International Journal of Brief Therapy and Family ScienceVol. 6, No. 1, 2016

CONTENTS
Original Paper: Research and Experiment
The role of Japanese wives in moderating the association between
striving for self-verification and marital relationships
Kenji Yokotani Tai Kurosawa ............................................................................................... 1-10

Original Paper: Case Study
Approach to a stomachache: The case of teenager was diagnosed with irritable bowel syndrome.
Daisuke Kobayashi Gen Takagi Koubun Wakashima ............................................................. 11-20

Conference Report
Solution-Focused Approach to Suicide Prevention－Report on the 8th conference of National Foundation of Brief Therapy－
Norimasa Itakura Megumi Kato ............................................................................................. 21-24

International Journal of Brief Therapy and Family Science
2016 Vol. 6, No.1, 1-10
< Original Paper: Research and Experiment >The role of Japanese wives in moderating the association between
striving for self-verification and marital relationships
Kenji Yokotani1) Tai Kurosawa2)
1)

Niigata Seiryo University, Graduate School of Clinical Psychology

2)

Ibaraki Christian University, Faculty of Human Life Science

ABSTRACT. People seek self-verification from others. Previous studies suggest that striving for self-verification (e.g., the disclosureof accurate self-information and the preservation of a sense of coherence about oneself in social relationships) functionalizes couple
relationships in Western cultures. However, there has been little research on couples in Asian cultures. The aim of this study is toaddress this gap by examining 46 heterosexual Japanese couples. Attitudes and behaviors regarding striving for self-verification,
stress communication, and trust in marital relationships were assessed using a questionnaire. In contrast to previous Western studies,Japanese couples striving for self-verification had a stronger association between the attitudes of wives regarding striving forself-verification and their own trust and stress communication than that of their husbands. The role of Asian wives is also discussed.
KEY WORDS: Striving for self-verification, Asian gender, Marital relationship, Stress communication, Trustsatisfying relations than those who do not

Introduction
People like to maintain consistency ofreceive self-verification (even if they receive

concepts within an individual (Lecky, 1945)

negativeself-evaluations)(Weinstock&

because they dislike cognitive dissonance

Whisman,2004).

research

also(Festinger,

thissuggests that people reported higher levels of

self-consistency theory, Swann (1987) proposessatisfaction when they received self-verificationthat people seek verification from others,

from partners in marriage than during courtshipbecause the verification fosters to maintain(Swann, De La Ronde, & Gregory, 1994).

consistency

anThese studies indicate that self-verificationindividual. Verification is referred to as

from partners is a key factor in ensuring

self-verification and numerous studies havesatisfying couple relationships. Previous studies,

focused on this subject (Swann, 1997). For

however, are largely based on Western couples,example, people who receive self-verification

so the effects of self-verification in Asianfrom their partners claim to have more

couples are unclear. The present study aims to1962).

of

In

line

self-concepts

withwithinPrevious

examine the effects of self-verification in
CORRESPONDENCE

TO:

Yokotani

Niigata Seiryo

University, Graduate School of Clinical Psychology, 1-5939,

Japanese couples.
To receive self-verification, some people

Suidocho, Chuo-ku, Niigata-shi, Niigata, 951-8121, Japan

disclose honest self-information to others ande-mail: yokotani@n-seiryo.ac.jp

try to preserve a sense of coherence about1

2

Yokotani.

themselves in their social relationships. Such

relationship is still unclear. Many studies

behaviors and attitudes are referred to assuggest that Asian traditional gender roles

striving for self-verification (Cable & Kay,require women to be compliant rather than2012). Striving for self-verification is beneficial

vocal in their opinions (Harter, Waters, &in intimate relationships. For example, honest

Whitesell,

self-disclosure and emotional expression to

Holtzworth-Munroe, 2006). These findings

partners functionalizes dating relationships

suggest that Japanese women as Asian women(Brunell et al., 2010). Furthermore, university

would strive for self-verification less thanstudents who frequently lied to their dating

Japanese men (Hypothesis 1).

partners were found to be dissatisfied with their

In

1997;

Western

Rehmancountries,

man’s

a

coupleself-verification

studies suggest that striving for self-verification

relationship is deemed more beneficial than ais also functional in couple relationships.

woman’s because such an act by a man isregarded

as

an

in

a

dating relationships (Peterson, 1996). These

Striving for self-verification can change

striving&

extraordinary

intimate

according to an individual’s situation (Chen,

expression (Brunell et al., 2010). In Asian

Chen, & Shaw, 2004). For example, whencountries,

peopleself-verification

meet

those

who belong tothehowever,

women

might

be

for

regardedasexperimentally-constructed same group, they

representing

seek self-verification from them. However,husbands because such acts are restricted inwhen they meet those that belong to anothermostexperimentally-constructed group, they do not

Holtzworth-Munroe, 2006). In Asian cultures,

seek self-verification. These findings suggest

when a wife seeks self-verification, she isthat one’s striving for self-verification in one

asking her husband to accept such behavior,situation might be different from that in anothereven though such behavior is not generally

situation. In other words, people who live in

accepted (Sen, 2003). Hence, wives need todifferent cultural environments might have

trust

different

self-verification.

patterns

ofstrivingforself-verification.
Previous studies on this topic mainly focus

extraordinary

striving

Asian

their

trust

cultureshusbands
In

to

their

(Rehmanwhencontrast,it&seekingis

more

acceptable and expected that men strive forself-verification in Asian cultures (Fikree,

on Western cultures. One Japanese study2004).

Therefore,suggested that people in dating relationshipself-verification is regarded as normal behavior.

were likely to receive both positive andThisself-accurate evaluation from their partner

patterns of self-verification in Asian marital(Taniguchi & Daibo, 2008), but the study did

relationships. When Japanese couples strive for

not include marital relationships, so the patternself-verification, wives trust their husbandsof striving for self-verification in Asian marital

more

genderthanhusbands’ striving

difference

husbands

implies

trust

their

for

different

wivesWIVES’ SELF-VERIFICATION IN JAPAN(Hypothesis 2).

