A team of Japanese researchers proposed a shortened mental health support and care intervention for individuals with severe social withdrawal and their families.
‘Hikikomori’ is a phenomenon in Japan that has garnered international media attention due to the extreme and prolonged social withdrawal observed in such cases. Hikikomori is typically characterised by staying at home for most of the day and avoiding social participation, with these conditions continuing for at least six months.
Hikikomori is commonly accompanied by other mental health problems. Hence, there is ongoing debate regarding whether hikikomori should be regarded as a standalone condition or as a manifestation of underlying root causes, including psychiatric, physical and social issues. Adding to the complexity of the matter is the lack of understanding surrounding mental health problems and the stigma associated with both mental health and hikikomori itself. Many family members of individuals with severe social withdrawal hesitate to seek professional help for their loved ones.
To that end, a team of multi-institutional scientists in Japan developed a “five-day hikikomori intervention programme for family members” based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). The programme, consisting of five weekly sessions of two hours each, was aimed at supporting family members in approaching people with hikikomori.
“Although we have shown preliminary effectiveness, some challenges relevant to program content and frequency of the sessions required further simplification and shortening of the program,” explained corresponding author of the study, Takahiro Kato, from Kyushu University.
To enhance the effectiveness of the program, the team conducted a new study aimed at refining the existing five-day program. They modified it into a condensed version consisting of three sessions, each lasting 180 minutes, held over a two-week period.
They reported the study in the journal Japanese Psychological Research.
“We observed that mental health conditions among participants improved at the four-month follow-up,” said Kato. “Short-term improvements in perceived skills in approaching individuals with hikikomori were also detected, and actual behavioural changes, such as social participation or utilisation of support, of the participants were observed.”
According to the authors, the new programme appears to be less burdensome for families to attend. Nonetheless, they recommend conducting randomised controlled trials with long-term evaluations to validate the effectiveness of the program.
Note: MHFA is a training programme that provides individuals with the knowledge and skills to offer initial assistance and support to someone experiencing a mental health crisis or developing a mental health problem. CRAFT is an evidence-based approach designed to support families dealing with a loved one’s substance abuse or addiction.