Vol.12, No.1

2022

June

2022

International Journal of Brief Therapy and Family ScienceVol. 12, No. 1, 2022

CONTENTS
Invited Paper
The Single Session Therapy Mindset: Fourteen Principles Gained Through an Analysisof the Literature
Flavio Cannistrà ................................................................................................................ 1-26

Original Paper: Research and Experiment
The Effect of Depression Label on Verbal Communication
Saeko Kamoshida Nagisa Sando Koubun Wakashima ...................................... 27-39

Original Paper: Research and Experiment
Development of the Risk Assessment Scale for Ijiri: A Study on Reliability and Validity
Kazuma Sakamoto ........................................................................................................... 40-61

International Journal of Brief Therapy and Family Science
2022 Vol. 12, No.1, 1-26
< Invited Paper >The Single Session Therapy Mindset:
Fourteen Principles Gained Through an Analysis of the Literature
Flavio Cannistrà 1)
1)

Italian Center for Single Session Therapy

ABSTRACT. Mindset, or the therapist’s series of beliefs which influence the actions and decisions taken in the course of their work,
is considered fundamental in its impact on the effectiveness and length of a course of therapy. This article gives a definition of“mindset” and analyses its implications for psychotherapy in general and Single Session Therapy (SST) in particular. This isfollowed by an analysis of the literature surrounding SST, leading to the description of fourteen principles which make up the typicalmindset of a single session therapist. The application of the principles is illustrated by a clinical case study.
KEY WORDS: Single session therapy, mindset, epistemology●●“deep” change typically takes years;
however, the exact duration depends
on the individual’s problems andsituation (whatever it may be).
Clearly, this is not a criticism of the above

Introduction: mindset is fundamental
Consider this statement: “[psycho]analysis
does not offer any quick fixes. What it can offer
is a depth of change and recovery that other,statement, which serves its purpose on an

short-term treatments often cannot. Typically,

informative website (albeit belonging to thepeople will see an analyst for several years,

Institute of Psychoanalysis of the British

though the exact length of an analysis will of

Psychoanalytical Society). Neither should thecourse depend on the individual’s specificproblems

andsituation”(Institutereader

of

see

it

as

a

criticismofthepsychoanalytical method.

Psychoanalysis, n.d.).

Instead, we would like to pose some

What does this tell us about psychoanalysis,

questions.

people, psychotherapeutic change and change

For example: how would a therapist proceed

in general?

if they believe that “a depth of change andFor example:●
a short-term treatment (whatever thisis and whatever “short-term” means)cannot offer “deep” change andrecovery (whatever these may be);recovery” can only be gained by seeing ananalyst “for several years”?
How would the same therapist react if theclient returned a few weeks later with a

CORRESPONDENCE TO: Flavio Cannistrà

complete remission of symptoms?

c/o ICNOS ICSST

And, more generally, how will the therapist’s

via Nomentana, 60

work be influenced by their beliefs?

00137 Rome, ITALY

In this article we will attempt to answer suche-mail: fcannistra@flaviocannistra.it

questions. We will define the concept of
1

XX
2

Cannistrà.

mindset, explore its place at the heart of Single

thinking and acting in the therapy room that

Session Therapy, identify fourteen principles ofbelong to that person. For example, mindset

mindset drawn from a preliminary analysis of
the literature and illustrate a case which canprovide a more concrete idea of the issue.

includesepistemological,

theoretical,

andtechnical opinions, as well as personal attitudes
to relationships with clients.

What is mindset?

On the other hand, what do we not mean byFirst and foremost, we should clarify whatmindset? It is definitely not operational

we mean by “mindset”. In English, theguidelines which indicate what to do during adefinition is “a mental attitude or inclination”,

session. But we could perhaps say that if thewhere “attitude” is “a feeling or way of

famous alien were to arrive and watch athinking that affects a person's behaviour”, andtherapist in action, they could determine the“inclination” is “a tendency to a particular

mindset from what the therapist is doing. What

aspect, state, character or action”1.

they are doing is action (mostly, but not only,

The mindset of a therapist, then, is the series

verbal), and from these we can determine theof beliefs which influence the actions andtherapist’s views on various issues: how people

decisions taken in the course of their work.

work, how change works, what they expect toMoreover, we believe that these ways of

happen during the session and so on.

thinking are not always necessarily conscious.
We can also ask ourselves how the mindset
of a therapist is formed, in other words how

Why is it essential to take mindset into
account?

does the therapist come to have his or her

We believe that the organised series of ways

particular mindset. Although a detailed answer

in which we think and practise acts as a guideto this question falls outside the remit of thisto a number of key points of the therapy itself

article, we can assume that it is partly the result(which is what we aim to demonstrate in theof the therapist’s personal history, and partly ofcourse of this article). For example, depending

their professional career. Whether it is the lifeon their mindset, different therapists will giveexperience of the individual therapist, or thedifferent answers to basic general questions

experiences and studies undertaken in theirsuch as:professional life, jointly these form the ways of1!
!

Mindset, Attitude, Inclination

https://www.merriam-webster.com/dictionary/

how long should therapy last to beeffective?
what is the minimum and maximum
number of sessions, and how should
this be decided?

SINGLE SESSION THERAPY MINDSET
!
!
!
!
!
!

how is change produced in
psychotherapy?
should the therapist set homework to
be done between sessions?
who should be present in sessions?
who sets the objective of the therapy?
what should be addressed in therapy?
what is the ultimate aim of therapy?

And also highly specific questions, such as:!
!
!

is online therapy legitimate?
should the client be seated on a chair,in an armchair, or lying down?
should we shake the client’s hand?

In fact, all these questions are subjects fordiscussion and study, if not actual debate, in thewritings and gatherings of psychotherapists.
Different environments or systems obviously
have different ideas of what the correct answers
may be, and these lead to different practices:
shake the client’s hand or not, ask them to sit orXX
3

How does mindset affect psychotherapy?
We

have

previously

discussed

theseconsiderations (Cannistrà, 2021, pp. 82):
A mindset creates (and stemsfrom) constructs.
For example, in a psychoanalytic
mindset there is the construct of“flight into health.”
As Frick (1999, p. 63) explains,“reports to the therapist of rapid
improvement and a return to feelingsof well-being are viewed withsuspicion. Such positive patientreports, sometimes accompanied byearly termination, are considered to be‘self-deceptive’ […], are ‘fraught
with inherent dangers’ […], are ‘nottrustworthy’
[…],
and
are
‘pseudo-successes’.”How can therapy be brief or single
session with a mindset based on thesekinds of opinions?

lie, offer online therapy or not, what goals to
aim for, who defines them, whether to set
homework and why, etc.2

As Watzlawick et al. (1967) say: “[A] man
operates with a set of premises about theIt therefore appears clear that knowing thephenomena he perceives and [...] his interaction

mindset of a therapist, or of a particular type ofwith reality in the widest sense (that is, not only

therapist, is key, because it tells us a lot about

with other human beings) will be determined bytheir way of working. And probably also about

these premises” (p. 262).

their effectiveness and efficiency, in other

The question every therapist needs to ask is:words their ability to help people and the time

what happens when the “reality” we’re talking

needed to do so.

about is the reality of the therapy? What are the“interactions” that come into play in this2

Obviously, the issue is more complex than this, andmay include when to shake or not shake the client’shand, or when to ask them to sit or lie; but we assume
that the point is sufficiently clear.

reality? And, above all, what are the “premises”
that determine them?

XX
4Cannistrà.

