Josie Billington

Get into Reading as an intervention for common mental health problems: exploring catalysts for change

There is increasing evidence for the efficacy of non-medical strategies to improve mental health and well-being. Get into Reading is a shared reading intervention which has demonstrable acceptability and feasibility. This paper explores potential catalysts for change resulting from Get into Reading. Two weekly reading groups ran for 12 months, in a GP surgery and a mental health drop-in centre, for people with a GP diagnosis of depression and a validated severity measure. Data collection included quantitative measures at the outset and end of the study, digital recording of sessions, observation and reflective diaries. Qualitative data were analysed thematically and critically compared with digital recordings. The evidence suggested a reduction in depressive symptoms for Get into Reading group participants. Three potential catalysts for change were identified: literary form and content, including the balance between prose and poetry; group facilitation, including social awareness and communicative skills; and group processes, including reflective and syntactic mirroring. This study has generated hypotheses about potential change processes of Get into Reading groups. Evidence of clinical efficacy was limited by small sample size, participant attrition and lack of controls. The focus on depression limited the generalisability of findings to other clinical groups or in non-clinical settings. Further research is needed, including assessment of the social and economic impact and substantial trials of the clinical effectiveness and cost-effectiveness of this intervention.

A literature-based intervention for older people living with dementia

Background: While several studies have explored the impact of literature and reading on mental health, there has been relatively little work done on how a literature-based intervention might impact on the behaviours of those living with dementia. The present report addresses the effect that a specific literature-based intervention – Get into Reading, designed and practised by national charity The Reader Organisation – might have on the health and well-being of people living with dementia. Aims: This present study arises out of a service evaluation that specifically assessed to what extent the shared-reading intervention impacted upon behaviours symptomatic of dementia. Its aims were: (1) to understand the influence that reading has on older adults with dementia in different health-care environments; (2) to identify staff perceptions of the influence that engagement in a reading group has on older adults living with dementia; and (3) to investigate any changes in dementia symptoms of older adults participating in a reading group. Methods: The study employed a mixed-method design conducted within three health-care environments: three care homes, two hospital wards and one day centre. The Neuropsychiatric Inventory Questionnaire (NPI-Q) assessed staff views of any changes in dementia symptom severity for participants in reading groups conducted in the care homes. Semi-structured qualitative interviews were then conducted with staff who attended the reading groups and/or had extensive knowledge of service users involved in all of the health-care settings. Responses to questions were recorded verbatim and then subject to thematic analysis. Results: 61 service users and 20 staff members took part in the overall project. The NPI-Q results indicate that symptom scores were lower during the reading group period than at baseline. These findings were supported by the qualitative interviews, which suggested that three themes were perceived to be important to effective engagement with the reading groups: (1) the components of the reading group intervention; (2) enjoyment, authenticity, meaningfulness and renewed sense of personal identity; and (3) enhancement of listening, memory and attention. Conclusions: In light of quantifiable data of limited but indicative status, together with strongly corroborative qualitative evidence, engagement in reading-group activity appeared to produce a significant reduction in dementia symptom severity. Staff interviews indicated the contribution of reading groups to well-being.

Shared Reading: assessing the intrinsic value of a literature-based health intervention

Public health strategies have placed increasing emphasis on psychosocial and arts-based strategies for promoting well-being. This study presents preliminary findings for a specific literary-based intervention, Shared Reading, which provides community-based spaces in which individuals can relate with both literature and one another. A 12-week crossover design was conducted with 16 participants to compare benefits associated with six sessions of Shared Reading versus a comparison social activity, Built Environment workshops. Data collected included quantitative self-report measures of psychological well-being, as well as transcript analysis of session recordings and individual video-assisted interviews. Qualitative findings indicated five intrinsic benefits associated with Shared Reading: liveness, creative inarticulacy, the emotional, the personal and the group (or collective identity construction). Quantitative data additionally showed that the intervention is associated with enhancement of a sense of ‘Purpose in Life’. Limitations of the study included the small sample size and ceiling effects created by generally high levels of psychological well-being at baseline. The therapeutic potential of reading groups is discussed, including the distinction between instrumental and intrinsic value within arts-and-health interventions.

A literature-based intervention for people with chronic pain

Background: This study investigated the impact of a literature-based intervention – The Reader Organisations “Get into Reading (GIR)” shared read-aloud model – on people with chronic pain in a clinical setting. Methods: A mixed methodology approach was used. Quantitative self-report measures tested the effect of GIR on participants’ psychological symptoms and function before, during and after the reading group. Qualitative individual interviews and a focus group explored participants’ experience of GIR. Results: Three key themes emerged from the data: the value of the literature read in terms of quality and diversity, and in terms of promoting absorbed concentration and “flow”; a sense of shared community; improvement in mood, function and quality of life. Conclusions: The study has demonstrated that GIR can have a positive impact on the lives of people suffering chronic pain, which may help to alleviate some features of the condition with minimum risk of side effects.

