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Front. Psychiatry
Sec. Anxiety and Stress Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1368722
This article is part of the Research Topic Case Reports in Anxiety and Stress Disorders View all articles

Successful Remote Treatment of a Client with Hikikomori Using Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: A Case Study

Provisionally accepted
  • 1 Faculty of Education, University of Miyazaki, Miyazaki, Miyazaki, Japan
  • 2 School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
  • 3 Oxford Health NHS Foundation Trust, Oxford, England, United Kingdom
  • 4 Department of Experimental Psychology, University of Oxford, Oxford, England, United Kingdom

The final, formatted version of the article will be published soon.

    Hikikomori (prolonged social withdrawal) has been discussed as a hidden worldwide epidemic and a significant social and healthcare issue. Social anxiety disorder is the most common psychiatric disorder preceding the onset of Hikikomori. Although studies exist suggesting the effectiveness of family-support interventions, little is known about psychotherapeutic approaches for Hikikomori individuals. Here, we present a case of Hikikomori wherein an internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD) worked effectively in improving the client's social anxiety symptoms and social interaction behaviors. This case study demonstrates the principle that evidencebased psychological interventions focusing on social anxiety can be effective for clients with Hikikomori. Furthermore, the online mode of treatment delivery, along with a variety of relevant modules, may facilitate clients' engagement with treatment at home. The findings suggest that iCT-SAD might be a promising option for Hikikomori clients who have social anxiety problems, within the recommended stepped-intervention approach.

    Keywords: case study, Cognitive Therapy, Hikikomori, Internet-based intervention, Social Anxiety Disorder

    Received: 11 Jan 2024; Accepted: 19 Apr 2024.

    Copyright: © 2024 Sakai, Yoshinaga, Thew and Clark. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Motohiro Sakai, Faculty of Education, University of Miyazaki, Miyazaki, 760-8521, Miyazaki, Japan

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