In the words of Hoyt (2017, p. 230): “How
we look influences what we see, and what we
see influences what we do, ‘round and ‘round”.
It therefore goes without saying that we
need

to

understand

how

we

look

the therapy itself (for example, Connor &Callahan, 2015).
And what should we think, therefore, of thetherapist’s

expectations

regardingatcharacteristics attributed to the client, such as“therapy-related things” because this will“organisation of the Id”, “motivation”, “defence

influence how we see them, how we interpretmechanisms employed”, “organisation of thethem, and what they mean to us. And this will

personality”, “diagnosis” etc? Or expectations

influence the action we will consequently take.

as to “how long therapy should last”, “howWe consider it inevitable that the length of amany sessions are needed to establish acourse of therapy is partly determined by thetherapeutic

alliance”

orpremises with which we approach it.

resolution of the problem”.

“toconsideraPrior to Talmon (1990), the general

This does not seem very far removed fromtendency was often (not always, of course) to

Rosenthal’s classic experiment, known as theconsider the first session as geared solely to

Pygmalion effect (Rosenthal & Jacobson,

diagnosis,

1992).

ormerelyforbuildingtherelationship between therapist and client or, inthe best-case scenario, for establishing and

Mindset in Single Session Therapy: an

initiating a strategy.

initial examination of its constitutive

What might be the outcome of an initial

elements

session approached with this kind of mindset?

In the last thirty years, interest has grown

And what might the outcome be if - asaround Single Session Therapy (SST), a

discussed elsewhere (Cannistrà & Piccirilli,

method of (therapeutic) intervention aimed at2021) - ending after the first session is

maximizing the effectiveness of each single

interpreted as a negation of the “illness”, lack(and often unique) session. It all started withof motivation or an overly serious disturbance?

the first study by Talmon, Rosenbaum, andOur premises - our mindset - determine the

Hoyt (Rosenbaum et al., 1992), which led toactions we carry out in therapy and, to a large

three findings validated by subsequent research:extent, the very outcome of the therapy. Others
have highlighted the extent to which thetherapist’s expectations impact the outcome ofFinding #1: that the most common numberof service contacts that clients attend is one,
followed by two, followed by three…

SINGLE SESSION THERAPY MINDSET
irrespective of diagnosis, complexity or theseverity of their problem (Talmon, 1990).
Finding #2: that the majority (often about
70-80%) of those people who attend only
one session was adequate given theircurrent circumstance (Talmon, 1990;
Bloom, 2001; Campbell, 2012).
Finding #3: possibly the hardest finding toaccept, is that it seems impossible toaccurately predict who will attend only one
session and who will attend more, aproposition that has significant clinical andorganizational ramifications.
(Young, 2018, p. 44).

XX
5

decisions and actions allow the therapy Single
Session?
There are several answers to this question.
At our centre we have chosen to extrapolate a
response by examining a series of contributions
by researchers and practitioners of SST in its
various forms, not only clinical and therapeutic(although these make up the overwhelming
majority of the sample). This is also the reason
why we favour the terms “therapy” andOver the years, various SST methods have“therapist”, which the reader may extend to

been developed (see for example Cannistrà &other

Piccirilli, 2021), but one thing that seems to us“practitioner”. For the same reasons, we use theto be common to all is the importance of thealternatives “person”, “client” and “patient”,

mindset underlying them.

while preferring the first two terms, considering

For example, Slive and Bobele say that “a

nouns

such

as

“counselling”

andthe latter excessively medicalised.

crucial element for conducting successful
walk-in [single] sessions is the therapist’s own

Methodology

beliefs about the effectiveness of brief therapy.

We reviewed fifty-three contributions on

Therapists’ expectations are communicated

SST, including chapters of books, research andovertly and covertly about how rapid and how

articles. Numerous texts refer to SST, but wemuch change can be expected” (2012, p. 29).

limited our search to those which focus

Mindset is so fundamental in SST that Hoyt

explicitly on this approach, excluding those thatclaims that: “SST can be thought of more as anmention it in passing. Furthermore, we sought

affirmative and optimistic mindset [...] rather

to prioritise writers who discuss SST more orthan as a particular method” (2021, p. 31).

less continuously, or who have published major

The essential question therefore becomes:

work on the subject (such as systematic reviews

what are the basic characteristics of the mindset

or meta-analyses). We are aware that this andin the therapist who approaches their clientsthe previous criterion exclude many importantwith SST? Or, in other words, what modes ofcontributions; our decision was based solely onthinking should a therapist adopt to ensure their

the need to simplify this work, which is notXX
6Cannistrà.

intended to be a exhaustive review and may

extra-therapeutic factors’ such as the client’s

subsequently be extended. Therefore, theunderlying strengths, supportive elements in the

non-inclusion of certain contributors/writers

environment, and chance events of spontaneous

does not imply that they have nothinghealing”, we took this as an indication of ainteresting to say; indeed, it may mean that we

mindset in which the belief is that the client has

missed them or did not have time to include

resources, although Talmon does not say thisthem in this article: we may well do so in the

directly, stating, for instance, that “The Single

future. Moreover, we absolutely do not believe

Session therapist believes that the client hasthat the elements observed constitute the “trueresources and that these are part of themindset”

therapy”. Moreover, when we make this kind of

of

SST:

since

we

embraceconstructivism

andconstructionism(vonchoice, we nevertheless seek to prioritise

Glasersfeld, 2001; Gergen & McNamee, 1991)

assertions that were already in accordance with

and,

and

similar views by other writers, while omitting

pluralism (Bernstein, 2010), the concept ofothers which would have required inordinate“truth” does not belong to us. What we presentinterpretation on our part, at the risk of crudely

here is a version derived from our perspective

distorting the author’s words.

more

generically,

pragmatism

and our current work, with the sole purpose ofAbove we mentioned that we had referred togiving an interpretation which may be useful indescriptions of “how the therapist approaches

the adoption of a single session mindset.

therapy”. This means we sought elements that

In our analysis of the literature, we

referencethetherapist’s

view

of

the

prioritised passages referring explicitly tocharacteristics of the client, the therapist, themindset, in other words direct descriptions ofprocess of therapy and change. However, we

the therapist’s approach to therapy, leaving

have avoided reference to procedural or

aside situations in which mindset may be

operational elements such as methods, practices

derived (interpreted) from other assertions

or guidelines on how to conduct SST, although(such as suggestions of what to do duringin certain passages we have used these to add

therapy); obviously, the boundaries are notclarity; but we have attempted to minimise thisalways clear, and we occasionally resorted toand also to avoid being overly specific. For

abstraction. For example, when Talmon (2014,

instance, we avoid giving descriptions or

p. 35) states that “the ‘DNA’ of good SST”

examples of specific techniques.

includes “Mobilizing so-called ‘client andXX
7

SINGLE SESSION THERAPY MINDSET

Among the main sources for our research

they have received, starting with the category

were three publications edited by Hoyt andthatcolleagues (2014, 2018a, 2021). These allowed

However, this order is essentially arbitrary;

us to access a large number of articles andmore extensive research might change thewriters directly and explicitly involved in SST.

position of one or more categories; moreover,

However, we also wanted to include authors

given the process of abstraction we used, we

whose contributions did not appear in thesemaythree works, in order to ensure our research was

Furthermore, no weighting is given to thenot overly polarised.

statements: some authors may have writtenAsmentioned

previously,

duringhasreceived

have

the

omittedgreatestsomenumber.

statements.

ourseveral lines highlighting certain elements ofresearch we collected both direct and indirect

mindset and fewer lines on other elements; instatements, with the aim of identifying theirsuch cases we have included both. For this andcommon principles. By doing this, categories

other reasons, the reader should not assume thatwere created, in which we placed statementsa particular principle is more commonly heldthat we believed pointed to common elements

than others and, above all, should not considerof the mindset. We ended up with fourteen

any to be more important or essential (with thecategories: the fourteen principles of the Single

possible exception of the first principle): it is

Session mindset. We are aware that thislikely that the authors quoted (see Table 1)

presentation is a reflection of our viewpoint,share most of the other principles, but they may

which is itself limited, partly by the small

not be in agreement on some, or give themamount of material examined. Other writers

different weight.

might differentiate more or fewer categories or

Whenchoosing

names

for

the

disagree partially or wholly with our inclusioncategories/principles, we opted for the clearestof certain elements in certain categories.

and most accurate possible, without overly
abstract or metaphorical terms. The same goesThe

fourteen

principlesofSingleSession mindset
Below

we

will

for our descriptions of the categories.
In order to avoid excessive heaviness in thepresent

thefourteen

text, instead of including a bibliography forprinciples of single session mindset, i.e. theeach principle, we have summarised ourfourteen categories we identified. They aresources in Table 1.

presented in order of the number of mentions

8

SINGLE SESSION THERAPY MINDSET

Cannistrà.

