Psychol Health Med. 2026 Jun 26:1-13. doi: 10.1080/13548506.2026.2694730. Online ahead of print.
ABSTRACT
Sickle Cell Disorder (SCD) is a complex, multi-system blood condition affecting 7.78 million people, with 80% of global cases in sub-Saharan Africa, especially Nigeria. The condition is associated with physical health complications and increased risk of emotional difficulties, highlighting the need for scalable psychosocial interventions for adolescents with SCD in Nigeria. This pilot study assessed the effect of Bibliotherapy as a low-intensity, scalable intervention for adolescents with SCD. The non-randomised pilot-controlled trial involved 42 adolescents with SCD recruited from a Sickle Cell Centre and a Haematology Clinic. Participants were stratified by gender, age and baseline Rosenberg Self-Esteem (RSE) scores, and dyad-matched into Intervention and Control groups to reduce baseline differences. The treatment arm received weekly, virtual, group-based, manualised Bibliotherapy over five weeks, based on selected texts from a memoir by a Nigerian psychiatrist who lived with SCD. Pre-specified primary outcome was the RSE score; secondary outcomes were Hope, Depressive symptoms and Satisfaction with the intervention. The control group received no intervention beyond routine psychoeducation. Participants were aged 13-19 years (M = 16.1, SD = 1.96), with 59.5% females. Controlling for baseline scores, age and gender, the intervention showed a statistically significant effect on self-esteem scores with medium effect size {F (1,37) = 4.84, p = 0.03, Partial Eta Squared = 0.12}, but no significant effect on Hope {F (1,36) = 0.64, p = 0.20, Partial Eta Squared = 0.04} or depressive symptoms {F (1,36) = 0.95, p = 0.34, Partial Eta Squared = 0.03}. All participants in the intervention arm found the book interesting and indicated that it helped them believe they could succeed despite having SCD. They expressed satisfaction with the intervention. This pilot Bibliotherapy intervention was feasible, well received and showed promising efficacy on self-esteem. Larger controlled trials are recommended to establish the generalisability of these findings in the region.Pan African Clinical Trial Registry (Registration Number PACTR202110602061985).
PMID:42363631 | DOI:10.1080/13548506.2026.2694730