Since the first bibliotherapy or healthy reading scheme in Ireland was set up in Dublin in 2007, thousands of self-help books recommended by GPs have been taken out of libraries around the State, writes MICHELLE McDONAGH
IMAGINE THE scenario. You go to your GP complaining about feeling anxious all the time. Instead of reaching for his prescription pad and writing up a script for Valium or some other anti-anxiety medication, he recommends that you read Overcoming Anxiety by Helen Kennerly or How to Stop Worrying by Frank Tallis.
Or maybe you’ve been feeling very down for a while and think you might need an anti-depressant to pull yourself out of the black hole. Instead of (or as well as) Prozac, your GP prescribes Depression, The Commonsense Approach by Tony Bates or The Feeling Good Handbook by David Burns.
The effectiveness of using self-help books as a means of psychological therapy for people experiencing mild to moderate emotional and psychological difficulties – known as bibliotherapy – has been well established in clinical trials.
The National Institute for Clinical Excellent (NICE) in the UK now recommends bibliotherapy as a useful starting point in the treatment of mild and moderate depression, anxiety, panic and some other mental health problems.
Since the first bibliotherapy or healthy reading scheme in Ireland was set up in Dublin in 2007, thousands of self-help books recommended by GPs have been taken out of Irish libraries by people who want to gain insight into and treat the problems that are upsetting or disturbing them.
The North Inner City Partnership in Primary Care (Dublin), in collaboration with Dublin City Public Libraries, piloted the State’s first bibliotherapy scheme which was led by Elaine Martin, HSE senior psychologist.
And in February 2009, the Library Council of Ireland, the HSE and the Irish College of General Practitioners introduced the Power of Words scheme.
Since then, other bibliotherapy or healthy reading schemes have been started around the State including Mind Yourself in Wexford and in October of this year, the Your Good Self programme in north Cork.
Martin says: “There are thousands of self-books available and while the best of these are very effective, others are not so useful.
“We compiled a list of high-quality self-help books for our book scheme which are written by leading clinicians in their fields – psychologists, psychotherapists and psychiatrists. Most of the books on our list include not only a description of a condition or difficulty but offer an intervention that the reader can try to put in place.”
The Power of Words reading list is available to all GPs and the books and CDs are stocked in many public libraries and in all good bookshops. The full list is also available for download on the website of the ICGP (icgp.ie) and the Libraries Council of Ireland (librarycouncil.ie).
Martin explains that the Power of Words scheme was set up as a primary care psychological service with the aim of making psychology information accessible to a broader swathe of the population.
“A significant number of people at any given time are experiencing psychological or emotional difficulties, but only a tiny percentage have access to psychological services. Self-help books have a role to play.
“Firstly, they can empower people to address their own difficulties through providing good quality information.
“It’s also a very low cost intervention compared with face-to-face therapy and there is no stigma attached.
“It has been found to be highly effective, in some cases as effective as medication and face-to-face therapy, depending on the clinical issue.”
The Power of Words was originally started as a book prescription scheme, similar to those in England and Wales, where GPs prescribe a book from the recommended list to a patient with anxiety issues or depression, for example.
However, this did not work as well with Irish patients who seemed reluctant to hand a prescription into their local librarian and it has evolved into more of a book recommendation scheme.
The GP recommends a book from the list to the patient who can then go into their local library and access it on the shelf. “The books have been flying off the shelves since we dropped the prescription access. There were thousands of books taken out in the first year of the scheme. There seems to be a huge willingness and appetite in Irish people for using self-help books.
“The most popular ones on the list are those dealing with depression and anxiety which are the most prevalent presenting issues to GPs. Self-esteem is another popular area,” says Martin.
While book-based therapy will not be suitable for everyone, Martin points out that it is appropriate for a proportion of those who consult their GP or other healthcare professionals with a psychological problem.
For those who are able to make use of bibliotherapy, the books provide a problem-solving approach to recovery and emphasise the potential of self-management.
The Power of Words scheme includes books on many of the common psychological problems that people experience including depression, eating disorders, obsessive compulsive problems, social phobia, relationship and sexual problems, panic, anger, stress, parenting, low self-esteem, and the aftermath of sexual abuse.
Bibliotherapy is the main component of the Your Good Self programme, recently launched by the HSE in conjunction with Cork County Library and Arts Service in Co Cork.
Dr Rosarie Crowley, HSE south clinical psychologist, wants to spread the message as widely as possible that resources are now available at Mallow Library that can help people of all ages to take an active part in looking after their emotional wellbeing.
Books, CDs and DVDs are available on topics from parenting and stress management to self-esteem as well as lists of useful websites.
A list of these materials is available in the library and can also be accessed through local GPs, health professionals, teachers and other individuals working in the community. The list will also be available on the HSE and Cork county library websites.
“Bibliotherapy is about trying to intervene initially at the least intense level on a population-wide level on public education and information to help people look after their own emotional wellbeing.
“If somebody is still in difficulty after this, they may need to be referred to other services but this is the foundation level of the stepped care approach.
“For people interested in looking after themselves and being in control of their health, it can be very positive,” Crowley says.