Table 1.

XX

The fourteen principles of the Single Session Mindset and the related references
Principle

References
Rosenbaum et al., 1990; Talmon, 1990; Hoyt et al., 1992; Bloom, 1992; Bobele et al., 2008; Slive et al.,2008; Hoyt, 2009; Miller, 2011; Campbell, 2012; Slive & Bobele, 2012; Paul & van Ommeren, 2013;
Hoyt & Talmon, 2014; Keeny & Keeny, 2014; Slive & Bobele, 2014; Talmon & Hoyt, 2014; Rycroft &1. A SINGLE SESSION MAY BE ENOUGH

Young, 2014; Young, Rycroft & Weir, 2014; Barnes et al., 2018; Hoyt et al., 2018b; Hoyt et al., 2018c;
Hoyt, 2018; Slive & Bobele, 2018; Söderquist, 2018; Story, 2018; Stweart et al., 2018; Talmon, 2018;
Hoyt & Cannistrà, 2019; Dryden, 2019; Cannistrà et al., 2020; Hoyt et al., 2021; Bobele et al., 2021; Hoyt,
2021; Schleider, Dobias et al., 2020; Schleider, Sung et al., 2021
Talmon, 1990; Bloom, 1992; Cummings, 2000; Bobele et al., 2008; Slive et al., 2008; Hoyt, 2009; Miller,
2011; Paul & van Ommeren, 2013; Boyhan, 2014; Hoyt & Talmon, 2014; Keeny & Keeny, 2014; Slive &Bobele, 2014; Talmon, 2014; Talmon & Hoyt, 2014; Rycroft & Young, 2014; Young, Rycroft & Weir,

2. THE THERAPIST CAN PLAY AN ACTIVE ROLE

2014; Hoyt et al., 2018b; Hoyt et al., 2018c; Guthrie, 2018; Rodriguez, 2018; Slive & Bobele, 2018;
Soo-Hoo, 2018; Stweart et al., 2018; Young, 2018; Young K., 2018; Hoyt et al., 2021; Hoyt, 2021;
McElheran, 2021; O'Hanlon 2021; Schleider, Dobias et al., 2020; Schleider, Sung et al., 2021
Rosenbaum et al., 1990; Talmon, 1990; Bloom, 1992; Miller, 2011; Campbell, 2012; Feldman & Dreher,
2012; Slive & Bobele, 2012; Hoyt & Talmon, 2014; Slive & Bobele, 2014; Talmon, 2014; Talmon &3. PEOPLE HAVE RESOURCES THEY CAN USE TO FEEL

Hoyt, 2014; Bobele et al., 2018; Hoyt et al., 2018b; Hoyt et al., 2018c; Hoyt, 2018; Guthrie, 2018; Josling

BETTERet al., 2018; Soo-Hoo, 2018; Story, 2018; Stweart et al., 2018; Talmon, 2018; Young K., 2018; Dryden,
2019; Hoyt & Cannistrà, 2019; Cannistrà et al., 2020; Hoyt et al., 2021; Hoyt, 2021; McElheran, 2021;
O'Hanlon, 2021; Schleider, Dobias et al., 2020; Schleider, Sung et al., 2021
Hoyt, 2009; Miller, 2011; Feldman & Dreher, 2012; Slive & Bobele, 2012; Slive & Bobele, 2014; Young,
Rycroft & Weir, 2014; Barnes et al., 2018; Bobele et al., 2018; Hoyt et al., 2018b; Hoyt et al., 2018c;

4. THE CLIENT IS THE EXPERT IN THEIR OWN LIFE

Hoyt, 2018; Levin et al., 2018; Rodriguez, 2018; Stweart et al., 2018; Söderquist, 2018; Soo-Hoo, 2018;
Talmon, 2018; Young K., 2018; McDonald et al., 2021; McElheran, 2021; O'Hanlon, 2021; Rycroft et al.,2021; Schleider, Dobias et al., 2020
Talmon, 1990; Miller, 2011; Paul & van Ommeren, 2013; Hoyt & Talmon, 2014; Slive & Bobele, 2014;

5. DIFFERENT METHODS MAY BE USED

Talmon, 2014: Talmon & Hoyt, 2014; Rycroft & Young, 2014; Barnes et al., 2018; Hoyt et al., 2018c;
Hoyt, 2018; Josling et al., 2018; Rodriguez, 2018; Söderquist, 2018; Story, 2018; Stweart et al., 2018;
Young, 2018; Hoyt et al., 2021; Hoyt, 2021; McElheran 2021; Schleider, Sung et al., 2021
Rosenbaum et al., 1990; Talmon, 1990; Miller, 2011; Hoyt & Talmon, 2014; Hoyt et al., 2018b; Guthrie,

6. FURTHER SESSIONS MAY BE NEEDED2018; Rodriguez, 2018; Story, 2018; Young, 2018; Hoyt et al., 2021; Bobele et al., 2021; Hoyt, 2021;
O'Hanlon et al., 2021; Rycroft et al., 2021
Rosenbaum et al., 1990; Talmon, 1990; Cummings, 2000; Slive & Bobele, 2012; Paul & van Ommeren,

7. SST IS SUITABLE FOR DIFFERENT CONTEXTS AND NEEDS

2013; Boyhan, 2014; Slive & Bobele, 2014; Talmon, 2014; Young, Rycroft & Weir, 2014; Söderquist,
2018; Young, 2018; Dryden, 2019; Hoyt et al., 2021

8.

IT’S

FINE

TO

AIM

FOR

SMALL

OR

SIMPLE

Rosenbaum et al., 1990; Talmon, 1990; Bloom, 1992; Miller, 2011; Hoyt & Talmon, 2014; Talmon, 2014;

INTERVENTIONS

Talmon & Hoyt, 2014; Hoyt et al., 2018b; Guthrie, 2018; Söderquist, 2018

9. IT’S FINE TO HAVE LESS PRIOR KNOWLEDGE

Young & Rycroft, 1997; Slive et al., 2008; Bedggood, 2018; Harper-Jacques, 2018; Guthrie, 2018; Levinet al., 2018; Miller et al., 2018; Story, 2018; Hoyt et al., 2021

10. IT’S BEST TO STICK WITH PROCESS AND THE HERE AND

Bloom, 1992; Paul & van Ommeren, 2013; Talmon, 2014; Talmon & Hoyt, 2014; Rodriguez, 2018;

NOW

Rycroft, 2018

11. RESULTS ARE MAINLY ACHIEVED OUTSIDE THE SESSION

Rosenbaum et al., 1990; Hoyt, 2009; Hoyt & Talmon, 2014; Talmon, 2014; Guthrie, 2018; Josling et al.,2018

12. A STRUCTURE IS NEEDED FOR THE SINGLE SESSION
13.

A

CLIENT-THERAPISTRELATIONSHIP

CAN

Talmon, 1990; Bobele et al., 2018; Hoyt et al., 2018a; Dryden, 2019; Hoyt, 2021; Rycroft et al., 2021
BE

Talmon, 1990; Talmon, 2014; Stweart et al., 2018; Talmon, 2018ESTABLISHED RAPIDLY
14. NOTHING IS TAKEN FOR GRANTED

Bloom, 1992; Hoyt & Talmon, 2014

SINGLE SESSION THERAPY MINDSET

Here are the fourteen principles of the single
session mindset.

