Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial
Hiroaki Kubo,
Hiromi Urata,
Motohiro Sakai,
Shunsuke Nonaka,
Kazuhiko Saito,
Masaru Tateno,
Keiji Kobara,
Naoki Hashimoto,
Daisuke Fujisawa,
Yuriko Suzuki,
Kotaro Otsuka,
Hiroho Kamimae,
Yuya Muto,
Takashi Usami,
Yoko Honda,
Junji Kishimoto,
Toshihide Kuroki,
Shigenobu Kanba,
Takahiro A. Kato
Affiliations
Hiroaki Kubo
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
Hiromi Urata
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
Motohiro Sakai
Faculty of Education, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki, Miyazaki, 889-2192, Japan
Shunsuke Nonaka
School of Child Psychology, Tokyo Future University, 34-12 Senju Akebono-cho, Adachi-ku, Tokyo, 120-0023, Japan
Kazuhiko Saito
Aiiku Counseling Office, Aiiku Research Institute, Imperial Gift Foundation Boshi-Aiiku-Kai, 5-6-8 Minami-azabu, Minato-ku, Tokyo, 106-8580, Japan
Masaru Tateno
Department of Neuropsychiatry, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
Keiji Kobara
Shimane Prefectural Counseling Center for Physical and Mental Health, 1741-3 Higashi-Tsuda-Cho, Matsue, Shimane, 690-0011, Japan
Naoki Hashimoto
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
Daisuke Fujisawa
Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
Yuriko Suzuki
Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
Kotaro Otsuka
Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
Hiroho Kamimae
Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
Yuya Muto
Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
Takashi Usami
Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
Yoko Honda
Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
Junji Kishimoto
Center for Clinical and Translational Research, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
Toshihide Kuroki
Department of Clinical Psychology Practice, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
Shigenobu Kanba
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
Takahiro A. Kato
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan; Corresponding author.
Backgrounds: Hikikomori, a severe form of social withdrawal, is increasingly a serious mental health issue worldwide. Hikikomori is comorbid with various psychiatric conditions including depression, social anxiety and suicidal behaviors. Family support is encouraged as a vital first step, however evidence-based programs have yet to be established. Mental Health First Aid (MHFA) is one of the most well-validated educational programs encouraging lay people such as family members, to support close persons suffering from various psychiatric conditions such as depression, anxiety and suicidal behaviors. Methods: We newly developed an educational program for family members of hikikomori sufferers mainly based on MHFA and ‘Community Reinforcement and Family Training (CRAFT)’ with role-play and homework. As a single-arm trial, 21 parents (7 fathers and 14 mothers) living with hikikomori sufferers participated in our program with five once-a-week sessions (2 h per session) and six monthly follow-ups, and its effectiveness was evaluated using various self-rated questionnaires. Results: Perceived skills toward a depressed hikikomori case vignette, stigma held by participants, and subscales of two problematic and one adaptive behaviors of hikikomori sufferers were improved throughout the sessions and follow-ups. In addition, positive behavioral changes of hikikomori sufferers such as improved social participation were reported by participants. Limitations: Single-arm design and evaluation using self-rated questionnaires are the main limitations of the present study. Conclusions: Our newly developed program has positive effects on family members in their contact and support of hikikomori sufferers. Future trials with control groups are required to validate the effectiveness of this program.
