disseminating interpersonal psychotherapy in japan: overview and challenges h mizushima, m.d....
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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)
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History of dissemination of IPT in Japan
Original manual
translation Group IPT Quick guide
Comprehensive guideresearch
Introduction of IPSRT
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1996 1997 2000 2001 2004 2005 2006 2007 2008 2009 2010
review in journalspsychoeducational booklecture in academic society
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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.
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EDI-II scores during 16 sessions of IPT (n=10)
p=0.015
99.5
75.3
62.9
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BDI-II scores during 16 sessions of IPT (n=10)
p=0.011
31.6
21.619.1
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SAS-SR scores during 16 sessions of IPT (n=10)
p=0.018
2.59
2.222.09
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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
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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.
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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.
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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.
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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.
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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%)
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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
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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