disseminating interpersonal psychotherapy in japan: overview and challenges h mizushima, m.d....

Disseminating Interpersonal Psychotherapy in Japan:

Overview and Challenges

H Mizushima, M.D. (MIZUSHIMA HIROKO IPT Clinic, Keio University School of Medicine)

KM Pike, Ph.D. (Temple University Japan)

Y Oyama, M.D. (Tohoku University Graduate School of Medicine)

M So, M.D. (King's College London)

History of dissemination of IPT in Japan

Original manual

translation Group IPT Quick guide

Comprehensive guideresearch

Introduction of IPSRT

0

1

2

3

4

5

6

7

8

9

10

1996 1997 2000 2001 2004 2005 2006 2007 2008 2009 2010

review in journalspsychoeducational booklecture in academic society

First efficacy study(2008-2009)

Interpersonal psychotherapy for Japanese bulimic patients :

an open pilot study

Hiroko Mizushima, M.D.Kathleen M Pike, Ph.D.

Haruka KonishiMirai So, M.D.

EDI-II scores during 16 sessions of IPT (n=10)

p=0.015

99.5

75.3

62.9

BDI-II scores during 16 sessions of IPT (n=10)

p=0.011

31.6

21.619.1

SAS-SR scores during 16 sessions of IPT (n=10)

p=0.018

2.59

2.222.09

Number of patients with comorbid depressive disorders and anxiety

disorders (n=10)

Pre-treatment

Mid-treatment

Post-treatment

Mood disorders

6 5 3

Anxiety disorders

6 2 2

Summary

• Among the BN subjects (n=10), four (40%) achieved remission at the termination assessment.

• Scores of EDI-2, BDI-2, and SAS-SR reduced significantly in the course of treatment.

• No one dropped out.• Mean satisfaction rate of the treatment was

91.0%. • One-year follow-up study is now taking place.

Three-year research program to develop dissemination strategies of

IPT (2010-2012)

• Funded by the Japanese Ministry of Health, Labor and Welfare.

• Expected to develop feasible and effective training programs.

Challenges

 (1) Psychotherapy training is not included in the mainstream of psychiatric training.

(2) Continuing education and training programs for psychiatrists are not utilized effectively.

(3) Evidence-based psychotherapies are mostly not covered by the National Health Insurance Plan.

(4) Clinical psychology is a relatively new profession in Japan, professional qualifications and standards are not established and clinical practicum training is limited.

Current training program in Tokyo

• Introduction workshop after reading IPT manuals

• Monthly group supervision

• Challenges particularly for IPT training– Shortage of Japanese-speaking supervisors.– Language barrier when trying to learn from

English-speaking specialists.

Previous exposure to psychotherapy training of the participants of IPT workshops

(Tokyo, Nov. and Dec. in 2010)

CBT Supportive psychotherapy

others none

Introduction level

(N=29)

13 (44%)

formal

7 (24%)

10 (34%)

formal

7 (24%)

7

(24%)

9

(31%)

Attendance in group

supervision for more

than 6 times

(N=13)

4 (31%)

formal

1 (8%)

4 (31%)

formal

3 (23%)

4

(31%)

3

(23%)

Subjective challenges in providing IPT

Formulation Maintaining positive therapeutic attitude

Time-limited structure

Maintaining therapeutic focus

Others

Introduction level

(N=29)

19

(66%)

3

(10%)

11

(38%)

3

(10%)

2(medical model ）

Attendance in group

supervision for more

than 6 times

(N=13)

10

(77%)

1

(8%)

3

(23%)

6

(21%)

0

Presenter Company Product Research Other:

H. Mizushima Sogensha,Iwasaki Gakujutsu Shuppansha

Royalty (Japanese translation of IPT books)

H. Mizushima Sogensha,Kongo Shuppan,Kinokunisha shoten

Royalty(psychoeducational books including introduction of IPT)

Disclosure