XX
9

the session itself. This is a more specificconsideration, in which “can” or “could” isvital, and not a necessity, and where perhaps

1.

A

SINGLESESSION

MAY

BE

ENOUGH
The

therapist

the meaning of the word “change” merits
discussion. In general, we believe that all

believesthatasingletherapists who have this mindset agree that -encounter between them and the client may be

regardless of how - one session may be all thesufficient for both parties. This means theclient needs.

therapist accepts the idea that the client may

A second consideration is that the therapist

think they do not need further sessions, and that

does not necessarily believe they can “cure” thethe help given by the therapist in the single

person or “solve” the problem. The session may

session may be all the client needs.

be enough exactly as it occurs, whether it is an

In other words, the therapist approaches theinstance of listening, problem solving, ansession with the idea that it may be the only

opportunity for containment or an encountermeeting between them and the client, notwith an “expert”. This means that the therapist

because the session is a “failure”, but because,

does not go in with the idea of “solving theconversely, it has been sufficiently useful.

client’s problem”, “curing the mental disorder”

This also means that the therapist willor “eliminating symptoms”, but instead with theconduct the session bearing in mind that it must

idea that the goal they set with the client may

be complete in itself. So they believe it is

be more than sufficient (see 4th Principle).

important to consider the possibility of

Paradoxically, this is not the most explicitly(co-)creating a session that can achieve astated principle, but this is not unusual: wepurpose by the end of the time allotted. In otherconsider it normal that in any discussion of SST

words, the therapist will avoid leaving things(e.g. a chapter in a book on the subject) there ishanging or conducting the session in a way thatno need to reiterate the fact that one session

makes another appointment obligatory or

may be enough in itself. For this reason weessential.

decided to place it before the others.

Some authors state other considerations
which we believe are linked to this principle.
For example, that change can happen
because of the session, and not actually within

2. THE THERAPIST CAN PLAY AN
ACTIVE ROLE

XX
10Cannistrà.

The therapist believes they can play anmost appropriate ways in an attempt to help theactive role in conducting the session. This may

client in the single session, always in line withbe done in a number of ways: giving direct

the client’s requests, needs and individuality, as

feedback, asking the client to do certain things

well as offering the possibility of further

during the session, using various techniques,sessions where necessary (6th Principle).

recommending doing, not doing or changing

Although an active role is a given for manycertain things outside the session, either

therapists, many single session practitioners

formally (for example, prescribing a certain

highlight this as a fundamental premise which

technique) or less formally (for example, asking

is essential, or at least to be considered, in orderthem to slightly change or completely stop

to maximise the effectiveness of the therapy.

certain behaviours); interrupting the client if
and when necessary, involving or requesting
the more or less direct involvement of otherpeople, being more decisively directive or moreindirect and suggestive, etc.

3. PEOPLE HAVE RESOURCES THEYCAN USE TO FEEL BETTER
Many SST practitioners describe this as aresource-based or strength-oriented approach.

In general, the therapist gives himself orThis means that the therapist believes it isherself permission to conduct the session in theuseful to assume that the client, like every

manner they consider most appropriate to help

person, possesses resources which to somethe client. This should absolutely not be

extent can be identified during the session andconfused with the idea of a forcedly directive,

used, partially or wholly, to help achieve theirimperious or manipulative therapist. As we willgoals.

see in the 4th Principle, the individual is

Such resources may be internal (moredesignated as the expert in their own life anddirectly belonging to the individual in question)

decider of the most appropriate ways to achieve

or external (more directly belonging to their

their goal. Instead, this second principle reflects

systems of reference); cognitive, emotional,

the idea of a therapist who is not limited torelational or other types.

listening to the client, letting them vent, asking

They can be identified for example bythem to merely describe the past, and generally

exploring what the client does, has done or

takinghermeneutic

could do to address this or other issues. The

approach. On the contrary, the therapist takes

therapist approaches the session with the idea

responsibility for thinking and acting in theof finding and using these resources through theanexploratory

andSINGLE SESSION THERAPY MINDSET

XX
11

conversation and the techniques used duringaware of it. Rather, the therapist believes that

and/or after the session.

the client should be helped to discover what

Many therapists believe that it is theseworks for them. It also means that the therapist

resources that make the difference, and that adoes not approach the session with the idea oflarge proportion of the therapist’s work should

imposing something but, at most, proposing,be directed to helping the client identify themand always taking the client’s opinion into

and use or unlock them. Other therapists

account.

consider them as a base on which to work, astarting point or useful in some way.

Digging deeper, we could say that thetherapist can be considered an expert in the

In this way a view or vocabulary focused on

method of helping a hypothetical client toor leading to pathologies is avoided andachieve their own goal, but at the same time

considered of little use; the therapist seeks toconsider the person in front of them as anfocus on what works or might work, rather thanexpert in their own life, and as such in what

cure something seen as illness or pathology.

may be appropriate or inappropriate for them.
This means the therapist believes they have

4. THE CLIENT IS THE EXPERT IN
THEIR OWN LIFE

to understand the problem from the client’s
point of view; conduct the session in a manner

The therapist believes that the client canthat ensures it is the client who ultimately

identify, recognise and communicate what

decides the goal of the session; in general,

works for them. This principle encompasses

making the client the co-constructor of themany aspects, including identifying what theirsolution, which will be based on, or at least

problem is and how it works; deciding what theinspired by, their own resources. For example,

goal is - this may be at the end of a potential

a number of therapists ask their clients whatcourse of several sessions, or at the end of athey think is the first step to take, or what they

singleaneed to do to resolve their problem, or work totechnique, comment, explanation, analogy or

actively build a plan of action to use outside theother intervention by the therapist may besession.

session-recognisingwhether

appropriate for them, whether it is worth
putting into practise, etc.
This does not mean the client knows all thisat the time, i.e. they are immediately and fully

Obviously, this also means that the therapist
will meet the client halfway in terms of theircultural background and preferences.

XX
12

Cannistrà.

5. DIFFERENT METHODS MAY BE
USED

By emphasising that SST is not a single
structured way of working with a client, several

Regarding the methods used to increase thewriters explicitly state that, rather than an

likelihood that a single session is sufficient,approach, SST is a form of delivering a service.

many therapists explicitly underline that one

We could perhaps say that SST is first andsize doesn’t fit all, meaning that there is no

foremost a mindset, taking the form of various

single method or approach suitable for every

structured practices which can be used toperson, problem or situation.

deliver assistance to individuals.

Even in view of the fact that every person
has their own resources (3rd Principle) and is

6.

