Treating nighttime fears in young children with bibliotherapy: evaluating anxiety symptoms and monitoring behavior change

J Anxiety Disord. 2015 Mar:30:103-12. doi: 10.1016/j.janxdis.2014.12.004. Epub 2015 Jan 8.


Objective: Children's nighttime fears are a normal part of child development and are transient for most children, but result in considerable distress for others. The present study evaluated a 4-week bibliotherapy intervention designed to treat young children with persistent and interfering nighttime fears utilizing a multiple baseline design.

Method: Nine children between 5 and 7 years of age with specific phobia diagnoses were randomized into one of three baseline control conditions (1, 2, or 3 weeks). The treatment protocol involved parents reading Uncle Lightfoot, Flip that Switch: Overcoming Fear of the Dark, Academic Version (Coffman, 2012) with their children over 4 weeks while engaging in activities prescribed in the book. Assessments took place at baseline, post treatment, and 1 month following treatment. Daily and weekly tracking of nighttime behaviors was also obtained.

Results: Pre-post group analyses revealed that eight of the nine children demonstrated clinically significant change in anxiety severity. In addition, decreases in child-reported nighttime fears were observed, as were parent-reported decreases in separation anxiety and increases in the number of nights children slept in their own bed.

Conclusions: The present study provides initial support for the use of bibliotherapy in the treatment of nighttime fears. Further replication and evaluation are needed to determine appropriate length of treatment and long-term effects. Implications of the findings are discussed.

Keywords: Anxiety; Bibliotherapy; Exposure; Nighttime fears.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anxiety / psychology
  • Anxiety, Separation / psychology
  • Anxiety, Separation / therapy
  • Bibliotherapy / methods*
  • Child
  • Child, Preschool
  • Family
  • Fear / psychology
  • Female
  • Humans
  • Male
  • Night Terrors / psychology
  • Night Terrors / therapy*
  • Psychiatric Status Rating Scales
  • Treatment Outcome