Reading to Recover: Books Helped Earthquake-Hit Children Rebuild Flexibility and Comprehension

When a pair of devastating earthquakes struck southeastern Türkiye on 6 February 2023, centered in Kahramanmaraş and felt across eleven provinces, the destruction was measured not only in collapsed buildings but in the psychological wreckage left behind for children. Many young survivors withdrew emotionally, avoiding reminders of the disaster and struggling to put their experiences into words. A new study published in BMC Psychology by İbrahim Doyumgaç of Adıyaman University and colleagues suggests that a carefully structured reading program, built on the principles of acceptance and commitment therapy, may offer a low-cost and scalable way to help these children regain both psychological flexibility and specific language skills.

The research team set out to answer a deceptively simple question: can reading the right book, in the right way, with the right guidance, change how traumatized adolescents think, feel, and communicate? To find out, they designed a quasi-experimental study with a pretest–posttest control group structure, recruiting middle school students living in the earthquake-affected region. One group took part in a twelve-week, multicomponent bibliotherapy program, while a comparison group continued with the regular educational curriculum. Psychological flexibility and four language-related outcomes—listening, speaking, reading comprehension, and writing—were measured before and after the intervention period.

The program’s backbone was Russ Harris’s book The Reality Slap, a popular psychology text that translates the core processes of acceptance and commitment therapy, or ACT, into accessible language. ACT rests on the idea that psychological suffering often stems not from painful experiences themselves but from rigid attempts to avoid or control them. Psychological flexibility, the therapy’s central target, is the capacity to stay in contact with difficult thoughts and feelings while still pursuing valued actions. For children who had survived a catastrophe, this framework had an obvious appeal: rather than asking them to talk directly about their trauma, the program gave them a book that talked about suffering, loss, and rebuilding in general terms they could approach at their own pace.

Each weekly session followed a structured format that went well beyond silent reading. Students read designated chapters and page ranges chosen to align with the thematic focus of that week and the specific ACT process being targeted. Around the reading, the researchers layered guided activities: metaphor-based exercises drawn from the ACT tradition, mindfulness practices designed to anchor attention in the present moment, reflective writing assignments, and group discussions in which students could respond to the material and to one another. This multicomponent design is significant from a technical standpoint, because it means the intervention cannot be reduced to reading alone; it combined exposure to narrative content, emotional regulation practice, expressive language production, and peer interaction within a single protocol.

The results, analyzed with attention to the study’s nonrandom design, were nuanced. The researchers reported significant differential changes between the intervention and control groups for psychological flexibility and for reading comprehension, the two outcomes where the evidence was most consistent. For listening skills, the picture was mixed: the primary Time × Group interaction reached the conventional 0.05 significance threshold, but the effect did not survive Bonferroni correction, a statistical procedure that adjusts for multiple comparisons to guard against false positives. However, a baseline-adjusted analysis of covariance did show a statistically significant between-group difference for listening, with a p-value of 0.008. Because the two analytical approaches disagreed, the authors explicitly advised that the listening findings be interpreted cautiously.

For the remaining two language outcomes, the evidence was clearer in its absence. The Time × Group interactions for speaking and writing were not statistically significant, meaning the program could not be shown to have produced measurable gains in those skills relative to the control condition. This pattern is instructive. Reading comprehension, which is practiced directly every time a student works through a chapter of The Reality Slap, improved as one might expect from sheer dose and engagement. Listening, which is exercised during group discussions and guided reading, showed a weaker and analytically unstable signal. Speaking and writing, which were practiced through reflective and dialogic activities but perhaps with less intensity or individual feedback, showed no detectable advantage over ordinary schooling.

The authors are unusually candid about the limits of their design, and that candor matters for how the findings should be used. Because participants were not randomly assigned to conditions, pre-existing differences between the groups could have influenced the results. The control group received regular education rather than an attention-matched active control, meaning that some of the observed benefit could reflect extra adult attention, group belonging, or structured activity rather than bibliotherapy specifically. The researchers state plainly that the findings should not be interpreted as definitive causal effects attributable exclusively to bibliotherapy. In intervention science, this kind of restraint is a marker of credibility rather than weakness: it tells practitioners exactly how far the evidence can be pushed.

Even with those caveats, the study carries real weight for disaster response. Psychosocial support after mass disasters is chronically undersupplied, particularly in regions where the disaster itself has damaged the infrastructure that professional mental health services depend on. Bibliotherapy has long attracted interest precisely because it is inexpensive, does not require a clinician for every participant, and can be delivered in schools by trained facilitators. The present study adds something the field has often lacked: a fully specified protocol, tied to a specific book and a specific therapeutic model, tested against a comparison group with standardized outcome measures spanning both psychological and linguistic domains.

The dual outcome focus is also what makes the study distinctive. Most bibliotherapy research targets psychological symptoms alone, but these researchers treated language as an outcome in its own right, reasoning that trauma in children often manifests as difficulty with self-expression and that a reading-based intervention might simultaneously strengthen the very skills children need to process and communicate difficult experiences. The partial confirmation of that hypothesis—strong for psychological flexibility and reading comprehension, weak for listening, absent for speaking and writing—gives future researchers a map of where to concentrate effort, perhaps by adding explicit speaking and writing components or by extending the program beyond twelve weeks.

The study was conducted in accordance with the Declaration of Helsinki, approved by the Adıyaman University Social and Human Sciences Ethics Committee, and carried out with written informed consent from parents or legal guardians along with voluntary assent from the students themselves. It received financial support from the Ministry of Youth and Sports of the Republic of Türkiye through the Disaster Empowerment Support Program for Young People Affected by Disasters. Published open access, the work invites replication in other disaster settings, and its honest accounting of what worked, what did not, and what remains uncertain offers a template for how school-based psychological interventions should be evaluated. For the children of Kahramanmaraş and the regions around it, the message is quietly hopeful: sometimes the path from trauma back to words begins with a book, a group, and twelve weeks of guided reading.

Subject of Research: Effects of an ACT-based bibliotherapy intervention on psychological flexibility and language skills in children affected by the 2023 Kahramanmaraş earthquakes in Türkiye

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

Article References: Doyumgaç, İ., Akyüz, A. N., Söner, O., & Tanhan, A. (2026). From trauma to words: the effect of bibliotherapy on psychological flexibility and language skills in children affected by an earthquake. BMC Psychology. https://doi.org/10.1186/s40359-026-05756-z

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05756-z

Keywords: bibliotherapy, psychological flexibility, acceptance and commitment therapy, earthquake, trauma, children, language skills, reading comprehension, disaster intervention, quasi-experimental study, Türkiye, BMC Psychology