From trauma to words: the effect of bibliotherapy on psychological flexibility and language skills in children affected by an earthquake

The 6 February 2023 Kahramanmaraş earthquakes caused widespread devastation across 11 provinces in southeastern Türkiye, resulting in profound psychosocial consequences for children, including increased emotional avoidance and difficulties in self-expression. This study aimed to examine changes in psychological flexibility and language-related outcomes (listening, speaking, reading comprehension, and writing) associated with participation in a bibliotherapy-based intervention among children affected by the earthquakes. The study employed a quasi-experimental pretest–posttest control group design. Participants were middle school students residing in the earthquake-affected region. The experimental group participated in a 12-week multicomponent ACT-based bibliotherapy program, whereas the control group continued with the regular educational curriculum. The intervention was structured around Russ Harris’s The Reality Slap and incorporated guided reading, metaphor-based activities, mindfulness practices, reflective writing, and group discussions. Each session involved structured reading of designated chapters and page ranges aligned with the thematic focus and targeted ACT processes. Psychological flexibility and four language-related outcomes-listening, speaking, reading comprehension, and writing-were assessed at pretest and posttest. Significant differential changes were observed for psychological flexibility and reading comprehension. For listening, the primary Time × Group interaction reached the conventional 0.05 significance level but did not remain statistically significant after Bonferroni correction, whereas the baseline-adjusted ANCOVA showed a statistically significant between-group difference ( p = 0.008). Thus, the findings for listening were not consistent across analytical approaches and were interpreted cautiously. The Time × Group interactions for speaking and writing were not statistically significant. The findings suggest that participation in the multicomponent ACT-based bibliotherapy program was associated with improvements in psychological flexibility and reading comprehension among earthquake-affected adolescents. Evidence for listening skills was less consistent across analytical approaches and should therefore be interpreted cautiously. Given the quasi-experimental design, nonrandom allocation, and absence of an attention-matched active control condition, these findings should not be interpreted as definitive causal effects attributable exclusively to bibliotherapy.