a therapist. Bibliotherapy using CBT have been empirically tested the most and directed CBT appears to be the most prevalent methodology in the literature. The selection of CBT books is important since there are many on the market that purport to help. Pardeck's analysis on choosing books is quite instructive and much of his criteria mirror what librarians teach in information literacy. These include the authority of the author on the topic, the type of empirical support offered for treatment claims, the existence of studies testing its clinical efficacy, and a comparative review of other books. Affective treatment There is not as much research on using fiction in bibliotherapy when compared to cognitive self-help books. The recent work of Shechtman has been important in investigating the use of affective literature for bibliotherapy. In her work on counseling with aggressive boys, Shechtman discusses the deficits these children exhibit and describes affect disorders with symptoms of emotional arousal, low levels of empathy, and difficulties in self-expression. Using integrative treatment whereby the patient explores the problem, gains insight, and commits to change, Shechtman found that using affective bibliotherapy techniques achieved therapeutic change while indicating gains in empathy and insight. Visual treatment and graphic novels In the simplest sense, graphic novels are long-form comic books, usually 100 pages or more in length. The application of graphic novels in this context will allow people struggling with literacy to have better access to materials. Dozens of graphic novels have been published over the last decade that address public health topics, such as depression, drug abuse, and PTSD. Public health based comic books originated in the 1940s. The earliest public health comics averaged around twelve pages and were aimed at preventive instruction for children. Over the last fifteen years, however, the genre has evolved and public health graphic novels and are now commonly 150 pages long and focus more on adult struggles with physical or mental illness. This change has gotten the attention of medical professionals who gather and evaluate these materials. Currently, a group of physicians, professors, artists, and bioethicists run the website Graphic Medicine and hosts an annual conference to discuss the use of graphic novels and comic books in health. There is a wide range of research that indicates graphic novels are an effective tool for people struggling with literacy and communication problems. They also have been shown to be effective with populations that