FURTHERthe expert in their own life (4th Principle),

NEEDEDSESSIONS

MAY

BE

many therapists explicitly state that there is not

The therapist knows that one session may

one single method of conducting SST, andnot be sufficient and that, consequently, at theneither is any particular method better thanend of the session the client may request

another.

another appointment, or the therapist himself or

The single session therapist therefore has
the expectation that a range of methods can beherself may acknowledge or suggest that afurther session may be needed.

useful, and considers it necessary to be flexible

Many single session therapists believe that it

and pragmatic, in other words to use what

is not possible to establish the necessity orworks for that individual rather than sticking

desirability of making further appointments

rigidly to a single model. This is not to say that

before the end of the ongoing session.

the single session therapist is necessarily an

Therefore, neither the therapist nor the client

expert in a wide range of methods or

can know whether other sessions will be needed

approaches to therapy; in fact, writers tend tobefore the end of the current one - regardless ofdescribe their own more or less structured

the number of sessions carried out (whether it ismethods of conducting SST (see also 12th

the first, second, third etc). Moreover, thePrinciple). Nevertheless, many do so while

therapist “always leaves the door open” -stating explicitly that they do not believe their

meaning that they give the client the possibility

method will work for all clients, and this partly

of further sessions at any time, even if they

coincides with the idea that further sessions

previously thought the initial session was

may be needed (6th Principle).

enough.

SINGLE SESSION THERAPY MINDSET

XX
13

Besides, the therapist knows that further

As previously stated, the fact that this is thesessions may be necessary with the same

6th Principle does not imply that it is lessservice and with the same therapist, but also

important than the previous points. Indeed, it iswith different services and with different

highly likely that all single session therapists

therapists; they also know that the client may

believe further sessions may be needed, andrequest a further appointment for the samethat one is not necessarily enough.

problem or different ones, or make a new
appointment only to realise that there is actually

7.

SINGLE SESSION THERAPY IS

no need. As we saw in the 5th Principle, this is

SUITABLE FOR DIFFERENT CONTEXTS

part of the basic flexibility needed by the

AND NEEDS

therapist, who does not consider SST as a

The therapist believes that the idea that achallenge or a test, but simply a type of service

single session may be enough is valid in a wide

which, if it turns out to be insufficient, leaves

range of cases. Regardless of who they areother options open.

faced with and the problems the client brings,

Among other things, this implies that thethe therapist does not approach any initial

therapist does not approach the session with thesession thinking that it will definitely beidea that they have to make sure that the sessionnecessary to arrange another, and they usuallyis the only one needed, at any cost. They follow

maintain this approach throughout the session

the mindset principles and the structure (model,

and the course of therapy.

method, approach etc) they consider necessary

By way of example, this means that theto maximise the effectiveness of the session,therapist’s starting point is the idea that a single

bearing in mind that it may be the only one, but

session may be enough, regardless of (a) who

not considering this to be essential.

requests and attends the session, e.g. anThis principle does not contradict theindividual, a couple, a family or a group; (b) the

methods of delivering the service chosen by the

problem they bring, which may be assessed astherapist or the centre. For example, some“serious” (for example in terms of symptoms)

walk-in services do not offer the possibility ofor “urgent”; (c) the culture of the client inmaking further appointments with the samequestion.

therapist (i.e. ongoing therapy with the same

Naturally, this assessment may change inperson), but this does not mean they think thethe course of the session, but the change is not

single session may not be sufficient.

prior to it; for example, on the basis ofXX
14

Cannistrà.

identifying certain diagnoses which are nottechniques, complicated manoeuvres, grandcompatible with SST. The appropriateness ofobjectives or, in general, efforts to produce

SST depends first and foremost on the goals

major change.

that the client wishes to achieve with the

Although the therapist may accept that sometherapist during the first session, and thechanges happen suddenly and obviously, they

possibility of helping the client achieve them.

do not think that the session should necessarily

It should, however, be noted that therapists

aim to effect this type of change. Instead ofthemselves concur that they should “evaluate

undertaking to achieve large or complex

situations of risk”: a single session therapist

changes, they consider it more appropriate to

may agree or not agree to end the therapy after

come to the session with the aim of identifying,a single session if, during that session, theyagreeing and (working towards) achieving

ascertain situations of risk, leading to the belief

small objectives and limited changes. This maythat it is necessary to continue with further

also (but not necessarily) involve the setting ofsessions.

simple homework to be done outside theTo summarise - and this will be detailed

session.

later - the therapist does not approach the

Many authors emphasise the need to not besession with methodological limitations orbrilliant and avoid rushing during the session.

particular diagnostic views that include or

Approaching a session with the idea that it may

exclude the client from SST, or from thebe enough, and proceeding with a structure thatpossibility that one session may be all theexpresses this idea, does not mean trying toperson believes they need. Effectively, as

accomplish as much as possible: as stateddiscussed above, it is only at the end of thepreviously, SST is not seen as a test of skill, so

session that a decision can be made as tothere is no need to seek major results within thewhether the session has been sufficient or if

session.

others are needed, based above all on theobjective agreed with the client.

Indeed, the single session therapist basicallyknows that the “outcome of the session” may
not coincide with “solving the problem” or

8. IT IS FINE TO AIM FOR SMALL ORSIMPLE INTERVENTIONS“achieving the ultimate goal” of the client.
They entertain the possibility that the client

The therapist believes that when a session is

may resolve the problem or achieve thesufficient, this is not due to the use of brilliant

objective on their own, with another therapist

XX
15

SINGLE SESSION THERAPY MINDSET

or in another context, or in other ways

writers, the aim is in fact “therapy, not(Principles 5 and 6).

diagnosis”: the purpose of the session is to help

As we saw in Principle 3, therefore, thetherapist believes it is useful to establish thethe person to change, not to decide “what’s
wrong with them”.

aim of the session for the client, which will

This does not mean that the therapist can orprobably be simpler and smaller than ashould start from a tabula rasa: the process ofhypothetical goal for the end of a course of

categorisation and recognition is part of being

therapy designed to be conducted over several

human. Single session therapists instead statesessions. After all, the therapist always knows

that, just as they avoid deciding the aim of SST

that if the objective is not achieved by the end

in advance (1th Principle), they also avoid priorof the session, or if it is reached, but is notclassification of the client in set diagnostic

sufficient for the client, the “worst” thing thatcategories.

can happen is that they realise another session
is needed (6th Principle).

The underlying idea seems to be that theprocess of familiarisation should not involve
predetermined

9. IT IS FINE TO HAVE LESS PRIORKNOWLEDGE

terminology,

such

as,

for

example, certain systems for evaluating andclassifying psychological pathologies: instead

Since the therapist does not know which

they concentrate on efforts to explore theprocess of change is best for the person they are

person, the problem, the goal and the situation

meeting for the first time, they embark on afrom zero, as well as their resources (4thsession with the idea and the aim of getting to

Principle). This may be done, for instance, byknow the person in front of them, the reason

prioritising

why the client has requested help and theinvestigations into the nature of the problem as

details of the situation they are in and thedescribed by the client, rather than interpreting

condition they are experiencing. Some authors

what they say and their reference to pre-set

refer to this principle by saying the therapist

psychological theories.

functionaldescriptions

andstarts from a not-knowing-stance.
During the session, the therapist avoids
conducting or referring to a diagnostic process

10. IT IS BEST TO STICK WITH
PROCESS AND THE HERE AND NOW

geared to placing the client in a specific

As mentioned earlier, the therapist believes

nosographic category. In the words of several

that change can happen rapidly and in response

XX
16

Cannistrà.

to action on ongoing processes, rather thanrequiring lengthy periods of investigation and

11. RESULTS ARE MAINLY ACHIEVEDOUTSIDE THE SESSION

exploration of discursive content relating to the

The therapist believes that most change

past. Therefore, instead of exploring thehappens outside the therapy room. This

meaning,andprinciple involves the simple idea that a major

examining the past, the therapist approaches thepart of the process of change is more likely tosessiontheoccur in the hours and days following theconversation and any intervention on processes

therapy session than in the hour (or less) spentand interactions, with an emphasis on the here

face to face with the therapist.

