Cognitive Therapy and Research

, Volume 33, Issue 5, pp 449–461 | Cite as

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

  • Emily Tung-Hsueh Liu
  • Wan-Lan Chen
  • Yi-Hwei Li
  • Chiao Han Wang
  • Tze Jing Mok
  • Hwei Shan Huang
Original Article


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.


Chinese Bibliotherapy Depression Learned resourcefulness Mediator 



This study was funded by a research grant (94-2413-H-030-002) from the National Science Council (NSC) in Taiwan.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Emily Tung-Hsueh Liu
    • 1
  • Wan-Lan Chen
    • 2
  • Yi-Hwei Li
    • 3
  • Chiao Han Wang
    • 1
  • Tze Jing Mok
    • 1
  • Hwei Shan Huang
    • 1
  1. 1.Department of Clinical Psychology, College of MedicineFu Jen Catholic UniversityHsin ChuangTaiwan
  2. 2.Department of Human DevelopmentTzu-Chi UniversityHualien CityTaiwan
  3. 3.Department of Public HealthTzu-Chi UniversityHualien CityTaiwan

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