3(48%) were completed. While there may be

Similarly, striving for self-verification also

differences between those participants who

involves open discussions between a couple,

answered questionnaires and those who did not,including the expression of one’s feelings of

we cannot compare these two groups becausestress to the other partner (Bodenmann, 2005).

we did not obtain any information from theWives striving for self-verification could be

latter. Among the 112 respondents, 47 couples

regarded as a display of extraordinary trust. It

were identified. One set of paired data reported

has been found that wives in Asia express

the same responses for all questions, so thisthemselves less than their husbands (Rehman &pair was excluded from the analysis. Thus, theHoltzworth-Munroe, 2006). When they do

final sample comprised 46 couples (46 wives

express themselves, they need to express

and 46 husbands).

everything, including stress, within a short

Table 1 shows participants’ ages. The mean

period of time because their opportunities forages of wives and husbands were 45.4 years

expression are limited. In contrast, husbands(SD = 14.1) and 46.4 years (SD = 15.4),

have sufficient time to express themselves sorespectively. The mean marital duration was

their self-expression does not need to include

18.5 years. All couples had been married for at

everything at once. Hence, when Japanese

least 1 year (minimum: 1; maximum: 55; SD =couples strive for self-verification, wives15.0).

express their stress more than their husbands

Procedure

express (Hypothesis 3).

Two leaders from the local communities in

To explore Asian marital relationships, we

Tohoku (Northeast Japan) and Kansai (Westsampled Japanese couples as one example of an

Japan) recruited couples in their communities.

Asian culture (Markus & Kitayama, 1991). To

Three university professors also recruitedevaluate striving for self-verification in general,

couples in Chubu (Central Japan), Kyushu

we used general striving for self-verification(South Japan), and Tohoku. The leaders andscores (excluding employment-related scores)

professors asked their friends to participate in(Cable & Kay, 2012). To evaluate the trust

our study. Couples who showed interest in

relationship and expressions of stress, we usedparticipating received questionnaires in Octobertrust in marriage (Rempel, Holmes, & Zanna,

2014. The questionnaire included separate

1985) and stress communication (Bodenmann,material for the wives and husbands, along with2005), respectively.

a self-addressed envelope and instructions toreturn the questionnaires to the laboratory by

Methods

December 2014.

ParticipantsParticipantsreceivednopaymentforTwo-hundred and thirty questionnaires werecompleting the questionnaire. In addition to

distributed to Japanese couples. Of these, 112

their basic information, we collected data on

4

Yokotani.

strivingforself-verification,

stressin English and Japanese. Then, the Japanesecommunication, and trust.

versionoftheMeasuresback-translatedbyStriving for self-verification. The present
study

used

a

revisedversionof

thebilinguals.

Thequestionnaire
two

final

was

English–Japaneseversionofthequestionnaire was approved by the two

Self-verification Striving questionnaire (Cable

psychologists.

& Kay, 2012). The original version of thisStresscommunication.

We

used

the

questionnaire included eight items and assessedsubscale stress communication found in theattitudes (Do you agree with the following

Japanesecomments?) using an anchored five-point scale

Matsumoto, & Sugawara, 2014) of the Dyadic(1 = strongly disagree to 5 = strongly agree).

Coping Inventory (Bodenmann, 2005). The

The eight items included four general items

items(e.g., It’s worth being truthful with others about

Likert-type scale (1 = very rare to 5 = very

my habits and personality so that they know

often). The Japanese stress communication was

what

four

back-translated and has been shown to have

employment-related items (e.g., When looking

good validity and reliability (Kawashima et al.,for a job, I work hard to find a place where2014). Higher stress communication reflects

people will accept me for who I am). We didbetter stress communication.

toexpect

from

me)

and

versionwere(Kawashima,scoredusing

aYoshitake,five-point

not use the four employment-related items

Trust. We used a 17-item trust scalebecause some participants might not be in(Rempel et al., 1985) with a seven-point scale

regular employment. The questionnaire was(1 = strongly disagree to 7 = strongly agree).

revisedfour

Higher scores in the trust scale reflect higher

employment-related items were amended totrust in the marital relationship. As with theconcern marriage (e.g., When looking for amethod used for striving for self-verification,

partner, I work hard to find a partner who will

the trust scale was back-translated fromaccept me for who I am). Second, the revised

Japanese and approved.

version also assessed actual behaviors (Do you

Analyses

in

two

ways.

First,

theactually behave in accordance with these

We compared basic scores using t-tests andvalues?) using the same five-point Likert scale.

correlations using Z-tests. We also compared

Hence, the revised version has two subscales:

regression coefficients using chi-square tests.

(1)

for

We used the Actor Partner Interdependence

self-verification in marriage and (2) behaviors

Model (APIM: Figure 1) to simultaneously

regarding striving for self-verification inestimate the actor (e.g., a wife’s behaviors

marriage. The revised version was translated

when striving for self-verification in her

into Japanese by two Japanese psychologists,

marriage affect her stress communication) andboth of whom had published academic papers

partner (e.g., a wife’s behaviors when striving

attituderegarding

striving

WIVES’ SELF-VERIFICATION IN JAPAN

5

Table 1Means, standard deviations, and t-tests of all study variables between wives and husbands (N = 46 couples)
Wife

Husband

M

SD

M

SD

Pared-tdf

Cohen's d

Age

45.46

14.10

46.46

15.46

-1.06

45

-0.07

Striving for self-verification attitudes in general

4.10

0.71

4.00

0.74

0.65

44

0.14

Striving for self-verification behaviors in general

3.54

0.64

3.73

0.75

-1.66

44

-0.27

Striving for self-verification attitudes in marriage

4.29

0.66

4.12

0.78

1.35

43

0.24

Striving for self-verification behaviors in marriage

3.68

0.74

3.78

0.62

-0.80

43

-0.16

Trust

4.93

0.90

5.04

0.84

-0.85

43

-0.13

Stress communication

3.60

1.02

3.30

0.83

2.18*

44

0.32

Note. *: p < .05, †: p < .10

for self-verification in her marriage affect her

participants from previous studies with our datahusband’s stress communication) effects ofusing

striving

stresscommunication was not significantly different

communication and trust (Kenny, Kashy, &from that of European couples (Ledermann etBolger, 1998). SPSS 21.0 and HAD version

al., 2010), the Japanese participants showed

12.240 (Shimizu, 2016) were used for theless trust in their marital relationships (wife t =analyses.

3.2, df = 130.1, p < .01; husband t = 2.8, df =forself-verificationon

133.3,

Results
Culturalt-tests.

p<

Although

.01)

their

than

their

stressAmericancounterparts (Rempel et al., 1985).
differences

in

trust

and

stresscommunication

Do Japanese wives strive for self-verification

The present data did not include Europeanand American couples so we compared our data

less than Japanese husbands?
We compared the score of striving forwith European and American counterparts fromself-verification

previous studies. We compared averages,

husbands (Table 1). Table 1 does not show any

standard

significant gender differences for striving for

deviations,andnumbersA

Husbands’ Striving for

Self-Verification

Wives’ Striving forof

Husbands’ Trust andbetweentheError 1Stress Communication

PP

Self-Verification

Figure 1
Actor–partner interdependence model
Note: A represents actor effect; P represents partner effect.