interpreting

with

the

idea

the

of

content

focusing

and now: they are more interested in what theThis does not imply that the therapist does

person is doing than in seeking a distant why

not think change is possible during the session,

they are doing it and, when exploring possibleor that important changes, or even resolutions,reasons, the therapist is more interested incannot take place during it (see 1th Principle).

understanding present reasons than going back

Nevertheless, the therapist approaches theto (assumed) past reasons.

session with the idea that the client spends far

Several writers state explicitly that it is not

more time in their own life than in therapy, andappropriate to open too many doors or go too

therefore that the session should in some way

deep: working on what the person (or people, in

trigger change outside itself, even if that change

the case of a couple or groups) brings to themay begin during the time spent with thesession and how they are functioning at thetherapist.

present moment and within their current

A deeper understanding of the concept ofsystems of reference is considered to be the“change” is needed in order to fully clarify thismost effective and suitable approach.

point. However, we can say that in relation to

The therapist therefore believes that in orderthis principle, the therapist conducts part of theto maximise the effectiveness of the single

session with the view that the person’s life issession, interventions on current processes,

lived outside the session, and so it is here that ageared to changing what is actually happening

large part of the process of change will occur.

now and in the client’s current situation, areThe client could therefore be helped by thepreferable to explorative processes based on theassignment of homework, or the drafting of an

past.

action plan, or a discussion of what it might beuseful to do or think differently once theSINGLE SESSION THERAPY MINDSET

XX
17

session is over and the person is back in theirthat the therapist does not attempt to conduct

daily life, with the problem they are facing or

the session in an improvised manner.

the goal they wish to achieve.
Nevertheless, the therapist attaches great

13.

A

CLIENT-THERAPIST

importance to what happens within the session;

RELATIONSHIP CAN BE ESTABLISHED

it is simply that they do not assume that all the

RAPIDLY

work must be done in the space of a single

The therapist is aware of the importance ofhour, and believe that in order to maximise thethe therapist-client relationship for the successlikelihood of the session being single, they needof any therapy and believes that this can beto help the person to somehow translate what

created rapidly even within a single session,

happens in the session to their own life.

and in a way which facilitates success. The

As mentioned, there may be a number oftherapist does not place any theoretical or

methods of doing this (5th Principle), and theepistemological limits on the possibility oftherapist does not think that inducing suchconnecting appropriately in the course of achange should be geared to producing major

single session.

differences (8th Principle).
14.
12. A STRUCTURE IS NEEDED FOR
THE SINGLE SESSIONNOTHING

IS

TAKEN

FOR

GRANTED
The therapist believes that although theTherapists know that single sessions alsoclient may have resources, he or she does not

happen when they are not planned (unplanned

necessarily possess those needed to achieve thesingle sessions). However, they also know that

goal, or is not necessarily able to recognise,approaching every session with the idea that it

access or use them. Furthermore, although the

may be the only one, and therefore with aclient is the expert in their own life, theprecise (but flexible) structure in mind,

therapist does not overestimate their level ofincreases the likelihood that the session will be

self-awareness or take it for granted that thethe only one needed (planned single session).

client sees and thinks the things they see andThey therefore believe it is necessary to have athink. This principle reflects the flexibility withsingle session structure to follow, which iswhich the therapist approaches the single

obviously flexible and adaptable, but ensuressession and their understanding of the session

XX
18

Cannistrà.

as strongly adapted to the needs of the person

behaviour, the aim of the session is to find aand their situation.

way, a strategy to start the process.
So we agree to focus on this small objective,

Mindset in practice: a clinical caseand to this end I ask her if there have been

M. presents with a problem she has had forsituations in the past when she managed to stop

forty-two years: she is fifty, and since the age

pulling out her hair. She answers no: at certainof eight she has been pulling out her hair. She

times she might do it more, but she links thisdoesn’t do it to excess; there appear to be no

closely to poorly-defined periods of stress. I

bald patches and she does not need to wear hatspush her a little, seeking to identify possible

or other head coverings. Nevertheless she does

exceptions of the problem that might bethis constantly and frequently: every day she

addressed systematically, but we find nothing.

plays with her hair and pulls out five, ten,
fifteen hairs, sometimes more…

strategy before the end of the session whichFirst I explore with her how the problem
works.

I

avoid

using

Then, still with the idea of trying to find athewill help her start the process of stopping theterm

behaviour, I ask if there have been other habits“trichotillomania”, since she herself does not

she has given up and how this was done. M.

use it. Instead, I try to understand the issue

tells me that indeed, she used to smoke, and shefrom her perspective: I ask her to describe how

stopped more or less from one day to the next. I

she does it, when, in which situations…

ask her to go into details, and she tells me that

Although this is something that has been withafter years and years of smoking cigarettes, one

her uninterruptedly all her life, I don’t go into

day a friend challenged her, saying she was

the past at all, except to satisfy myself that theincapable of stopping. “I don’t feel the need”,

problem is not connected to an event she

she said, “but if you give up, I will too”. Whenconsiders important in her current life. For thethe friend agreed, M. found herself having tosame reasons, I don’t link the problem to any

keep her word. “To start with I didn’t know

particular symbolic interpretation or family

how to do it, but then I realised something: I

dynamic: I stay always with the here and now,

didn’t have to give up smoking, all I had to do

how she feels today.

was resist one cigarette. And it’s easy to not

After this investigation I ask her what goal
she would like to achieve by the end of oursession: while the aim of therapy is to stop thesmoke one cigarette!” And from that moment
she stopped smoking completely.

SINGLE SESSION THERAPY MINDSET

XX
19

I ask her if she could do the same: resist

We are in touch by email four more times:

pulling out the first hair. She says yes, but

two months, five months and nine months after

without much conviction. So I ask her whether

the second session, and then almost three years

she was ever tempted to go back to smoking,after, when I reach her for an update for thisand how she handled it. M. replies that for a

article. M. has still not pulled out a single hair,short period she would suck liquorice sweets as

not even after her father’s death, whichan alternative to smoking, and I ask her whether

occurred between our second and third

she can do the same now. Again, she agrees,

conversations. She sometimes plays with her

but seems unconvinced. When I ask her if thishair, but she no longer pulls it out.

strategy might work, she agrees, but when I ask
if this session will be enough, she says she’dlike to book another.

We consider this to be an emblematic casefor several reasons. Firstly because it shows

We meet again three weeks later: she hasn’t

that a single session was sufficient: indeed, thepulled out a single hair. I ask her if she needed

second visit was merely a catch-up, without

the liquorice and she replies that she reallyreinforcement or the suggestion of further

doesn’t know what happened: she hasn’t usedstrategies. Secondly, it shows how a behaviour

the liquorice, and neither has she thought aboutthat has been ongoing for a very long time

“resisting pulling out a single hair”. Quite(forty-two years) and has never spontaneously

simply, she quit overnight.

been interrupted (“not even a single week”) can

I ask her if, in forty-two years, she has evercease completely and without repercussions

gone three weeks without pulling out her hair,after just one session with a therapist: thisand she answers no: “Not even one week”.

seems significant to us, partly in view of the

She tells me she’s happy and thinks she

belief that, for reasons linked to longstanding

won’t need further sessions. I’m slightly

unconscious dynamics, deep-rooted cognitive

concerned that a behaviour that has lasted suchanda long time might recur unless we work toneurological structures, change is impossible inconsolidate the results, but I keep this thoughta single session. Lastly, we wanted to illustrate

to myself, only saying that my door is open anda case in which even the strategic planning of

asking her permission to contact her from time

the therapist (the idea of using liquorice as ato time for research purposes, to see how she’s

substitute) was superfluous: although this does

doing.

not help us understand what specifically helped

behavioural

patterns

orestablishedXX
20

Cannistrà.

the client, it allows us to hypothesise how a

are treating, or who believe their task is not

person’s own resources were able to make thenecessarily to “resolve” anything by the end ofdifference, and we hope this will serve as

the session.

inspiration for anyone considering a single
session mindset.

