As a qualified and practicing psychotherapist in Japan, I just would like to point out first that the original AFP article upon which the assertions made in the Dial T for Therapy post seem to have been based on contains serious errors. For example, such the error as the AFP article writer (not Dr Ohno), asserts that “The interactive service offers cognitive therapy sessions” (the writer does not seem to understand that a psychotherapy session takes place in real time in person between a client and therapist). Another of the many errors in the AFP article can be found in its claim that "depression is euphemistically referred to as "the heart flu." In fact in everyday Japanese the recognized and widely used word for depression in Japanese is 'Utsubyou' and not the misnomer "kokoro no kaze", which, as it happens is also wrongly translated in the AFP as the “the heart flu”).

The technologically web-based interactive service launched by Dr Ohno, (who in Japan is a well known and highly respected practicing psychiatrist who received training in CBT under Dr Beck in America and who is widely recognized as a leading authority on Cognitive Behavioral Therapy in Japan) is a very interesting one but it should be emphasized that it only intended as a self-assessment tool for mobile phone users who feel they may be depressed. On this point even the AFP gets it right when it says, "The service explains symptoms of depression but warns that it is not a substitute for treatment and encourages users to consult a doctor if he or she is evaluated as having more than a mild depression."

A more accurate report on the mobile phone service that Professor Ohno launched in November was written by Julian Ryall for and published in the Telegraph. As he wrote, "The system, which launched on Wednesday, enables users to access a web page through his or her mobile phone and enter replies to a series of cognitive therapy questions, such as about their eating habits, sleeping patterns, changes in their weight or emotional situation.

The replies enable an individual diagnosis, although Professor Ohno is quick to emphasise that while the system may identify the indicators of depression and associated conditions, only a face-to-face meeting and the appropriate treatment will alleviate the problem."

The Telegraph article is far more accurate and better researched report in English on this web based mobile phone interactive function.

http://www.telegraph.co.uk/news/worldnews/asia/japan/3487627/Japanese-ge...

It may be of interest to readers here to compare this with the AFP article:

http://asia.news.yahoo.com/081119/afp/081119113248hightech.html

The Telegraph Article leaves less room for misunderstand that the web based interactive phone function just launched in Japan is in fact a form of "phone therapy".

Japanese media reporting on mental health issues can contain inaccuracies and be given suffer at the hands of sensational journalism. just as can be the case in any other language medium. However the problem in further complicated by the fact that not all reporters and journalists based inside and outside of Japan who file reports on Japan can actual speak or understand the Japanese language. Perhaps it would be advisable to exercise caution and even restraint before expressing expressing perceptions of the provision of mental health treatments or unsubstantiated opinions of numbers or availability of practicing psychotherapists in another country. For example it can lead to misunderstand and errors as just one sentence from the post above demonstrates:

"The service is hoped to be attractive to Japanese consumers as access to treatment for depression is limited by insurance constraints, a dearth of practicing psychotherapists, and a strong cultural bias against mental illness.

1. Access to treatment for depression in Japan is universal and is not limited by insurance constraints. Medical consultation fees with a general physician or psychiatrist on any mental health issue and the prescrition charges for any and all medications prescribed to consumers are all covered by the Japanese National Health Insurance System.

2. As of April 2007 there were 16,732 JSCCP licensed Clinical Psychologists, over 11,000 Ministry of Health licensed Psychiatrists and over 34,000 MoH licensed Psychiatric Social Workers in Japan. It seems unfair to all the hard working devoted mental health professionals working here in Japan to be summed up by a the expresion of a "dearth of practicing psychotherapists".

3, As for the last phrase, "a strong cultural bias against mental illness." this is no longer true. Even the AFP article gets it partly right here when it says, "Over the past decade, Japanese society has broken down taboos surrounding depression.." Actually it is more accurate to say that the traditonal taboos against mental illness in Japan have broken down over the last two decades.

Thank you very much for your detailed comments.  Your perspective as a practicing psychotherapist in Japan is a valuable contribution to this blog.  Through your response, I was aware of a passion and committment to your work that I'm certain is likely to benefit your patients and the mental health community.

There are a number of your points which I would like to address.

1. Re: the source information.  You are correct to note that the AFP article was a major (though not only) source for this posting.  I appreciate your links to the original and the Telegraph article.  Following your concerns and having looked over the Telegraph article, I have updated the link in my posting to go to the Telegraph article instead of the AFP one.  I would also encourage readers to check out both sources.  Given the complexity of mental health issues, brief popular press articles (including these postings!) may be not always be able to fully capture the nuances of mental health problems and treatments.  It is important for readers to respond with their thoughts!

2. Re: the phone service as "therapy".  You state that the phone service is "only intended as a self-assessment tool for mobile phone users who feel they may be depressed."  While self-assessment is a part of the service offered, it is not the entire service.  In the words of Dr. Ohno himself: "So this new system enables us to offer an alternative and additional form of therapy outside the clinic setting."  Dr. Ohno calls his service "a form of therapy".  It includes self-assessment as well as guidance through cognitive-behavioral therapy techniques.  Many cognitive-behavioral therapists would suggest that mental health treatment can occur outside of a face-to-face relationship, through homework, workbooks, even through computer programs!  See for example the claims of David Burns' "Feeling good: The new mood therapy", a widely noted 'self-help' workbook that's even taught in some doctoral psychology programs.  

3. Re: Mental health care coverage.  This certainly is an area I'm not highly knowledgeable about, but let me provide you some information behind my statement that "access to treatment for depression is limited by insurance constraints, a dearth of practicing psychotherapists,".  As you noted, Dr. Ohno is widely recognized as a leading authority, so I will quote his words from the Telegraph article you suggested: "We do not have nearly enough mental health professionals to deal with the rise in depression that we are seeing today".  He also stated: "In Japan, most therapists prescribe medication to people with mental issues but they really do not have all that much time to actually talk to their patients".  Also, according to the group International Mental Health Professionals Japan: "Psychologists are not able to seek reimbursement for services through the Japanese national health insurance system, unless they receive this reimbursement indirectly by working under the direction of a licensed psychiatrist, typically in a hospital setting.  However, these arrangements are somewhat rare and gaining regular access to the services of a hospital-based psychologist is difficult."

 4. Re: "a strong cultural bias against mental illness."  You state in your opinion that this is not true.  I am glad to hear that you seem to be experiencing reduced stigma around mental illness.  While taboos against psychotherapy may have reduced, I stand behind my statement that there remains a strong cultural bias against mental illness in Japan.  My statement is supported by the 2002 New York Times article that is linked to on that phrase, by Dr. Ohno's statements, by statements in the Telegraph article you submitted, and by my own clinical experiences.

Thank you again for your input, I am repeatedly surprised by the international reach of these blog postings, and truly value the chance for many thoughts and opinions to be heard.  I hope you will continue reading The Shrink Tank and would value any of your input on this or future posts!

I strongly encourage other readers to weigh in on these issues.  Write in with your experiences of cultural stigma against mental illness or with thoughts about therapy outside of a face-to-face relationship!