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Explore (NY). 2014 Jul-Aug;10(4):248-52. doi: 10.1016/j.explore.2014.04.002. Epub 2014 Apr 19.

Bibliotherapy to decrease stress and anxiety and increase resilience and mindfulness: a pilot trial.

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Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address:
Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.



Interventions to decrease stress and enhance resiliency and mindfulness are more likely to be widely implemented if they can be offered without the need for in-person training. The purpose of this study was to assess effectiveness of a self-directed Stress Management and Resiliency Training (SMART) program delivered using only written material for improving stress, resiliency, and mindfulness.


A total of 37 employees at a large medical center were recruited and given written material on the SMART program. Subjects were instructed to practice the skills presented in the written materials without any additional training. The skills included education about the neuropsychology of stress and resilience, training attention to focus in the present moment, and refining interpretations. Primary outcome measures assessed resilience, perceived stress, anxiety, and quality of life.


Out of 37 employees, 34 (89%) enrolled subjects completed the study and provided the baseline and follow-up data. A statistically significant improvement in perceived stress, resilience, mindfulness, anxiety, and quality of life was observed at 12 weeks.


This study demonstrated that a brief, self-directed program to decrease stress and enhance resilience and mindfulness provided excellent short-term effectiveness for enhancing resilience, mindfulness and quality of life, and decreasing stress and anxiety.


Bibliotherapy; anxiety; psychological resilience; psychological stress

[Indexed for MEDLINE]

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