The State of Art Education Initiative

Bibliotherapy May Have Value, But More Research is Needed

Reviewed by the medical professionals of the ISSM’s Communication Committee

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Bibliotherapy may benefit patients with sexual dysfunction, but more study is needed, according to a recent review in the Journal of Sexual Medicine.

It isn’t clear how effective bibliotherapy may be for certain types of sexual dysfunction, the authors said.

Bibliotherapy refers to the use of printed materials, such as books and pamphlets, for a therapeutic goal. Such use might be unassisted (e.g., a patient buying a self-help book and working through an intervention on their own) or assisted (e.g., a patient reads a book assigned by a therapist). In some cases, internet interventions are used.

The current study aimed to summarize the current state of bibliotherapy in the treatment of sexual dysfunction. In particular, the researchers investigated the effectiveness of assisted and unassisted bibliotherapy in comparison with other interventions (such as group therapy and face-to-face therapy) and no treatment.

Researchers examined fifteen randomized controlled trials published between 1970 and January 2020. Overall, the participants included 1,113 people (781 women and 332 men) seeking help for a variety of sexual problems, including orgasmic disorder, low desire, and premature ejaculation. Some studies focused on just one sexual problem; others looked at multiple sexual issues. All studies took place in either Europe or North America.

The data suggested that bibliotherapy appeared to benefit women more than men:

  • When unassisted bibliotherapy was compared to no treatment, women were more likely than men to have sexual problems resolved. In addition, both men and women who underwent unassisted bibliotherapy had higher sexual satisfaction rates than participants who had no treatment.
  • When assisted bibliotherapy was compared to no treatment, sexual health outcomes were positive for women. But there were no effects on male sexual function.
  • When both unassisted and assisted bibliotherapy were compared to other interventions, no differences were found for either men or women.
  • No differences were found in dropout rates among studies.

The authors pointed out that the certainty of the evidence was “low or very low” because of “imprecision and study limitations.” Most of the studies had small sample sizes, they added. For example, only three of the studies had 100 or more study subjects. Also, some of the studies were over 20 years old, and not all data could be obtained.

“Indications of positive effects of bibliotherapy for sexual dysfunctions were found. However, owing to limitations in the study designs and the imprecision of the findings, we are unable to draw any firm conclusions about the use of bibliotherapy for sexual dysfunction,” the authors wrote.

It was also unclear how effective bibliotherapy was for specific kinds of sexual dysfunction.

The authors recommended additional studies with larger sample sizes and investigations into types of bibliotherapy used. It could also be helpful to explore how participants’ personal characteristics – such as age, literacy, and computer literacy – might influence experiences with bibliotherapy, they said.


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