More in-depth analysis of the literature, oreven analysis simply carried out by a different
observer, could undoubtedly provide anotherConclusions
We hope the fourteen principles discussed

reading of the principles underlying thementality of therapists who use SST in theirown practice. However, we hope we have madeabove will be helpful to therapists seeking toa meaningful contribution for those wishing tounderstand how to help people in a single

adopt this effective way of helping people.

session.
We have attempted to demonstrate how
mindset - i.e. the series of beliefs that influence
the therapist’s actions - is fundamental in taking
therapy in one direction rather than another. In

References
Barnes, M., Carruthers, P. & Gigovic, M.
(2018). One...Two...Three Ways to Help
You Today: Therapeutic Models in aSingle-Session Therapy Program. In M. F.

fact, many writers believe that the decision not

Hoyt, M. Bobele, A. Slive, J. Young & M.

to adopt a single session model, in spite of the

Talmon (Eds.), Single-session therapy by

results and benefits the past thirty years of

walk-in or appointment: Administrative,

research have brought, is influenced by theirclinical,own mindset, and, we could say, theirepistemology. And even therapists who wish to
adopt, or have already adopted, a SST approachandone-at-a-timesupervisory
services(pp.

aspectsof

175-185).

Routledge.
Bedggood, J. (2018). The First Time: Teaching
Skills that Prepare Interns and New

can often be hampered by certain elements ofTherapists for Walk-In Counseling. In M. F.

their mindset: it is not uncommon to comeHoyt, M. Bobele, A. Slive, J. Young & M.

across a therapist who, even while practising

Talmon (Eds.), Single-session therapy by

SST, believes it does not work for “personality

walk-in or appointment: Administrative,

disorders”, or that it is “impossible to resolve
certain problems in a single session”. We now
know that this at the very least contradicts theview of colleagues who prefer to avoid anosographic interpretation of the person theyclinical,andone-at-a-timesupervisory
services(pp.

aspectsof

327-333).

Routledge.
Bernstein, R. J. (2010). The Pragmatic Turn.
Polity Press.
Bloom, B. L. (1992). Planned short-term

XX
21

SINGLE SESSION THERAPY MINDSET

psychotherapy: Current status and future

Familychallenges.

Applied&https://doi.org/10.1017/aft.2012.3

Psychology,1(3),157–164.

Preventive

Therapy,33(1),

15-26.

DOI:

DOI:

Cannistrà, F. (2021). The vital role of thehttps://doi.org/10.1016/S0962-1849(05)801

therapist’s mindset. In M. F. Hoyt, J. Young

37-4& P. Rycroft (Eds.), Single session thinking

Bobele, M., Fullen, C., Houston, B., Martinez,

and practice in global, cultural, and familialA., Moffat, L. & Santos, L. (2018). Westsidecontexts:

Stories:

77-87). Routledge.

Walk-In

andSingle-Session

Expandingapplications(pp.

Therapy in San Antonio. In M. F. Hoyt, M.

Cannistrà, F., Piccirilli, F., D’Alia, P. P.,

Bobele, A. Slive, J. Young & M. Talmon

Giannetti, A., Piva, L., Gobbato, F.,(Eds.), Single-session therapy by walk-in or

Guzzardi, R., Ghisoni, A. & Pietrabissa, G.

appointment: Administrative, clinical, and(2020).

supervisory

Clients’ Experiences of Single Session

aspectsofone-at-a-time

services (pp. 221-250). Routledge.
B.

the

Incidence

andTherapy in Italy: A Feasibility Study.

Bobele, M., López, S. S.-G., Scamardo, M., &Solórzano,Examining(2008).

Australian and New Zealand Journal of
FamilyTherapy,

41,271-282.

Single-session/walk-in

therapywith

DOI:10.1002/ANZF.1421

Mexican-American

clients. JournalofCannistrà, F. & Piccirilli, F. (2021). Single

Systemic Therapies, 27(4), 75–89. DOI:

Session Therapy. Principles and Practices.

https://doi.org/10.1521/jsyt.2008.27.4.75

Giunti.

Bobele, M. & Slive, A. (2021). An Open

Connor, D. R. & Callahan, J. L. (2015). Impact

Invitation to Walk-In Therapy: Openingof psychotherapist expectations on client

Access to Mental Health Care. In M. F.

outcomes. Psychotherapy, 52(3), 351–362.

Hoyt, J. Young & P. Rycroft (Eds.), Single

DOI: https://doi.org/10.1037/a0038890

session thinking and practice in global,

Cummings, N.A. (2000). The single session

cultural, and familial contexts: Expanding

misunderstanding. In The Collected Papers

applications (pp. 54-65). Routledge.

of Nicholas A. Cummings. Vol. 1: The Value

Boyhan, P. (2014). Innovative uses for single
session therapy: Two case studies. In M. F.
Hoyt & M. Talmon (Eds.), Capturing the
moment: Single session therapy and walk-in
services (pp. 157-176). Crown House
Publishing Limited.
Campbell,A.

(2012).

of Psychological Treatment (p. 77). Zeig,
Tucker & Theisen.
Dryden, W. (2019). Single-Session Therapy:
Distinctive Features. Routledge.
Feldman, D. B. & Dreher, D. E. (2012). Can
Hope be Changed in 90 Minutes? TestingSingle-Session

theEfficacyofaIntervention

Single-Session

Approaches to Therapy: Time to Review.

Goal-PursuitforCollege

Australian and New Zealand Journal ofStudents. Journal of Happiness Study, 13,

XX
22

Cannistrà.

745-759. DOI: 10.1007/s10902-011-9292-4

session thinking and practice in global,

Gergen, K. & McNamee, S. (Eds.). (1991).

cultural, and familial contexts: Expanding

Therapy as Social Construction. Sage.

applications (pp. 29-41). Routledge.

Guthrie, B. (2018). Reflections on Providing

Hoyt, M. F., Bobele, M., Slive, A., Young, J. &Single-Session Therapy in Post-Disaster

Talmon, M. (Eds.) (2018a). Single-Session

Haiti. In M. F. Hoyt, M. Bobele, A. Slive, J.

Therapy

Young & M. Talmon (Eds.), Single-session

Administrative, Clinical, and Supervisory

therapy

Aspectsbywalk-inor

appointment:

Administrative, clinical, and supervisory
aspects of one-at-a-time services (pp.
303-317). Routledge.

by
of

or

Appointment.

One-at-a-Time

Services.

Routledge.
Hoyt, M. F., Bobele, M., Slive, A., Young, J. &Talmon,Harper-Jaques, S. (2018). Supervision and theWalkinM.

(Eds.).

(2018b).

Single-Session/One-at-a-Time

Walk-In

Single-Session Therapist: Learnings from

Therapy. In M. F. Hoyt, M. Bobele, A. Slive,

Ten Years of Practice. In M. F. Hoyt, M.

J.

Bobele, A. Slive, J. Young & M. Talmon

Single-session(Eds.), Single-session therapy by walk-in or

appointment: Administrative, clinical, andappointment: Administrative, clinical, andsupervisory

supervisory

services (pp. 3-23). Routledge.

aspectsofone-at-a-time

services (pp. 334-346). Routledge.

Young

&

M.

