Can fiction improve wellbeing?

:speech_balloon: Speaker: Franziska Hartung @FranHartung

:classical_building: Affiliation: Newcastle University

Title: Can fiction improve wellbeing?

Abstract (long version below): Engaging with stories can help individuals and communities to process traumatic experiences and build resilience. Bibliotherapy has become a promising low-cost and non-invasive wellbeing intervention. We tested whether wellbeing can be improved in adult volunteers over a 6-week intervention in bibliotherapy or creative writing. Our results show that both reading and writing have positive effects on wellbeing and are promising and cost effective tools in public health.


:newspaper: Long abstract

Engaging with stories can help individuals and communities to process pain and traumatic experiences, build resilience and connections, learn about the world and other people, and escape into alternative worlds. Bibliotherapy has become popular as a promising low-cost and non-invasive intervention that can improve wellbeing, e.g., in cancer patients. Reading, either as shared reading in groups or individually, especially in conjunction with group discussions about the reading contents can help individuals to process distressing thoughts and feelings indirectly in a safe fictional space without direct confrontation of personal traumatic events. Similarly, writing as a creative exercise also seems to be a promising tool in wellbeing interventions. What is less clear from existing research is what components of wellbeing are improved by reading or writing and whether individual differences affect the effectiveness of bibliotherapy or creative writing wellbeing interventions.

We tested the effectiveness of 2 types of bibliotherapy (trauma-relevant vs trauma-irrelevant fiction reading) and creative writing as group-based wellbeing interventions and a control group that completed the bibliotherapy interventions without group meetings. The study was preregistered at We recruited 2 cohorts of adult volunteers with varying degrees of mental wellbeing at baseline for this study: Creative Writing (N=36), Reading and weekly meetings (N=81), and Reading and weekly online surveys (Control Group, N=38; only for cohort 2, not part of the preregistration).

All groups apart from the control group participated in 6 weekly 1h zoom meetings with their intervention group. The reading group discussed the experiences while reading their book and reading in general in a semi structured discussion while the writing group did creative writing exercises together and also group discussions linked to the topics discussed in the reading group. Participants in the control group completed the same discussions individually via weekly online questionnaires. Since agency is critical to wellbeing, participants chose their preferred intervention type (writing or reading) and book or writing journal from a list. Participants choosing the reading intervention were randomly allocated to the trauma (e.g. dystopian Sci Fi, trauma centered contemporary fiction) or non-trauma (e.g. romance, classics, historic fiction) fiction list and chose a book they would like to read from that list. Each list contained 15 titles from a variety of genres. Participants choosing the writing intervention chose a journal or daily planner of their choice. We provided the books for the reading group and writing journals for the writing group and shipped them directly to the participants. If participants finished their reading before the intervention ended, they could pick another book of their choice from the same list.

Before and after the intervention, wellbeing was assessed with a battery of standardized measures such as WHO Quality of Life survey, diagnostic questionnaires for depression and anxiety, mental resilience, optimism, and life satisfaction via a Qualtrics survey. After the intervention, we additionally measured aesthetic experiences and the Story World Absorption Scale for the reading group in reference to their chosen books. We hypothesized that participants in every intervention group would experience improvement in some aspects of their wellbeing. All volunteers who completed the intervention received a 25£ Amazon voucher as a thank you.

Qualitative data from participant feedback revealed that almost every participant who completed the study reported subjective feelings of improvement on different aspects of life. The themes that came up the most in discussions and on the final feedback were escapism (such as finding time for yourself), learning (about other people, ideas, and cultures), reflection (about yourself and characters), and catharsis (processing difficult emotions). The quantitative data from the questionnaires also shows improvement in wellbeing for every group in the study. The creative writing group showed the largest improvement for life satisfaction and physical quality of life. The reading group who met weekly online showed the largest improvement in resilience and state optimism. The most improvement, however, was shown in the control group who read the same books without meeting online and instead filled out weekly questionnaires about the same topics we covered in the discussion. This group showed improvement in health satisfaction, state optimism, and almost all aspects of quality of life (physical, social, and environmental, but not psychological) as well as decreased levels of depression and anxiety. We think the main difference between the reading group that met online and the control group is that the people who met up weekly were mostly people who already read a lot regularly while many people in the control group started reading regularly again. Improvement in all participants in the reading groups was linked to narrative engagement. Increased attention during reading was linked to more improvement in depression and higher transportation scores predicted more improvement in anxiety symptoms. High mental imagery was associated with lesser improvement in depression symptoms and more improvement in resilience. Stronger plot related emotions also predicted better improvement in anxiety symptoms.

