Evaluating the Effectiveness of Bibliotherapy on Self-Compassion and Shame in Individuals with Eating Disorders

Angel Lee; Amirul Iskandar

doi:10.61838/kman.jarac.6.3.28

Authors

Angel Lee Faculty of Social Sciences & Liberal Arts, Department of Psychology, UCSI University, Kuala Lumpur, Malaysia

Amirul Iskandar * Department of Psychology, University of Malaya, Kuala Lumpur, Malaysia amirul@um.edu.my

https://doi.org/10.61838/kman.jarac.6.3.28

Keywords:

Bibliotherapy, Self-Compassion, Shame, Eating Disorders, Randomized Controlled Trial, Psychological Intervention

Abstract

Objective: This study aimed to evaluate the effectiveness of a bibliotherapy intervention on enhancing self-compassion and reducing shame in individuals with eating disorders.

Methods and Materials: The study employed a randomized controlled trial design involving 30 participants with clinically diagnosed eating disorders from Malaysia, randomly assigned to either an intervention group (n = 15) receiving a six-session bibliotherapy program or a control group (n = 15) receiving no intervention. The bibliotherapy sessions were conducted weekly over six weeks, incorporating evidence-based reading materials and reflective exercises targeting self-compassion and shame. Standardized instruments—the Self-Compassion Scale (SCS) and the Experience of Shame Scale (ESS)—were administered at three time points: pre-test, post-test, and five-month follow-up. Data were analyzed using repeated measures ANOVA with Bonferroni post-hoc tests via SPSS-27.

Findings: Descriptive analysis indicated that the intervention group experienced an increase in self-compassion from pre-test (M = 2.61, SD = 0.33) to post-test (M = 3.39, SD = 0.41) and follow-up (M = 3.31, SD = 0.38), while shame scores decreased from pre-test (M = 3.47, SD = 0.29) to post-test (M = 2.68, SD = 0.33) and follow-up (M = 2.72, SD = 0.35). The control group showed no significant changes. Repeated measures ANOVA revealed significant time × group interaction effects for both self-compassion (F(2, 56) = 20.31, p < .001, η² = .43) and shame (F(2, 56) = 17.82, p < .001, η² = .39). Bonferroni post-hoc comparisons confirmed that changes from pre-test to post-test and follow-up were statistically significant for the intervention group (p < .001), but not between post-test and follow-up (p > .05), indicating sustained effects.

Conclusion: The findings suggest that bibliotherapy is an effective and durable intervention for increasing self-compassion and reducing shame in individuals with eating disorders.

Downloads

Download data is not yet available.

References

Alcaraz‐Córdoba, A., Fernández, M. D. R., Ibáñez‐Masero, O., Ventura‐Miranda, M. I., García-Navarro, E. B., & Ortega‐Galán, Á. M. (2024). The Efficacy of Compassion Training Programmes for Healthcare Professionals: A Systematic Review and Meta-Analysis. Current Psychology, 43(20), 18534-18551. https://doi.org/10.1007/s12144-024-05618-0

Andersson, C., Mellner, C., Lilliengren, P., Einhorn, S., Bergsten, K. L., Stenström, E., & Osika, W. (2022). Cultivating Compassion and Reducing Stress and Mental Ill-Health in Employees—A Randomized Controlled Study. Frontiers in psychology, 12. https://doi.org/10.3389/fpsyg.2021.748140

Burnette, C. B., & Davis, H. A. (2024). A Case for Integrating Self‐compassion Interventions Targeting Shame and Self‐criticism Into Eating Disorder Treatment: Commentary on Paranjothy and Wade. International Journal of Eating Disorders, 57(8), 1642-1645. https://doi.org/10.1002/eat.24220

Egan, S. J., Rees, C. S., Delalande, J., Greene, D., Fitzallen, G. C., Brown, S. M., Webb, M., & Finlay‐Jones, A. (2021). A Review of Self-Compassion as an Active Ingredient in the Prevention and Treatment of Anxiety and Depression in Young People. Administration and Policy in Mental Health and Mental Health Services Research, 49(3), 385-403. https://doi.org/10.1007/s10488-021-01170-2

Fan, Y.-C., Hsiao, F. H., & Hsieh, C. C. (2022). The Effectiveness of Compassion-Based Interventions Among Cancer Patients: A Systematic Review and Meta-Analysis. Palliative & Supportive Care, 21(3), 534-546. https://doi.org/10.1017/s1478951522001316

Gracias, K. R., & Stutts, L. A. (2024). The Impact of Compassion Writing Interventions on Body Dissatisfaction, Self-Compassion, and Fat Phobia. Mindfulness, 15(7), 1793-1802. https://doi.org/10.1007/s12671-024-02401-x

Grégoire, C., Paye, A., & Vanhaudenhuyse, A. (2024). Self-Compassion-Based Interventions in Oncology: A Review of Current Practices. Obm Integrative and Complementary Medicine, 09(01), 1-14. https://doi.org/10.21926/obm.icm.2401007