A

Wives’ Trust and StressCommunication

Error 2

wives

and

6

Yokotani.

Table 2
Correlations among self-verification attitudes/behaviors, trust, and stress communication in Japanese couples (df = 44)

1.Striving for self-verification attitudes in marriage

Wives’ αHusbands’ α

1

.84

.93

.50

*

2
.31
.45

**

.31

*

2.Striving for self-verification behaviors in marriage

.89

.83

.49

**

3.Trust

.88

.87

.56

**

4.Stress communication

.88

.84

.25

.76

3
**

4

.62

**

.56

**

.71

**

.63

**

.65

***

.65

**

.53

**

.68

***

Note. Correlations for wives are on the upper diagonal, correlation for husbands are on the lower diagonal, and paired correlations between (wives andhusbands) are on the diagonal. The paired correlations are intra-class correlations, whereas the other correlations are Pearson’s correlations. ***: p< .001, **: p < .01, *: p < .05.

self-verification. However, overall, the wives’husbands more than husbands communicate

attitudes regarding striving for self-verification

with their wives?

showed significantly less support for the

A comparison of simple correlations did notconcept than their actual overall behavior

show any significant differences (Table 2).

regarding striving for self-verification (paired t

However, the APIM produced significant= 6.5, df = 45, p < .0001).

differences (Table 3). There was a greater

When couples strive for self-verification, do

significant association between the wives’

wives trust their husbands more than husbands

attitudes regarding striving for self-verification

trust their wives?

than between the husbands’ attitudes and stress

A comparison of simple correlations did notcommunication (χ2 = 19.36, p < .0001).

show any significant differences (Table 2).

Similarly, there was a greater significant

However, the APIM produced significant

association between the wives’ behaviors

differences (Table 3). There was a stronger

regarding striving for self-verification and theirsignificant association between the wives’

own stress communication than between theattitudes regarding striving for self-verification

husbands’ behaviors and stress communicationand their own trust than between the husbands’(χ2 = 14.73, p < .001). Moreover, wives’ actual

attitudes and trust (χ2 = 4.69, p < .05).

behaviors

Furthermore, there was a significant association

predicted their husbands’ stress communication,

between the wives’ behavior regarding striving

but husbands’ behavior actual behavior forfor self-verification and their own trust, but

self-verification did not predict their wives’

there were no significant difference between

stress communication (Table 3).

forself-verification

positively

husbands’ and wives’ unstandardized estimates(Table 3).

Discussion
Our study tested the moderator effects ofWhen couples strive for self-verification, do

Asian women’s roles in the association between

wives communicate about their stress with theirstriving for self-verification and marital

WIVES’ SELF-VERIFICATION IN JAPAN

7

Table 3
Actor and partner effects for trust and stress communication in relation to self-verification attitudes and behaviors (N = 44 couples)
Parameters
Striving for self-verification attitudes in marriage
Estimate
Z
Actor effects
WSelf-verification→WTrust
WSelf-verification→Wsc
HSelf-verification→ HT rust
HSelf-verification→ Hsc
Partner effects
WSelf-verification→HTrust
WSelf-verification→Hsc
HSelf-verification→WTrust
HSelf-verification→Wsc

Striving for self-verification behaviors in marriage
Estimate
Z0.80**
0.81**
0.50**
0.12

4.76 b
10.92 a3.53 b
0.79 a0.88**
0.84**
0.55**
0.34**

6.91 b
12.43 a2.96 b
2.62 a0.37*
0.48**
0.20
0.06

2.22 b
3.87 a1.39 b
0.62 a0.23
0.44**
0.14
0.22†

1.50 b
3.78 a0.95 b1.88 aNote. All estimate scores were unstandardized coefficients. H = husband; W = wife; SC = Stress communication**: p < .01, *: p < .05, †: p < .10, a: N = 43 pairs, b: N = 42 pairs.

relationships. Seemingly, women’s striving forprevious

findingsforAmericancouples

self-verification was not significantly different(Brunell et al., 2010). These results indicate

from men’s. However, there was a significant

that cultural context and gender roles need to be

gap between women’s attitudes and behaviorsconsidered in future self-verification studies

regarding striving for self-verification in(Neff & Suizzo, 2006), as individuals change

general. This gap suggests that for women,

their self-verification striving depending on

there is a discrepancy between what they want

their situation (Chen et al., 2004).

to be and what they actually are. This gap has

In the context of couple therapy in Japan,

been frequently reported in public health fields

therapist might need to pay special attention to(Fikree, 2004; Sen, 2003) and could be

wife’s actual behavior for self-verification inregarded as indicating a gender difference incouplestriving for self-verification in Asia (Rehman &predicted her trust. Furthermore, husband’s

Holtzworth-Munroe, 2006).

expression of stress in couple also needs an

becauseherbehavior

positively

As hypothesized (Hypotheses 2 and 3), there

attention, because his expression of stress

was a stronger association between wives’

might be linked with his wife’s actual behavior

attitudes regarding striving for self-verification

for self-verification. Enhancement of wife’s

and their trust than between their husbands’

actualattitudes and trust. Similarly, there was ahusband’s stress expression might be linked

stronger association between wives’ actualwith positive marital relationships.

behaviors for self-verification and their stresscommunication

than

for

their

husbands.

behaviorforself-verification

andOur study did not find any significant
differences in striving for self-verification

Furthermore, wives’ actual behaviors for

betweenhusbands

andwives.

