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Review of home-based bibliotherapy for fear of the dark in children aged 4 to 8 years

Review of home-based bibliotherapy for fear of the dark in children aged 4 to 8 years
Photo by CDC / Unsplash
Key Takeaway
Consider play-based bibliotherapy as a potential intervention for fear of the dark in young children.

This publication is a review of a clinical trial investigating the efficacy of bibliotherapy combined with games for children between 4 and 8 years old experiencing fear of the dark. The intervention took place in a home-based setting and involved reading a book and playing games proposed in each chapter. The control group consisted of children on a waiting list. The primary outcome measured was a decrease in fears related to nighttime characteristics and imaginary stimuli, with secondary outcomes including nighttime behavior and the ability to act in dark situations.

The main results demonstrated a decrease in fears related to nighttime characteristics and imaginary stimuli in the experimental group, with no improvements observed in the control group. Significant improvements were also noted in nighttime behavior and the ability to act in dark situations for the experimental group. However, the absolute numbers, effect sizes, and p-values or confidence intervals for these outcomes were not reported in the source data.

Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported. The authors note that play-based bibliotherapy is an effective treatment for overcoming children's fear of the dark. Given the absence of statistical measures and the small sample size of 38 children, the certainty of these findings remains limited.

Study Details

EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
UNLABELLED: Intense fear of the dark is a common issue among children, which can interfere with their daily functioning at family, social, and academic levels. This study aims to analyze the effectiveness of a psychotherapeutic intervention based on bibliotherapy combined with play to overcome the fear of the dark in children between 4 and 8 years old. A total of 38 children participated, who were assigned to the experimental and control conditions on the waiting list. The bibliotherapy intervention in the experimental condition involved reading a book and playing the games proposed in each chapter. The intervention lasted 4 to 5 weeks. The results indicate a decrease in fears related to nighttime characteristics and imaginary stimuli in the experimental group, whereas no improvements were observed in the control group. Additionally, significant improvements were found in the nighttime behavior of children in the experimental group and their ability to act in dark situations. CONCLUSION: The findings demonstrate that play-based bibliotherapy is an effective treatment for overcoming children's fear of the dark. Furthermore, the relevant role of parents in addressing this type of problem is demonstrated. TRIAL REGISTRATION: registered on https://ClinicalTrials.gov (ID: NCT07067320). Date of registration: 16/07/2025, retrospectively registered. WHAT IS KNOWN: • Fear of the dark is common in children and can negatively affect sleep, behavior, and daily functioning. • Bibliotherapy is a promising, low-cost intervention for addressing children's nighttime fears. WHAT IS NEW: • Provides evidence for the effectiveness of a home-based bibliotherapy program combined with games for children aged 4-8 in reducing fears and improving nighttime behavior, highlighting the key role of parents. • Evaluates an expanded version of the intervention with new components (e.g., gradual exposure, nightmare management).
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