Han, A., & Kim, T. H. (2023). Effects of Self-Compassion Interventions on Reducing Depressive Symptoms, Anxiety, and Stress: A Meta-Analysis. Mindfulness, 14(7), 1553-1581. https://doi.org/10.1007/s12671-023-02148-x

Himmerich, S. J., & Orcutt, H. K. (2021). Examining a Brief Self-Compassion Intervention for Emotion Regulation in Individuals With Exposure to Trauma. Psychological Trauma Theory Research Practice and Policy, 13(8), 907-910. https://doi.org/10.1037/tra0001110

Huang, J., Chen, S., Yang, W., & Wang, Y. (2023). The Network Dynamics of Self‐compassion Components and Psychological Symptoms During an Intervention. Applied Psychology Health and Well-Being, 16(1), 296-314. https://doi.org/10.1111/aphw.12488

Kaelberer, C., & Tanenbaum, M. L. (2023). The Promising Role of Self-Compassion in Managing Type 1 Diabetes. Endocrines, 4(2), 293-311. https://doi.org/10.3390/endocrines4020024

Kashmari, A., Shahabizadeh, F., Ahi, G., & Rad, A. M. (2023). Comparing the Effectiveness of Cognitive-Behavioral Therapy Combined With Self-Compassion and Cognitive Motor Activities and Cognitive Motor Intervention Alone on Forgiveness and Self-Compassion in the Elderly. Health Spirituality and Medical Ethics, 10(02), 93-102. https://doi.org/10.32598/hsmej.10.2.460.1

Li, Y., Hu, Y., Yang, W., & Wang, Y. (2021). Daily Interventions and Assessments: The Effect of Online Self‐compassion Meditation on Psychological Health. Applied Psychology Health and Well-Being, 13(4), 906-921. https://doi.org/10.1111/aphw.12278

Liu, S., Wei, M., & Russell, D. W. (2023). Effects of a Brief Self-Compassion Intervention for College Students With Impostor Phenomenon. Journal of counseling psychology, 70(6), 711-724. https://doi.org/10.1037/cou0000703

Liu, Y., Yang, X., Liu, Y., Wei, C., Zhao, J., & Kong, F. (2024). Bidirectional Relationship Between Self‐compassion and Psychological Richness: A Two‐wave Longitudinal Study. Applied Psychology Health and Well-Being, 17(1). https://doi.org/10.1111/aphw.12607

Lou, W., Zhang, Y., & Zhuang, M. (2024). The Influence of Perfectionism on Subjective Well-Being of College Students: The Mediating Effect and Intervention of Self-Compassion. International Journal of Advanced Research, 12(12), 347-361. https://doi.org/10.21474/ijar01/20031

Mahmoud, H. A., El-Gueneidy, M., Naguib, M., & Elnakeeb, M. (2022). The Impact of Mindful Self-Compassion Intervention on Self-Esteem and Negative Symptoms of Male Patients With Schizophrenia. Alexandria Scientific Nursing Journal, 24(2), 28-36. https://doi.org/10.21608/asalexu.2022.248619

Póka, T., Veres, A., & Barta, A. (2023). Self-Compassion Predicts Student Athletes’ Negative and Positive Affect After Remembering Exercise-Related Setbacks. Studia Universitatis Babeş-Bolyai Educatio Artis Gymnasticae, 68(3), 31-44. https://doi.org/10.24193/subbeag.68(3).21

Sandham, C., & Deacon, E. (2023). The Role of Self-Compassion in Diabetes Management: A Rapid Review. Frontiers in psychology, 14. https://doi.org/10.3389/fpsyg.2023.1123157

Sheng, H., Wang, R., & Liu, C. (2023). The Effect of Explicit and Implicit Online Self-Compassion Interventions on Sleep Quality Among Chinese Adults: A Longitudinal and Diary Study. Frontiers in psychology, 14. https://doi.org/10.3389/fpsyg.2023.1062148

Solms, L., Heuvel, M. v. d., Nevicka, B., & Homan, A. C. (2024). Be a Hero, Be Your Own Best Friend: A Self-Compassion-Based PsyCap Intervention Improves PhD Students’ Well-Being. Higher Education. https://doi.org/10.1007/s10734-024-01257-3

Varley, D., Sherwell, C., & Kirby, J. N. (2024a). Daily Effects of a Brief Compassion‐focused Intervention for Self‐compassion. British Journal of Psychology, 116(1), 183-197. https://doi.org/10.1111/bjop.12746

Varley, D., Sherwell, C., & Kirby, J. N. (2024b). Does Attachment Influence Daily Effects of a Brief Compassion Focused Intervention. https://doi.org/10.31234/osf.io/c2xu9

Wakelin, K., Perman, G., & Simonds, L. M. (2021). Effectiveness of Self‐compassion‐related Interventions for Reducing Self‐criticism: A Systematic Review and Meta‐analysis. Clinical Psychology & Psychotherapy, 29(1), 1-25. https://doi.org/10.1002/cpp.2586