Japanese

self-verification only had a significant partner

husbands are more likely to be in regulareffect on their husbands’ stress expression. Our

employment than their wives (Tsuya, Bumpass,findings for Japanese couples differ from

Choe, & Rindfuss, 2005), so occupational

8

Yokotani.

differences between husbands and wives might

The authors assert that all procedures

affect our findings. Japanese husbands also

contributing to this work comply with thework in competitive job environments, so

ethical standards of the relevant institutionalemotional expression might hinder their job

committees on human experimentation andperformance. In contrast, Japanese wives whowith the Helsinki Declaration of 1975, as

did not work might feel free to express theirrevised in 2008.

emotion in general. Thus, the occupational
status of couples needs to be considered in

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International Journal of Brief Therapy and Family Science
2016 Vol. 6, No.1, 11-20< Original Paper: Case Study >Approach to a stomachache:
The case of teenager was diagnosed with irritable bowel syndrome.
Daisuke Kobayashi1) Gen Takagi1) Koubun Wakashima1)
1)

Graduate School of Education, Tohoku University

ABSTRACT. Irritable Bowel Syndrome; IBS is digestive disorder which causes constipation or diarrhea along with stomachache ordiscomfort in the abdomen even though no issue on examination of intestines or blood test show and it often happens to teenager.
We have clear guidelines from diagnosis to the end of treatment domestically but most of the research on psychotherapy is fromoverseas and we do not have many researches in Japan. On this report we show the case for session with teenager who wasdiagnosed with IBS.

This is the case where the client stated that he didn’t have clear stress but suffered with the sudden

stomachache without known reason and found out how to deal with it himself in the process of understanding the symptoms. We
had three sessions including intake session and he showed the improvement and the case was closed.

We observed the three points– the construction of rapport using noise, humor and confusion and the psychotherapy approach toward IBS and what changed CL’s
attitude.
KEY WORDS: Irritable bowel syndrome, Psychotherapy, Rapport

damage in daily life (Kanazawa et al., 2004).

Introduction
Irritable Bowel Syndrome; IBS is the

The guideline from diagnosis to the end ofdigestive disorder the patients suffer with long

treatment of IBS is set up (Japanese Society oflasting constipation or diarrhea along with

Gastroenterology, 2014) with instruction on

stomachache or discomfort of stomach without

diet and daily habit from a doctor and treatment

any finding from examination of intestines oron digestive organs as the first step and whenblood test (Longstreth et al, 2006). According

the treatment on digestive organs shows noto the online survey with 10,000 people byeffect use the medicine treatment as the second

Miwa (2008) 13.1% of people have thestep and when the medicine treatments shows

problem and according to Kumano (2004) it

no effect use the psychotherapy as the third step.

often happens to teenager. Also it is noticed

The effectiveness of various psychotherapy ofthat

IBS as group therapy, cognitive behavioral

itdecreases

thequalityoflife

tremendously as IBS symptoms cause hugetherapy, interpersonal therapy, hypno therapy,
stress management and relaxation are seen at

CORRESPONDENCE TO: Kobayashi Graduate School ofabroad (Japanese Society of Gastroenterology,

Education, Tohoku University, 27-1, Kawauchi, Aoba-ku,

2014), but it is current situation that we don’t

Sendai-city, 980-8576, JAPAN.

havee-mail: dkobayashi1922@gmail.com

including11

many researches
case

study

on

psychotherapy

orcomparative

12

Kobayashi.

effectiveness research (Ito & Muto, 2015).
Therefore, on this report we show the case of

to free from the pain. The session was donewith CL and his mother jointly.

teenager who didn’t have clear stress but
suffered with unknown stomachache and foundSession process

out how to deal with it in the process of「 」is CL’s comment, 「「 」」is mother’understanding the symptoms. In this case wes comment, 〈see the improvement after three sessions

hereinafter; the third author) ’ s comment,

including intake session and closed the case.

〈〈Upon publishing this case we got the approval(STH hereinafter; first author)’s comment.

〉 is therapist (TH〉〉is associate psychologist in training

on the phone after the case is closed and hadtheagreement

signedonthedocument(Intake session, March 8th, X year)

regarding publishing. On the phone, client’

The patient’s main complaint was that hes mother stated 「「He is doing very well.」」.

was desperate to stop the sudden stomachache

We note that some part of the following process

and since the medicine didn’t help he came toof session is amended to keep the privacy

consultation as 「If I can be free from this pain

without missing the core content.

I like to go for consultation.」. The symptom
was similar to the pain with diarrhea and he felt
like he needed to go to the restroom urgently.

SessionThe following is from the intake session withThe last few years the condition got worsen

a high school student (shown as CL hereinafter).

than ever. He didn’t have particular stress at

He claimed that he is desperate to get rid ofschool nor club and didn’t know the cause.

impossible sudden stomachache.

When TH asked 〈Isn’t stomachache itself thestress, is it?〉he replied 「It maybe is.」History of life, current medical history

When TH asked 〈How many sessions do

The family structure is father (50’s, office

you want to cure your problem?〉he replied thatworker), mother (50’s), younger brother (teen,

he didn’t care how and he wished to stop it

student). CL has the weak stomach from thesoon but he didn’t mind if it takes time as long

cradle but 2 years prior to X the stomachacheas he gets better. Also he said what he had

got worsen. In October, X-1 year, he went totried so far were going to the restroom, taking

see the doctor at internal medicine and he wasantidiarrheal or antiflatulent, resting at thediagnosed IBS. After that, CL went tonurse’s office at high school , going to bed

department of psychosomatic medicine toearly, and avoiding crapula.

received medicine therapy with anxiolytic but

attempt was to give him drinkable yogurt every

the condition didn’t get better and stopped

morning.

taking the medicine.

The mother’s

At the beginning CL

When asked about past doctor’s visit theywasn’t positive for session but decided to do sosaid he was diagnosed as nervous tendency

Approach to a stomachache

13

from psychological test at department ofconscious of stomachache and get more

psychosomatic medicine.

stressed.

According to CL as

In general adolescence peoples,

he lived self-paced he didn’t realize that.

especially in middle and high school, tend to be

When TH asked 〈If there is any advice fromnervous. But it doesn’t last forever and it willmom?〉she replied that in the beginning she

end some point.

didn’t think it was a big issue but she wanted toexample.〉.

help him now and wished someone could

soccer he always had knee pain but the stomach

understand and support his mind. When TH

was not bothering him.

asked CL 〈Your concern is to get well and notquitted soccer he started to suffer withyour feeling, right?〉CL replied 「I don’t carestomachache and the knee pain was gone.

about my feeling. What I am seeking is not

When TH explained the knee pain caused as his

being

the

conscious was on it and he seemed to bephenomenon. When TH checked the scale ofconvinced. Then TH said 〈It looks like wepain as 10 is the day he had hard time to get up

find the direction. What are we going to do

and 0 is the day he had no pain at all henow?

answered that 3 was good day.

something fun, right? 〉 .

understoodbutchanging

CL talked

The knee pain is a good

He claimed when he was into
However after heInstead of gloom you would rather do
He replied thatabout his symptom specifically as 「When I「 Even when I am doing something fun I

wake up in the morning I feel like I havecannot help thinking 『 Don ’ t let thesomething in my stomach on-and-off and thestomachache happen.』. So if they said it ispain and discomfort stay there and increase

because I am nervous I agree with them.

gradually. Then I need to go to the restroom

said he always focused on one thing like Legoor the nurse’s office.」and explained that heor picture and his focus was on stomachache

considered the day these pain and discomfort

now. As he didn’t pay attention to others hedoesn’t prevent him from attending classes wasnever felt stress from what people say. Once

3 and the day it happened a few time was 5 andhe got upset with the doctor at department of

the day he couldn’t even get up was 10. He

psychosomatic medicine he used to visit since

said he went to the restroom average 5 to 10

he insisted it was caused by stress. When TH

times at high school . TH said 〈Most of thesuggested 〈Mom, since you came along let’s

people would stay home with that condition.〉.

think about what you could do at home.

