Exploring the Efficacy of Cognitive Bibliotherapy and a Potential Mechanism of Change in the Treatment of Depressive Symptoms Among the Chinese: A Randomized Controlled Trial
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The present study investigated the efficacy of cognitive bibliotherapy in the treatment of depressive symptoms among Chinese individuals in Taiwan. Adults with depressive symptoms (N = 52, M age = 26.4) were randomly assigned to the treatment condition or the delayed treatment control condition. Participants were assessed at pretreatment, posttreatment, and 3-month follow-up. Results indicated that participants’ overall depression level lowered at posttreatment. Analyses were performed on the intention-to-treat basis. Multiple imputation inference procedure (Rubin in Multiple imputation for nonresponse in surveys, John Wiley & Sons, Inc., New York 1987) was adopted to estimate missing values and to draw inferences based on the imputed data. Results of the analyses indicated that the cognitive-affective symptoms of depression, rather than the somatic symptoms of depression, evidenced significant reduction as a result of cognitive bibliotherapy. Further reductions in cognitive-affective symptoms were observed at 3-month follow-up. Lastly, learned resourcefulness was found to be a mechanism through which bibliotherapy reduced depressive symptoms. The present study provides preliminary evidence that cognitive bibliotherapy may be a promising treatment option for Chinese individuals with depressive symptoms. In the meantime, participants’ qualitative feedback may provide important direction for cross-cultural adaptation of cognitive bibliotherapy. Applied implications and cultural issues are discussed.