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