TH asked if he had the stomachache in the past

pretty sure you have praised and pampered him

and how long he had the problem, his answer

but all these didn’t help, right?

was since he remembered he always had thethe physical pain to transfer but how about

weak stomach. It was just light pain with thetrying to give him the mental pain?〉. The

weak stomach before it reached to the current

mother smiled and made gesture thinking aboutlevel. So TH explained 〈What I think is thatit.

as your doctor said you were nervous you are

」He

I am

I don’t want

After the break TH made two suggestions

14

Kobayashi.

since paying attention to the stomach wasweek he didn’t have problem getting up in thegiving him stress. 〈Let’s see if we can makemorning and he looked better when he went tolittle progress for you to get 3 more often.

school.

First, don’t wait until you feel the need to go to

explained the duration of the maximum pain

restroom. Regardless you need to go or not

was shorten. He also said that the pain had ayou should go more often than you need.

pattern which certain time after meals he felt

For example if you usually go 4 times you go 5

discomfort in stomach and started focusing ontimes. Second, since you cannot help thinking

it and caused the stomachache.

about it let’s try the different approach. You

asked 〈What do you think made different on

have a sense of discomfort.

We call him

the first week?〉he replied 「I was not sure if it“Abareru-kun”

ofworks.

(The

name

Japanese

When TH asked about the pain he

When THI didn’t think it will stop my pain.

comedian;“Abareru”means“out of control”;

But once I started I felt like I was ready to deal“kun” means “Mr.”). You want to tell yourwith it.

stomach to stop messing up, right?

couldn’t wait to give try.

When you

I was looking forward to it.

I

I think that made it

feel discomfort tell him 『 Abareru-kun, do

work.

whatever you want! I don’t care what you

amendment as 「It stopped working on thedo!

second week and I thought it was because I got

Come on!

Go for it!』.

It has been」. He continued with reflection andthrown your concentration but you have beenused to it.

So I thought about creating newhandling well so far.

character.

」.

Don’t worry.

We

When asked if he actuallyknow that you can handle it. So just tell him

created another character he replied 「 No.

『Go for it!』.〉. The mother said she felt

Since I wanted to tell you the result of thiseasier and CL agreed to try.

challenge first I haven’t done it yet.

TH told him」. We〈Just like the hospital, I want to know if it

set the next challenge as to try his idea. When

works. You want to get rid of it quick, right?

asked his mother about the nurturing tips she

Comeanother

said that CL always loved to read philosophicalappointment at the same time and finished thebooks like Kant and Descartes since he was

first session.

little and he never had rebellious stage but his

backsoon. 〉 andmadeyounger brother go astray.
th(Second session, March 24 , X year)

Since he liked thephilosophy, TH asked 〈Based on the theory ofWith the intervention from the previous

Jung it looks like the younger brother is thesession when TH asked 〈I doubt it but wasshadow and the older brother is the self. I am

there any change?〉he replied that it was betternot so fan of Jung but your younger brotheron the first week but it went back to original on

might go astray because you are too good.

the second week.

So TH asked the motherWhy don’t you try being bad?〉. CL claimed〈So it was better on the first week. Did youthat he never be yelled by his father and evenrealize anything?〉. She said that on the firstwhen he had a problem he knew the limit.

Approach to a stomachache

15

When asked again 〈When did you start

psychosomatic medicine prescribed you thehaving stomachache?〉he said he always had

tranquilizer but the medicine for compulsive

weaktakingneurosis is not tranquilizer but antidepressant.

antiflatulent and it bothered a lot when he ate

We think it is the reason the medicine didn’t

greasy foods. He also said bread and salad

work.

didn’t bother him much but he used jam only

condition is not severe enough to diagnose aswith particular brand.

According to thecompulsive neurosis so we will leave themother he only ate the same foods every day

medicine treatment as final resort . So for thisand always drunk “gogo-no-kohcha”(the bottle

time as a challenge I want A to try his own idea.

of sweet tea) after the meal and went to the

Additionally, I’m sure you can think by

restroom. The mother said he was stubborn so

yourself but can you possibly change the time

TH explained to her 〈 Do you know thefor meals and the restroom after the meals?〉.

psychologist, Freud?

I don’t like him much as

CL showed the hesitation 「It is difficult.」.

he makes strange comments but he mentioned

As TH explained〈We suspect that your lifethat a person who has the anus problem tends tostyle

be stubborn or obsessive.

Both thestomachache. I also repeat the same routinemother and CL seemed to have remembered

every day. But it’s ok. Fortunately I have nosomething. CL said 「I can eat only certain

issue with stomachache.〉he said 「I see. I

things and I like to go to the restroom at certain

will try.」. TH told him 〈It is going to be verytiming. If not, I don’t feel good. 」. Whendifficult.

TH asked when he had the maximum

it a twist. Please let me know how it went

stomachache he replied it was in the morning

next time.〉and finished the session.

intestines

and

had

been

〉.

However A’s (A is CL’s name)rhythmandpatternmaintainstheIt’s a big challenge. You can giveand before bed. In the past two weeks after
the previous session he had three sleeplessnights.

(Third session, April 11th, X year)

He also said that the stomachache

Just as the previous session TH started as 〈Iattacked him when his mind wandered off anddon’t expect a big difference but if there wastrying to control it unconsciously gave him

any change … . 〉 CL reported that from thestomachache even he had no stress. On theprevious session there were three days he had

other hand, It never happened when he was indifficulties but he didn’t care much about

sleep but always happened right before thestomachache any more.

alarm goes off and there was no regularity.

mother 〈How does he look to you?〉she replied

After the break, when TH suggested 〈WeWhen asked his「「He looks much calm. Most of all, I canthink we need to work on compulsive neurosis

see he wants to change himself.

