

“Montgomery and Maunders [11] conducted a systematic review of creative bibliotherapy interventions, finding moderate evidence for their effectiveness in reducing internalizing behaviors in children aged 5–16.”

“Jedan od pregleda istraživanja učinkovitosti dječje biblioterapije donijeli su Montgomery i Maunders (2015), pokazujući kako njezina kreativna primjena u dobnoj skupini 5–16 godina može imati blagi do umjereni pozitivan utjecaj u prevenciji i liječenju internalizirajućih i eksternalizirajućih…”

“They found that the process of reading creative texts, such as poetry, could promote cognitive and affective reconstruction of the individuals, and this effect was similar to CBT mechanism in some degree (Montgomery & Maunders, 2015 ).”

“According to Norcross, Beutler, and Levant (2006) bibliotherapy is a process that involves cautiously prescribing books to persons with specific problems with the aim of guiding such individuals to make use of the lessons learned from the process, with the treatment being followed up by occasional meetings to discuss…”

“…there is growing evidence to support the important role certain early literacy activities can play in the social-emotional development of young children (e.g. Bramwell and Doyle, 2008; Doyle and Bramwell, 2006; Montgomery and Maunders, 2015), suggesting the two domains need not battle for priority.”

“One of the hallmarks of ERP is the practice of bibliotherapy, the use of books relevant to children’s therapeutic needs (Betzalel & Shechtman, 2010; Montgomery & Maunders, 2015).”