Our vision is “Improving mental health in Japan through counseling!”
For us, “improve” has four different meanings.

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. CBT is based on several core principles, including:

• Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
• Psychological problems are based, in part, on learned patterns of unhelpful behavior.
• People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CBT treatment usually involves efforts to change thinking patterns. These strategies might include:

• Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
• Gaining a better understanding of the behavior and motivation of others.
• Using problem-solving skills to cope with difficult situations.
• Learning to develop a greater sense of confidence in one’s own abilities

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

• Facing one’s fears instead of avoiding them
• Using role playing to prepare for potentially problematic interactions with others
• Learning to calm one’s mind and relax one’s body

Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy. CBT therapists emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. A certain amount of information about one’s history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

When Is It Used?
With its strong emphasis on emotion regulation skills, DBT is finding application as a treatment for a wide range of mental health conditions. They include:

• Personality disorders, including borderline personality disorder
• Self-harm
• Post-traumatic stress disorder
• Bulimia
• Binge-eating disorder
• Depression
• Anxiety
• Substance use disorder
• Bipolar disorder

What to Expect
DBT is present-oriented and skills-based, and patients are asked to practice their skills between sessions. Patients can expect homework assignments, which might, for example, focus on taking specific, concrete steps to master relationship challenges.
DBT specifically focuses on providing therapeutic skills in four key areas:

• Mindfulness enables individuals to accept and be present in the current moment by noting the fleeting nature of emotions, which diminishes the power of emotions to direct their actions.
• DBT also inculcates distress tolerance, the ability to tolerate negative emotion rather than needing to escape from it or acting in ways that make difficult situations worse
• Emotion regulation strategies give individuals the power to manage and change intense emotions that are causing problems in their life
• Last but not least, DBT teaches techniques of interpersonal effectiveness, allowing a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships

Emotionally Focused Therapy (EFT) is a well-known humanistic approach to psychotherapy formulated in the 1980’s and developed in tandem with the science of adult attachment, a profound developmental theory of personality and intimate relationships. This science has expanded our understanding of individual dysfunction and health as well as the nature of love relationships and family bonds. Attachment views human beings as innately relational, social and wired for intimate bonding with others. The EFT model prioritizes emotion and emotional regulation as the key organizing agents in individual experience and key relationship interactions.

EFT is to help clients overcome their challenges and crises by strengthening their relationships with their loved ones. An EFT couples therapist focuses on the emotions that couples feel when being separated from each other or when their bond is breaking apart and helps couples notice and feel each other's pain. Together with the therapist, they start to feel safe and connected to each other, to let their guard down, and to be able to reach out to the other on the same emotional wavelength. Then, they can learn how to create a new bond of attachment. EFT can also be used as EFiT to address personal trauma and other symptoms, and as EFFT to build attachment between family members.

Mindfulness-based cognitive therapy, MBCT, is a modified form of cognitive therapy that incorporates mindfulness practices that include present moment awareness, meditation, and breathing exercises. This therapy was formulated to address depression. Using these tools, the mindfulness-based therapist teaches a client to be in the here and now as well as break away from negative thought patterns that can cause a decline into a mood-disordered state; this therapy can help a person fight off a difficult frame of mind before it takes hold.

When It's Used
MBCT was developed for people to prevent relapse from recurring episodes of depression or deep unhappiness. It has been proven effective in patients with major depressive disorder who have experienced at least three episodes of depression. Mindfulness-based relapse prevention may also be helpful in treating:

• Generalized anxiety disorders
• Bipolar disorder
• General emotional distress
• Addictions

MBCT has also been shown to improve symptoms of depression in some people with physical health conditions as well, including:

• Vascular disease
• Traumatic brain injury
• Chronic pain

In addition, MBCT has been studied in women with fibromyalgia, showing its effectiveness in reducing the impact of this chronic condition.

Client-centered therapy is a psychotherapy developed by an American clinical psychologist, Carl Rogers from the 1940s to the 1980s. In recent years, it has also been called “person-centered approach.” This therapy encourages therapists to listen to their clients’ stories and to respond by understanding not only their concerns but also how they are feeling.

Through conversations with the therapist, clients grow and aim to resolve their problems through the process of becoming aware of themselves as they are, deepening their understanding, and accepting who they are. They eventually tackle their problems again within a more integrated self. For this reason, therapists believe in the client’s ability for self-growth, and support the client in self-examination by staying close to them, empathizing with them, and helping them become aware of their tendency toward self-actualization.

SST (social skills training) is a set of training that improves the overall skills for us to adjust to and live in our society. It focuses on skills for interpersonal relationships. In addition, it also improves medication management and self-management skills, depending on one’s condition or symptoms. For these reasons, it is not practiced not only in medical facilities but also in schools, workplaces, homes, and so on. Specific details are as follows:

• Basic knowledge about socially appropriate interpersonal behaviors, such as what to say to reconcile with other people
• How to understand what other people say and how to read their intentions and emotions that are not expressed in their facial expressions or gestures
• How to become aware of our thoughts and feelings, and how to express them as well as how to regulate our emotions
• How to deal with situations where things don’t go our way, such as being misunderstood or being made unreasonable demands by other