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How Bibliotherapy Can Help Students Open Up About Their Mental Health

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Mental health concerns, like anxiety, depression and post-traumatic stress disorder, can affect a student’s ability to concentrate, form friendships and thrive in the classroom. Educators and school counselors often provide Social and Emotional Learning programs (SEL) in order to help these students, as well as school-based therapeutic support groups. However, even in these forums, getting teenagers to speak about their problems can be challenging, especially when they feel like outsiders and worry about judgment from their peers.

That is why Anita Cellucci, a school librarian at Westborough High School in Westborough, Massachusetts, developed an alternative way to support struggling students at the school. Cellucci and school counselor Ceil Parteleno began a six-week group specifically targeted to students who had experienced trauma and loss.

Drawing upon Cellucci’s knowledge and love of books, and Parteleno’s expertise as a counselor, the pair began a unique school-based support group, using storytelling and literature as a way to help kids understand and cope with their emotions. This kind of support is known as bibliotherapy.

According to Dr. Liz Brewster, a bibliotherapy researcher and lecturer at Lancaster Medical School in Lancaster, England, bibliotherapy can help people understand, process and consider difficult emotions.

“When they recognize their thoughts and emotions in a work of fiction, or in a self-help book, it can help people to feel less alone,” says Brewster.


For adolescents struggling with depression, anxiety and grief, the use of books as a therapeutic tool can be invaluable. Tweens and teens often get stuck in their narratives, believing that the fictional stories they tell themselves are accurate. Because of the insecurities that adolescence can bring, it’s easy for them to assume that being excluded from a peer’s birthday party or being left out of a group text exchange is a personal affront. Social media often fuel these beliefs, which can take a toll on a youth's mental health. Shame and stigma often prevent students from speaking out and seeking the emotional support they need.

But reading about a fictional character’s experiences can normalize those feelings and give adolescents the courage to open up about their own struggles. During each meeting, Cellucci leads a discussion about a book, inviting students to share their impressions. Group members can also reflect privately about the readings by writing in their journals.

"'Buddha's Brain' offers practical mindfulness tips centered around kindness, empathy, love, and self-care," says Cellucci. While it's a nonfiction book, Cellucci uses the core concepts of Buddhism to help the students share their personal stories, such as times when they needed love and care, as well as moments when they offered this support to others. “After reading 'Buddha’s Brain,' the students discuss how they can relate to the readings,” says Cellucci.

Along with "Buddha's Brain," Cellucci also uses fiction books with students individually. Stories like "Please Ignore Vera Dietz" by A.S. King and "All American Boys" by Jason Reynolds and Brendan Kiely help students talk about sensitive topics, like race, privilege and human angst.

"Many of the students who read 'Please Ignore Vera Dietz' relate to Vera, the main character. This character helps them grapple with whether or not our family history determines our destiny," says Cellucci.

Getting Together

At Westborough's bibliotherapy group, each meeting follows a structured format in order to create a safe forum for the participants. The group begins with an activity, like yoga or a mindful breathing exercise. Then, Parteleno teaches the students cognitive tools, like reality testing and perspective taking, which helps them to challenge and cope with any distressing and worrisome thoughts. For example, if a worried student believes her friend is ignoring her, Parteleno might gently challenge the belief, asking a question like, “What evidence do you have that this is true?” followed by “Is there any other reason that could explain your friend’s behavior?”

Students also practice activities based on Dialectical-Behavior Therapy, which teaches kids how to manage intense emotions. During the group, Parteleno leads the students through mindfulness and cognitive role-play exercises, acting out challenging real-life scenarios that they’ve faced during the week. For example, teens in the loss group role-played how to talk with friends and family members about their grief and loss.

While studies show DBT is an effective form of psychotherapy, especially for young adults, bibliotherapy is a newer mental health intervention for youth. However, research suggests it can help reduce symptoms of anxiety and depression, especially among adolescents.

For some students, talking about their suffering can feel vulnerable. But hearing about the experience of loss from a trusted adult can help the students feel more secure about sharing. During one group meeting, Cellucci spoke about the death of her grandmother and how the loss affected her as a child. For many of the students, hearing these stories creates a sense of solace, which facilitates the healing process.

After enduring a family trauma, one student found the group especially helpful.

“The loss group was helpful because it allowed me to open up my feelings and share with people who were going through the same pain as me,” says the student in Cellucci’s group.

The student says that Cellucci and Parteleno helped her learn how to manage her stress and deal with intense emotions.

“In the group, I could feel compassion from others, and this gave me hope. I learned that we have to keep going with the belief that life will get better,” she says.

Cellucci says the students look forward to the group because it's a time of quiet reflection and personal connection in a safe and trusted space. Students who experience the therapeutic benefits of bibliotherapy also begin to see the library as a haven where they can find books to help them understand their feelings.

For school librarians who wish to begin a bibliotherapy program, Cellucci offers these tips:

  1. Create material displays that demonstrate awareness, cultural diversity and student voice (materials developed by students and/or with student input).
  2. Facilitate schoolwide events that promote literacy through diversity, breaking mental health stigma and inviting students to share their voices.
  3. Write grants to bring SEL-related programs that include poetry slams, reflective writing and community art.
  4. Collaborate with the school’s counseling department to design SEL and bibliotherapy programs.
  5. Pursue training in youth mental health education through Youth Mental Health First Aid and National Alliance on Mental Illness (NAMI).


Cellucci has also created a library guide for mental health bibliotherapy, and her list can be found here.

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