Treating Nighttime Fears in Young Children with Bibliotherapy: Evaluating Anxiety Symptoms and Monitoring Behavior Change

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Lewis, K., Amatya, K., and Coffman, M.F. (2015). Treating nighttime fears in young children with bibliotherapy: Evaluating anxiety symptoms and monitoring behavior change. Journal of Anxiety Disorders, 30, 103-112.

This article shows how a bibliotherapy, in the context of being a non-fiction, “Self-help” book and workbook, is used to help children with low to moderate sleep anxiety. Although nighttime fears are normal for children, there are children with severe nighttime fears that if left untreated, can go on to affect development or psychopathology in later life. Most of the time the first line of defense is cognitive behavioral therapy. While this form of therapy provides help in some cases, there is room for improvement. The researchers have proposed that bibliotherapy can help improve this approach.

Using books for therapy in the treatment of mental disorders also means the parent or guardian has to be highly involved with the process. They cited that bibliotherapy in the vein of self-help materials have proven useful for children. They see the application of this process as having:

ease of administration

potential to enhance motivation for change

the ability to incorporate a number of therapeutic components into a format that is intrinsically appealing to children.

The team used, Uncle Lightfoot, Flip that Switch: Overcoming Fear of the Dark, which is a 19 chapter book which has a parent guidebook. The hypothesis was this: the children’s severity of nighttime fears would lessen, their avoidant behaviors would decrease, and the child and parent report of fear and anxiety on the Koala Fear Questionnaire and Preschool Anxiety Scale would also decrease after the treatment was finished.

The design was basically book exposure therapy with parental or guardian involvement. There were call-ins, interviews with the researchers, questionnaires, and the results showed that by using a tiered approach, bibliotherapy can be a first-line defense for low to moderate fears and anxiety disorders before more invested treatments begin. It is a non-invasive process that can possibly remove the stigma attached to a lot of treatments, and it can be monitored before deciding to move on to further individual therapies.

I do think that this approach is commendable and useful even in the layman’s world of literature recommendation. Using read-aloud time with parents, guardians, even librarians, to expose children to books about fears and talk about these fears in a laid-back group setting (especially preschool age, which gets overlooked oftentimes in bibliotherapy settings,) can be beneficial for “normal” childhood fears and traumas. It does not have to be self-help like mentioned in this particular study, but using picture books to discuss fear normalizes the fear and exposes said fear to the daylight, if you will.

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