First, herather than irritable bowel syndrome.

Wedoesn’t drink “gogo-no-kohcha” he has been

believe that resolving the compulsive neurosis

regularly drinking any more. I have a 2 liter

will cure the stomachache. The department ofof bottle in the refrigerator just in case he wants

16

Kobayashi.

it.」」. 「That is right. The previous challenge

the pain.〉「Ok. I think I can manage time

to change the daily routine made that change.」.

more effectively in that way. I wanted to get

When TH asked as he saw the progress〈Whatrid of stomachache but now I am just hoping to

do you think to make this change?〉he showed

reduce the pain.

the change of attitude 「I believe the way I

useful.

think has changed. I used to wonder why onlym sure you can handle it now. Let’s not makemy stomach has problem but now I think thisthe next appointment. You can come back if

pain is restriction. You know that I have thisthe condition gets worse. 〉 . He gave the laststomachache. But because of this I can focus

intervention and closed the case.

when I study.

I will make stomachache」〈Ok. I gave you the next step. I’

But a person who has no

stomachache has the restriction as they don’t
have the problem.

It is like they cannot do(Follow up, June 7th, X year)
STH called the mother and asked 〈〈How is

what I can. Now I can think as everybody has

CL doing lately?〉〉and she explained that

disadvantage and mine is this.」TH told him

CL told her 「It doesn’t bother me anymore.」〈 That is great.

You discovered what theand it didn’t look like he was suffering withcounselor does. Should you (to STH) get thestomachache at all and he was not having any

discount on counselor fee? You are thinking

difficulties on daily life. She also explainedthat you can deal with stomachache.

〉.

that she used to be anxious about his future but

When asked the opinion from his mother she

the worries disappeared through the sessions.

gave a positive evaluation as she was worried

She said that CL didn’t listen to people neither

about the future and independency of CL buttalked to them prior to session but the fact heshe had hope now.

talked about himself at the sessions were

When asked for going forward 〈 Yousignificant.

She recommended him to offer

probably can handle everything by yourself

the same approach to other patients like CL at

now but is there anything I can help? Do you

consultation. She said 「「We will come backneed anything?〉he said 「Well, if someone

if we need help again.」」. STH told her to dogave me the direction I can try it. So if you

so and ended the telephone conversation.

could give me the trigger like the next step. 」.
When he said〈Ok. You shouldn’t tell people

Discussionthat you are making progress. You can makeThis is the case study where they performed

the stomachache as a good excuse to skip thethe session with teenager who was referredboring class.〉CL told the episode that he hadfrom department of psychosomatic medicine as

been using the stomachache as an excuse 「Yes.

the medicine treatment was not helping theI have used the trick before. Some cases itclient’s condition.

was true though. 」 .

You candiscussion from three points which arecontinue using the excuse even you don’t haveconstruction of rapport using noise, humor and〈 Really?

The following is theApproach to a stomachache

17

confusion and psychotherapy approach toward

pain to transfer but how about trying to give

IBS and the effect to CL’s attitude.

him the mental pain?〉was the humor toward
her based on CL’s comment 「 I never

Rapport construction using noise, humor andexperienced mental pain.」. As the result ofconfusionthese techniques TH gained the trust from bothAt psychotherapy including counselling the

CL and his mother at the first session.

Asrapport which is the trust between therapist andshown above the communication with humor,

client with acceptance and empathy is the mostnoise and confusion helped to relax at theimportant2013).

session and could even ease the seriousness on

Especially on IBS therapy it is noticed that the

problem and it resulted to increase theeffect of a placebo which 「 counterfeit

possibility for client to accept the intervention

medicine」brings the desirable results is shown(Iwamoto and others, 2016).

element(Yamaguchi,

with the average 40% of patients and provesthat patients 「sense of security」and 「hope」

Psychotherapy approach toward IBS

to health aid or therapy increases the effect of a

Basic intervention policy on brief therapy isplacebo (Ford & Moayyedy, 2010). With this「 make change to prior solution trial 」

aspect when performing counsel with IBS(Iwamoto and others, 2016).

patient it is important to create rapport quickly

study it shows several interventions but they

to make the therapy effective. It is explained

are all based on this intervention policy.

In this casethat the acceptance attitude of therapist at

CL in this case thought 「Oh, what am I

conventional counselling formed rapport withgoing to do?」 when the pain occured andclient (Yamaguchi, 2013).

focused on the pain and this sequential pattern

Wakashima andHasegawa (2000) are pointed out that rapport

made the problem worse.

can be formed quicker with noise, confusion

advised CL 〈Not to focus on the pain.〉it could

and humor. In this case study TH approachedcause the risk to actually focus on the pain

CL who had doubt on healing stomachache atparadoxically. Therefore TH used the paradox

department of psychosomatic medicine byintervention to fight against this negative cycle

asking 〈In how many sessions do you want tobystop the problem?〉〈The stomachache itself

stomachache 『Abareru-kun』and tried to create

must be your stress.〉〈Your feeling is not themore pain. The intension of this intervention

point but you just want to stop it, right?〉.

was to cut off the negative cycle by creating theThat was totally different approach than he hadnoise when he started to have the visual withseen at department of psychosomatic medicine

stomachache. In the past CL had the negativeand it caught his interest for treatment andcycle

created rapport smoothly. Also the approachconception-focus but now he simply thinks

to the mother as 〈I don’t want the physicalabout stomach and gets the noise including thegivingtheashumorous

However if TH

name

to

the

stomachache-automatic

18

Kobayashi.

visual of 『Abareru-kun』and the scene at thesymptoms is the benefit only accompany withsession（「I remember my counselor told me tosymptoms.

think about Abareru-kun.」）. Since the noise

CL the social liability and burden to change theis inserted in the pattern we can predict how tolife pattern.

handle the stomachache can be different. Also

the symptom is to avoid the burden and to help

CL reported on the second session that hecorresponding to the daily life naturally.

The complete cure will bring
The intervention to keep using

believed the reason for symptom improvement
was 「I felt like I was ready for the pain. It

What makes the change to CL’s attitude

was like I was looking forward to it and wanted

In this case study CL explained the reason of

to try the challenge.

