Health and Global Policy Institute (HGPI) held the sixth installment of “30-minute Health Policy Update,” a series of briefings for Diet Members on the most pressing health policy issues of today.

This meeting was titled “The Importance of Disseminating and Making Effective Use of Cognitive Behavioral Therapy (CBT)” and featured a lecture from one of Japan’s leading experts on CBT, Dr. Yutaka Ono (President, Center for the Development of Cognitive Behavior Therapy Training). Dr. Ono spoke about the mental health effects of the Coronavirus Disease 2019 (COVID-19) pandemic and various aspects of CBT, such as its usefulness. A lively opinion exchange session with many questions from attending Diet Members took place after the lecture.

■ Overview

HGPI has worked to identify current issues facing mental health policy in Japan and to indicate the direction for solutions since starting the Mental Health Policy Project in FY2019. In our first mental health policy proposal presented in July 2020, “Mental Health 2020 – Proposal for Tomorrow: Five Perspectives on Mental Health Policy,” we pointed out the importance of providing more non-pharmaceutical treatment options and called for the expansion of CBT, which has the greatest amount of evidence among methods used in psychotherapy.

Based on that proposal, HGPI implemented a project titled “Assessing the State of Cognitive Behavioral Therapy (CBT) Use in Japan and Examining Systems for Contributing to the Future Dissemination of CBT and CBT-based Practices” as part of the FY2020 Ministry of Health, Labour and Welfare Project for the Promotion of Comprehensive Welfare for Persons with Disabilities (Third Stage). We then compiled policy recommendations on the future dissemination of CBT. Dr. Ono, who served as speaker at this sixth briefing session, also participated in that initiative as a member of the working group.

Based on the past activities of the Mental Health Policy Project, this 30-minute Health Policy Update was held to ensure more Diet Members are informed on CBT.

A summary of Dr. Ono’s lecture on current circumstances and future prospects for CBT is provided below.

The COVID-19 Pandemic and Risks to Mental Health
The COVID-19 pandemic not only poses threats to physical health, it also has significant impacts on mental health caused by anxiety toward infection, worry toward the potential effects of economic crises on daily living, and isolation, depression, and anger caused by restrictions to activities.

The Usefulness of CBT to Treat Mental Disorders and Challenges Facing its Popularization
CBT was developed in the U.S. in the early 1960s and is a treatment method which aims to help people improve problem-solving abilities by modifying their cognition or thinking and their behavior. Against the backdrop of a growing suicide rate, CBT was granted insurance coverage as specialized psychotherapy for depression in Japan in FY2010. Compared to conventional therapies, CBT can be expected to produce long-term therapeutic effects because it helps people acquire self-care techniques. Currently, CBT is also being used to treat mental disorders like anxiety and Post-Traumatic Stress Disorder (PTSD) and to relieve physical symptoms like chronic pain.

However, the needs of patients who want to undergo CBT are not being sufficiently met. Steps to disseminate CBT must be taken to address these needs from multiple angles including human resource development, medical fees, and the provision system.

The Potential Of Using a Cognitive Behavioral Approach to Maintain and Improve Mental Health
Expectations are high for use of the cognitive-behavioral approach both as a treatment and as a method to help people appropriately cope with stress. In fact, the effectiveness of this approach has been demonstrated at certain companies and schools where it has been introduced. Expectations are also growing for the use of a cognitive-behavioral approach that uses digital tools like chatbots with artificial intelligence to respond to the COVID-19 pandemic. In the future, it will be necessary to provide forms of support that are tailored to each person’s condition or needs that are provided alongside in-person support.

The Need to Construct a Platform to Improve Public Wellbeing
In recent years, policies to improve public wellbeing have been proposed in other countries. Japan also needs a platform aimed at maintaining and promoting better mental health for the public. It is desirable that the cognitive-behavioral approach is utilized as one of the methods of providing support through that platform. It will also be necessary to establish a system that allows people to select services according to their own circumstances and needs to avoid the provision of services in a uniform manner.

Past reports on the Project to Assess State of Cognitive Behavior Therapy (CBT) Use in Japan and Examine Systems for Contributing to the Future Dissemination of CBT and CBT-based Practices:
The full project activity report can be found here.　
For an excerpt of our recommendations, please visit here.

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