Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial
Open accessAbstract
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.
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The average delay between onset of social withdrawal and intake in HYIP (2.06 years) is relatively shorter compared to data from Japan (4.4 years).
“which is relatively shorter compared to data from Japan [4.4 years, (50)]”
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- Authors
- Kubo, H., Urata, H., Sakai, M., Nonaka, S., Saito, K., Tateno, M., Kobara, K., Hashimoto, N., Fujisawa, D., Suzuki, Y., Otsuka, K., Kamimae, H., Muto, Y., Usami, T., Honda, Y., Kishimoto, J., Kuroki, T., Kanba, S., & Kato, T. A.
- Affiliations
- Kyushu University (JP)
- University of Miyazaki (JP)
- Tokyo Future University (JP)
- Imperial Gift Foundation Boshi-Aiiku-Kai (JP)
- Sapporo Medical University (JP)
- Shimane Prefectural Government (JP)
- Hokkaido University (JP)
- Keio University (JP)
- National Center of Neurology and Psychiatry (JP)
- Iwate Medical University (JP)
- Corresponding author
- Kato, Takahiro A.
- ORCID
- Venue
- Heliyon
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 6
- Issue
- 1
- Pages
- e03011
- ISSN
- 2405-8440 (ISSN-L)
- PMC
- PMC6953643
- OpenAlex
- W2998785148
- Cited by
- 46
- References
- 35
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 5 · 2020: 7
- FWCI
- 10.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Heliyon (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Japan Society for the Promotion of Science (JP16H06403)
- Ministry of Education, Culture, Sports, Science and Technology
- Japan Agency for Medical Research and Development (JP19dk0307073, JP18dk0307075)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- hikikomori, social withdrawal, family intervention, mental health first aid, Community Reinforcement and Family Training, family support, stigma, social participation (health and rehabilitation), role play, parents, depression
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