Finally, with respect to the trauma fiction and non-trauma fiction, we find that non-trauma fiction such as historic, romance, adventure and classics have more benefits for wellbeing than trauma fiction such as dystopian sci-fi, war fiction, or family trauma drama. This benefit was significant for health satisfaction, life satisfaction, social quality of life, and resilience. This suggests that escapism is more important for our (mental) health than trauma processing, at least for healthy adults.

In summary, our hypothesis is confirmed that both reading and writing have positive effects on wellbeing and are promising and cost effective tools in public health. Our results emphasize the need for more research on fiction and public health, including research with patients and other vulnerable populations. Additionally, we highlight the importance of joy in reading experience as predictors of intervention effectiveness and the need for access to reading particularly for vulnerable populations such as children, prisoners, and refugees. Future research should explore the relationship between reading and writing materials and wellbeing outcomes.

Hi! Wonderful study and presentation, with insightful results!
Just a thought regarding the finding that the individual reading groups (the control group) experienced the most improvement, which you say was a bit of a surprise since this group lacked a social component. In addition to the possibilities you mention that may explain this finding, this may also relate to findings of e.g. Eekhof and Mar, who present their work in parallel session 4. They posit that…

So to say, perhaps the control group did not experience benefits despite a lack of social component, but they experienced a different form of social-cognitive engagement. It may be an interesting aspect to explore further for individual reading.

Hope that this association is relevant to you! Thanks again for a lovely presentation.


Hi Bien,

Thank you for the suggestion, this is super interesting! I am also wondering about the role of reflection, in the sense whether people would improve in the same way without the discussion prompts where they have to engage more with the reading materials. I might do a quick study with a control group only but without weekly prompts…

Thank you so much for the interesting presentation, Franziska! I was thinking about the facilitators of the reading and writing groups. In interactive biblio(/poetry)therapy groups, one important aspect is also the group facilitator and the bibliotherapeutic methods they use (see e.g. Hynes & Hynes-Berry 2012/1986: Biblio/Poetry Therapy – The Interactive Process: A Handbook). So it might be interesting to explore more thoroughly the significance of group facilitators (whether the groups were facilitated by a trained bibliotherapy facilitator or not). Thanks again for your presentation!

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Thank you, Eevastiina! We originally planned to have a trauma specialized therapist who is experienced in bibliotherapy to lead the sessions but they had to drop out last minute due to scheduling conflicts because 6hs per week with the different groups outside of working hours (to make it most accessible) were not feasible. So, I ended up being the main facilitator based on the program written by the therapist assisted by my students. But what I gathered from literature review and the recommendations from the therapist is that there are no clear evidence based guidelines and that this is something direly missing from the literature. If you have additional recommendations, please send them my way!

Hi Franziska, thanks for an engaging and interesting presentation. I am very exited to see the outcomes of the study, and I really like the conclusion that bibliotherapy is easy accessible and does not necessarily require a bibliotherapist. For me it was also a surprise that the control group experienced the most improvement. Maybe in a follow-up study you could compare an individual group with both an online group and an on-site group? As meeting strangers online can, as you say, maybe lead to an amount of stress, and dialogues works significantly different in an online setting. Just an idea. I also wonder if the social dimension would benefit more the intervention if the participants read and discussed a text together live (as in shared reading) compared to reading beforehand and discussing a fixed topic together. In the first mentioned the collective dimension of reading together might add an additional layer to the reading experience. See for example this paper by Kristensen et al (2023): “We’re opening 20 doors”: .

Hi Tine,

Thank you for the suggestions! I think a shared reading intervention would be a new project. Maybe something I could run with undergraduates next year. But I have also been thinking to run such a project in our local refugee library.