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Bibliotherapy can consist solely of reading, or it can be complemented with discussion or play activity. A child might be asked to draw a scene from the book or asked whether commonality is felt with a particular character in the book. The book can be used to draw out a child on a subject (s)he has been hesitant to discuss.

Of necessity, bibliotherapy originally used existing texts. Literature that touched on the particular subject relevant to the child provided the source material. (For example, why is "Romeo & Juliet" usually read in 8th or 9th grade? Romeo is 15, Juliet is 13--students at that age can identify with them.) It is now possible, of course, to find texts targeted to the situation. For instance, many of The Berenstain Bears books seem to have as their sole and explicit purpose the targeting of particular behaviors and situations.

There seems to be a division of opinion as to whether bibliotherapy need take place in a therapeutic environment, with therapists specially trained in bibliotherapy at the far end of the spectrum taking the position that this technique should take place only in their skilled hands for fear of the damage that could be done even by the selection of the wrong text[citation needed]. Other psychologists see no reason why children can't benefit merely by their parents selecting meaningful reading material