Where does literary study happen? two case studies

This article explores the question of where literary study happens through reflection on two case studies. The article examines projects within two UK English departments, which were designed to allow students of literature to engage with local communities as part of their studies. The implications of this work are considered for curriculum design, for students and teachers in their interaction with the discipline, and for community participants. The article places this work in the context of broader questions about the ‘place’ of higher education and in particular earlier efforts at university ‘extension’ in England and Wales, out of which these projects developed. The authors consider the potential impact of this work not only on questions of where we study literature, but also on what is studied, how and why.

A comparative study of cognitive behavioural therapy and shared reading for chronic pain

The case for psychosocial interventions in relation to chronic pain, one of the most common health issues in contemporary healthcare, is well-established as a means of managing the emotional and psychological difficulties experienced by sufferers. Using mixed methods, this study compared a standard therapy for chronic pain, cognitive behavioural therapy (CBT), with a specific literature-based intervention, shared reading (SR) developed by national charity, The Reader. A 5-week CBT group and a 22-week SR group for patients with chronic pain ran in parallel, with CBT group members joining the SR group after the completion of CBT. In addition to self-report measures of positive and negative affect before and after each experience of the intervention, the 10 participants kept twice-daily (12-hourly) pain and emotion diaries. Qualitative data were gathered via literary-linguistic analysis of audio/video-recordings and transcriptions of the CBT and SR sessions and video-assisted individual qualitative interviews with participants. Qualitative evidence indicates SRs potential as an alternative or long-term follow-up or adjunct to CBT in bringing into conscious awareness areas of emotional pain otherwise passively suffered by patients with chronic pain. In addition, quantitative analysis, albeit of limited pilot data, indicated possible improvements in mood/pain for up to 2 days following SR. Both findings lay the basis for future research involving a larger sample size.

An evaluation of shared reading groups for adults living with dementia: preliminary findings

Purpose – Although there is a growing evidence base for the value of psychosocial and arts-based strategies for enhancing well-being amongst adults living with dementia, relatively little attention has been paid to literature-based interventions. The purpose of this paper is to assess the impact of shared reading (SR) groups, a programme developed and implemented by The Reader Organisation, on quality of life for care home residents with mild/moderate dementia. Design/methodology/approach – In total, 31 individuals were recruited from four care homes, which were randomly assigned to either reading-waiting groups (three months reading, followed by three months no reading) or waiting-reading groups (three months no reading, followed by three months reading). Quality of life was assessed by the DEMQOL-Proxy and psychopathological symptoms were assessed by the Neuropsychiatric Inventory Questionnaire. Findings – Compared to the waiting condition, the positive effects of SR on quality of life were demonstrated at the commencement of the reading groups and were maintained once the activity ended. Low levels of baseline symptoms prevented analyses on whether the intervention impacted on the clinical signs of dementia. Research limitations/implications – Limitations included the small sample and lack of control for confounding variables. Originality/value – The therapeutic potential of reading groups is discussed as a positive and practical intervention for older adults living with dementia.

The Very Grief a Cure of the Disease

Abstract This article uses Elizabethan poetics and the Renaissance sonnet as a template for understanding the power of reading as it is exhibited in modern-day mental health contexts, specifically in the work of national charity The Reader. Our concern is with the medicine of verbal beauty, representative expression and formal ordering towards perfection – in particular, the relation of ‘erected wit’ and ‘infected will’ in Sidney’s Defence of Poetry. We examine reading group transcripts produced as part of research projects on reading and mental health conducted by the Centre for Research into Reading, Literature and Society (CRILS) at the University of Liverpool (where the authors are based). We demonstrate how Elizabethan poetry, precisely by not offering a form of directive or targeted therapy, has the potential to help ease the suffering of those whose personal and existential problems are too often ignored by conventional therapies because ‘incurable’ as such.

Primary Sources and the MA Student

I have a clear memory of the point at which, as a student of nineteenth-century literature, I became committed to what I was doing. We had read and discussed, closely and carefully, John Stuart Mill’s “The Enfranchisement of Women” (Westminster Review, 1851).1 In the following seminar we read Charlotte Bronte’s Villette (1853), together with a letter (to Elizabeth Gaskell) recording the author’s equivocal response to Mill’s thesis, thus: I believe J. S. Mill would make a hard, dry, dismal world of it; and yet he speaks admirable sense through a great portion of his article – especially when he says that if there be a natural unfitness in women for men’s employment, there is no need to make laws on the subject … In short J. S. Mill’s head is, I dare say, very good, but I feel disposed to scorn his heart. You are right when you say there is a large margin in human nature over which the logicians have no dominion: glad am I that it is so. (qtd. in Gaskell 1996, p. 390) Having just experienced, from the inside, the rich and complex resistance in Villette even to narrative explanation of its protagonist Lucy Snowe, the relative reductionism of Mill’s logic was hard to deny. On the other hand, how did my acquiescence to Charlotte Bronte’s criticism square with my rapt acceptance of Mill’s thesis only a few days before? Was it worthless after all? What was the relation between these two discourses?