I was like “Come on,

visit was「I like to go to the consultation if I canThis showed that presenting of

be free from this pain.」at the first session but atchallenge itself was considered to had changed

the third session he said 「I like to make a goodtheuse of stomachache. 」 and reported the big

hurry!”.」
CL’s

attitudeandsituation

againstsymptoms.

difference of his thought. As pointed out by

At the end of second session CL mentioned
about obsessiveness on life pattern.

Ito and Muto (2015) on this IBS therapy theInpsychotherapy was used since the medical

particular, he ate the same meals, drunk thetreatment didn’t work and all psychotherapy

same sweet tea after the meals and went to thecases on IBS patients had experience of failure

restroom to prevent stomachache.

on treatment. Indeed the client on this case

So weassumed this rigid life pattern maintained the

explained

that

he

received

themedicalstomachache and suggested the intervention totreatment at department of psychosomaticchange the pattern. In this case TH explained

medicine but didn’t see the progress and we

the idea but as CL had high apprehension andbelieve that he felt helpless on symptoms andapplied skill we expected him to come up withhopeless on therapy.

the best idea from the explanation.

makes the big different on CL’s attitude in thisWe believe that what

At the third session he reported the change ofsituation was his own fundamental high ability

life pattern as 「I don’t drink the tea after meals

and understanding on symptoms. At the first

anymore.」and changed his thoughts to「I don’t

session CL was totally lost and didn’t know

pay attention to symptoms anymore. 」「 I

what to do with mysterious stomachache which

consider the pain is just one of the restriction.」no examination of stomach shows the issue and「I want to make a good use of stomachache.」.

had no idea of the stress the doctor diagnosed

As above CL’s IBS symptom indicated theas the reason. With CL in this situation TH

significant improvement but TH advised at thelistened to him about the details on symptoms

last session 〈Not to tell people that you got

and explained the mechanism of symptoms

better.〉. This paradox intervention is basedwith specific examples. CL’s high ability ofon the benefit of symptoms. The benefit ofunderstanding was shown on the second session

Approach to a stomachache

19after he practiced the suggested challenge andcontinue the inquest report through casecommented 「I felt like I was ready to deal with

example to accumulate knowledges.

it. It was looking forward to it. I couldn’t
wait to give a try like “Come on, hurry!”.

I

think that made it work.」without TH telling
him the intention he recognized it. With theAddition
Special thanks to the client A and A’s mother
who agreed to disclose the case study!

next challenge he also found out the intention
and practiced it in his own way.
As shown on these points CL from this case

References
Ford,

AC.,

&

Moyyedi,P.

(2010).

study had high apprehension and applied skill

Meta-analysis: factors affecting placebo

fundamentally as well as making action on

response rate in the irritable bowel syndrome.

challenges. However, we believe that as heAliment Parmacol Ther, 32, 144-158.

had no idea how to approach the mysterious

Ito, M. & Muto, T. (2015). Cognitive andsymptoms he felt helpless. Therefore, once hebehavior

therapiesforirritablebowel

got the better understanding on the symptoms

syndrome: A review.

he was able to think about how to tackle thePsychology ： therapy and research, 5(1),issue and make a plan to find the better way to

83-94. [ in Japanese] （伊藤雅隆・武藤 崇

deal with the pain.

These aspects showed(2015)．過敏性腸症候群に対する認知・行

that psychotherapy didn’t prevent his ability to

動療法の展望．心理臨床科学 = Doshisha

solve the problem and worked as the trigger to

Clinical Psychology：therapy and research,exert his fundamental skills.

5(1),83-94．
）

Doshisha ClinicalIwamoto, S., Itoh, Y., & Shida, N., et al. (2016).
Conclusion

Brief therapy no gihou. In Interactional Mind

Lastly, it indicated that IBS gives theⅧ(2015), edited by National Foundation ofeffected individual extremely huge burden withBrief Therapy, pp47-73, Tokyo: Hokuju

its unclear reason and big influence on daily

Shuppan.[ in Japanese] (岩本脩平・伊藤

life. Additionally, the percentage of effected

優・志田 望・花田里欧子(2016)．ブリー

individual proves that this is not rare condition

フセラピーの技法．Interactional Mind Ⅷ

in any way.

(2015) ． 日 本 ブ リ ー フ セ ラ ピ ー 協 会

According to the therapy,

psychotherapy approach appears to be very

(編)(pp47-73)．北樹出版)

important due to big psychosocial influence.

Kanazawa, M., Endo, Y., & Whitehead, WE., et

On the other hand, the current condition is thatal. (2004). Patients and nonconsulters with

we don’t have many researches into treatment

irritable bowel syndrome reporting a parentalof psychotherapy for IBS and it is difficult tohistory of bowel problems have more

say that we offer enough knowledge of clinicalimpaired psychological distress. Digestive

practice. This is also the reason we need to

Diseases and Sciences, 49(6), 1046-1053.

20

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Kumano, H., Kaiya, H., & Yoshiuchi, K., et al.
(2004). Comorbidity of irritable bowel
syndrome, panic disorder, and agoraphobia
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Gastroenterology, 99, 370-376.
Longstreth, GF., Thompson, WG., & Chey,
WD., et al. (2006). Functional bowel
disorders. Gastroenterology, 130, 1480-1491.
Miwa, H. (2008). Prevalence of irritable bowel
syndrome in Japan. Internet survey using
Rome III criteria. Patient Prefer Adherence,
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(2014). Evidence-based clinical practiceguidelines for irritable bowel syndrome,
Tokyo: Nankodo. [ in Japanese] (日本消化器病学会(2014)．機能性消化管疾患診療ガ
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南江堂．)
Wakashima, K. & Hasegawa, K. (2000). Brief
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Kongo Syuppan. [ in Japanese] (若島孔文・
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(2013).

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Yuhikaku Dictionary Of Psychology, editedby Nakajima, Y., Ando, K., & Koyasu, M., etal.pp874, Tokyo: Yuhikaku. [ in Japanese](山口正二(2013)．ラポール．心理学辞典．
中島義明・安藤清志・子安増生・坂野雄
二・繁桝算男・立花政夫・箱田裕司(編)(pp874)．有斐閣．)

International Journal of Brief Therapy and Family Science
2016 Vol. 6, No.1, 21-24< Conference Report >Solution-Focused Approach to Suicide Prevention－Report on the 8th conference of National Foundation of Brief Therapy－
Norimasa Itakura1) Megumi Kato2)
1)

Faculty of education, Gifu University

2)

Graduate School of Education, Gifu University

ABSTRACT. This paper is a brief report on a lecture and workshop, “SFA to suicide prevention” in 8th conference of National
Foundation of Brief Therapy held on November 26th and 27th, 2016 at Utsunomiya. A lecturer, Dr. Heather Fiske, gave theworkshop on how to encourage clients to get productive choices and to overcome crises of their life: therapists should focus on theslight difference between “intolerable now” and “just barely tolerable after all,” highlight clients’ strengths to keep on living, and not
only refrain from suicide but change their frame of problems.
KEY WORDS: Suicide prevention, SFBT, Conference report

perspective and a chance to consider how

Introduction
The 8th conference of National Foundationof Brief Therapy was held on December 26th

helpful and effective SFBT can be to suicide
prevention.

and 27th, 2016 in Utsunomiya, Japan. In theconference, Dr. Heather Fiske was invited as a

Suicide Prevention and SFBT

lecturer who is a practitioner of prevention for

Human beings potentially have a disgust for

suicide from the viewpoint of Solution-Focused

pain, blood, and death. Some, however, commit

Brief Therapy. She had a lecture on her specificsuicide against the feeling. This is because they

practice to suicide prevention. This paper is a

who are about to commit suicide believe thatbrief report on the lecture and workshop.

killing themselves is the only solution to all of

In Japan, although the number of suicides

the problems. For suicide prevention, thus,

has passed a peak, there are around 24,000

therapists should intervene to reframe clients’suicides a year. This number is a high levelproblems and to find another solution except

among developed countries. Particularly,

suicide.

suicide of the young is a serious problem, so it

Among various psychotherapy, one of thecan be said to be one of the biggest problem in

effective approach to suicide prevention is

21st century. This workshop gave a new

SFBT. This approach can help people evenfacing a challenge to acquire the meaning and

CORRESPONDENCE TO: Itakura Gifu University, Faculty

hope to live on. It can also bring clients’of education, 1-1, yanagito, gifu-shi, Gifu, 501-1193, Japan

strength, resource, and way of coping with theire-mail: 1takura313@gmail.com

problem so far, to give a light on the possibility

21

22

Itakura.

for their future and an alternative goal.

problem will be interminable,” “I cannotchange this awful situation,” and “I cannot barethis hardship.” But are these exactly true?
There will be a possibility that that problem is atemporality, something already changed, or theclient has overcome more trouble than now.
Therapists have to change the clients’ words“interminable,” “unchangeable,” “overcontrol,”and“intolerable”

into“terminable,”“changeable,” “controllable,” and “alreadyovercome several challenges,” and to offer
clients with a lager view.
Especially, solution-focused questions as

Photo 1. A scene from the lecture“why have you got along with such situation
without suicide?” “how can you cope with yourPractice in Suicide Prevention
There are specific descriptions on practice ofproblem?” have a cue to notice exception,

SFBT to suicide prevention below.

clients’ strengths, and their network. These

1) Helpful Strategies 1

questions help clients to shift their focus to

It begins with listening to client’s story. Notother aspects from their biased cognition. At thejust listening to him or her, but exploring “whatsame time, these questions also show thatis his strength,” “what resource does he have?”therapist appreciate client’s agony and pain to

and “what success has he experienced?”thinking of suicide, whereas therapist believe2) Helpful Strategies 2

client’s strength for potential change.

After listening, the therapist feedback that

4) Helpful Strategies 4

the client has strength, resource, and success. In

Given that the reason to live on, exception,

addition to that, therapist suggests that there arestrength, resource, success, and experience ofvarious choices in life and client may have thecoping with a hardship emerge in the dialogue

ability to produce them. Then, the reason to livewith a client, therapist ask more about them andnow ― not the reason not to die but to survive

outline the situation and episode with concrete― is required to be confirmed and enforced.

descriptions.

3) Helpful Strategies 3

5) Helpful Strategies 5

However,mostclients

who

think

of

Asking about relationships in the network

committing suicide look at only a part of thesometimes enables the client and therapist to

incident because of being in the midst offind a new hope. Therapist, for example, ask

problem, have biased ideation, or overestimate

questions focused on the relationships as “isa negative point. They think, for example, “thisthere someone who disapprove of suicide?”

SFA to Suicide Prevention

23

client’s problem from “the problem that there isnothing to do for solution” to “the problem that
there is a little hope.” Specifically, therapist caneasily review the problem with these logics:“the client has not enough skills,” “an infinite
amount of task exceeds client’s coping capacity
inevitably”, and “it is just a trouble”. This wayof thinking produce other standpoints that“getting skills may bring the solution”, “thePhoto 2. A scene from a role-play at theworkshopthat

person

say

for

you?”

These

conversations may develop such hope as theclient would like to do something for that
person. On the other hand, scaling-question cansearch the specific way of keeping the present
situation: what to do for maintaining that point.
With turning up the strength, resource, andability to succeed overlooked by the client,therapist construct a bridge to way of surviving
and a strength to overcome such hard situation.
6) Helpful Strategies 6
It is essential for a therapist to dialogue witha client in the standpoint that the client shouldhave other choices and the ability to generate achange. This perspective enables therapist to
identify client’s strength and resource throughsome questions: “how long can you tolerate
when you want to commit suicide?” “what can
you do to let the thought of suicide pass away?”
7) Helpful Strategies 7
Based on the knowledge of client’s strength,
resource,“the client just had a hard luck”. Thesestandpoints lead spontaneously new means to“tell me more about that person,” and “whatwillproblem can be resolved by decreasing tasks,”

andsuccess

findingfromtheconversation, therapist reconstruct the frame ofsolve the problem.
8) Helpful Strategies 8
As an important point at last, do not forget
appreciation for family and friends. It is also
necessary to support the client’s family member
to refrain the client from committing suicide.
Conclusion
In SFBT for suicide prevention, therapists
focus on a vital difference between “intolerable
any more” and “just barely tolerable,” and astrength which makes a client manage to live.
Then, therapists show clients a specific way to
overcome a hardship, and encourage clients toconfirm that the person who take the steps isthe client himself, and the client have theability to do that. This enables client to generate
a hope even in the hard situation, and takeanother choice but suicide. It can be said that
suicide prevention by SFBT facilitates not only
restraint from a thought of suicide, but also
reframing of a problem, offering of aconstructive choice in life, and negotiating of
the challenge. This viewpoint had a lot of24

Itakura.

influence on our practice to suicide prevention.
We would like to make a most cordial
acknowledgment to Dr. Heather Fiske for sucha grateful lecture.

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