Talmontherapy
aspectsby(Eds.),

walk-inofor

one-at-a-time

Hoyt, M. F., Bobele, M., Slive, A., Young, J. &Hoyt, M. F. (2009). Brief Psychotherapies:

Talmon, M. (Eds.). (2018c). Walk-In andPrinciples & Practices. Zeig, Tucker &By-Appointment Single Sessions Now and

Theisen.

in the Future. In M. F. Hoyt, M. Bobele, A.

Hoyt, M. F. (2017). Brief Therapy and Beyond:

Slive, J. Young & M. Talmon (Eds.),

Stories, Language, Love, Hope, and Time.

Single-session

Routledge.

appointment: Administrative, clinical, andHoyt, M. F. (2018). Single-Session Therapy:
Stories, Structures, Themes, Cautions, andProspects. In M. F. Hoyt, M. Bobele, A.

supervisory

therapy
aspects

byofwalk-inor

one-at-a-time

services (pp. 369-378). Routledge.
Hoyt,

M.

F.

&

Cannistrà,

Single-Session

Single-session

orapproach to effectively and efficiently

appointment: Administrative, clinical, andsolving client problems. Italian Journal ofsupervisory

Mental Health, CXLIII, 1, 74-85. DOI:

aspects

byofwalk-inone-at-a-time

services (pp. 155-174). Routledge.
Hoyt, M. F. (2021). The Hope and Joy ofA(2019).

Slive, J. Young & M. Talmon (Eds.),
therapy

Therapy:F.

healthful

10.3280/RSF2019-001005
Hoyt, M. F., Rosenbaum, R., & Talmon, M.

Single-Session Thinking and Practice. In M.

(1992).

Plannedsingle-session

F. Hoyt, J. Young & P. Rycroft (Eds.), Single

psychotherapy. In S. H. Budman, M. F. Hoyt,

XX
23

SINGLE SESSION THERAPY MINDSET& S. Friedman (Eds.), The first session inclinical,andbrief therapy (pp. 59–86). Guilford Press.

one-at-a-time

Hoyt, M. F. & Talmon, M. (Eds.). (2014).

Routledge.

supervisory
services

aspects(pp.

of

251-259).

Capturing the Moment: Single Session

McDonald, J., Hickey, P. & Wyder, M. (2021).

Therapy and Walk-In Services. Crown

Implementing Single Session Thinking in a

House Publishing.

PublicMentalHealthSettingsin

Hoyt, M. F., Young, J. & Rycroft, P. (2021).

Queensland: Part II — Adapting andSingle Session Thinking and Practice in

Integrating Single Session Therapy into an

Global, Cultural, and Familial Contexts.

Acute Care Setting. In M. F. Hoyt, J. Young

Routledge.

& P. Rycroft (Eds.), Single session thinking

Institute of Psychoanalysis (n.d.). Cost and
Time.

URL:

https://psychoanalysis.org.uk/what-is-psych
oanalysis/cost-and-timeand practice in global, cultural, and familial
contexts:

Expandingapplications(pp.

110-116). Routledge.
McElheran, N. (2021). The Story of the

Josling, L. & Cait, C. (2018). The Walk-In

Eastside Family Centre: 30 Years of Walk-In

Counseling Model: Research and Advocacy.

Single Session Therapy. In M. F. Hoyt, J.

In M. F. Hoyt, M. Bobele, A. Slive, J. Young

Young & P. Rycroft (Eds.), Single session& M. Talmon (Eds.), Single-session therapy

thinking and practice in global, cultural,

by walk-in or appointment: Administrative,andclinical,applications (pp. 125-133). Routledge.

andone-at-a-timesupervisory
services

aspects(pp.

of

91-103).

Routledge.
Keeney,H.

familial

contexts:

ExpandingMiller, J.K. (2011). Single-session intervention
in the wake of hurricane Katrina: Strategies&

Keeney,B.

(2014).

for disaster mental health counseling. In A.

Deconstructing therapy: Case study of a

Slive, & M. Bobele, (Eds.). When one hour

single session crisis intervention. In M. F.

is all you have: Effective therapy for walk-in

Hoyt & M. Talmon, (Eds.), Capturing theclients (pp. 185-202). Zeig, Tucker, Theisen

moment: Single session therapy and walk-in

Publishing.

services (pp. 441-461). Crown House
Publishing Limited.

Miller, J. K., Platt, J. & Conroy, K. M. (2018).
Single-Session Therapy in the Majority

Levin, S. B., Gil-Wilkerson, A. & Rapini De

World: Addressing the Challenge of Service

Yatim, S. (2018). Single-Session Walk-Ins

Delivery in Cambodia and the Implications

as a Collaborative Learning Community atfor Other Global Contexts. In M. F. Hoyt, M.

the Houston-Galveston Institute. In M. F.

Bobele, A. Slive, J. Young & M. Talmon

Hoyt, M. Bobele, A. Slive, J. Young & M.

(Eds.), Single-session therapy by walk-in or

Talmon (Eds.), Single-session therapy byappointment: Administrative, clinical, andwalk-in or appointment: Administrative,

supervisory

aspectsofone-at-a-time

XX
24

Cannistrà.

services (pp. 116-134). Routledge.

Rycroft, P. & Young, J. (2014). SST in

O’Hanlon, B. & Rottem, N. (2021). Single

Australia: Learning from Teaching. In M. F.

Session Family Consultation. In M. F. Hoyt,

Hoyt & M. Talmon (Eds.), Capturing the

J. Young & P. Rycroft (Eds.), Single session

moment: Single session therapy and walk-in

thinking and practice in global, cultural,

services (pp. 141-156). Crown Houseand

Publishing Limited.

familial

contexts:

Expandingapplications (pp. 66-76). Routledge.

Rycroft, P. & Young, J. (2021). Translating

Paul, K. E. & Mark van Ommeren, M. (2013).

Single Session Thinking into Practice. In M.

A primer on single session therapy and its

F. Hoyt, J. Young & P. Rycroft (Eds.), Single

potential

humanitariansession thinking and practice in global,

situations. Intervention, 11(1), 8-23. DOI:

cultural, and familial contexts: Expanding

10.1097/WTF.0b013e32835f7d1aapplications (pp. 42-53). Routledge.

applicationinRodriguez, I. J. (2018). Terapia Breve Sin Cita:
Collaboration

with

Marginalized

Mumper, E., & Mullarkey, M. C. (2020).

Community in Mexico City. In M. F. Hoyt,

Acceptability and utility of an open-access,M. Bobele, A. Slive, J. Young & M. Talmon

online single-session intervention platform(Eds.), Single-session therapy by walk-in orfor adolescent mental health. Journal of

appointment: Administrative, clinical, andMedical Internet Research: Mental Health,supervisory7, e2013. DOI: 10.2196/20513

aspectsaSchleider, J. L., Dobias, M. L., Sung, J. Y.,of

one-at-a-time

services (pp. 291-302). Routledge.

Schleider, J. L., Sung, J. Y., Bianco, A.,

Rosenbaum, R., Hoyt, M. F., and Talmon, M.

Gonzalez, A., Vivian, D., & Mullarkey, M.

(1990). The challenge of single-session

C.

therapies: Creating pivotal moments. In R.

single-session

Wells and V. Giannetti (Eds.), Handbook ofclients on psychotherapy waitlists. The

the brief psychotherapies (pp. 165-189).

Behavior

Plenum Press.

10.31234/osf.io/fdwqk

Rosenthal,

R.

&

Jacobson,L.

(2021).

Open

pilot

consultation

Therapist,

44,

trial

of

a

service

for

8-15.

DOI:

(1992).

Slive, A & Bobele, M. (2012). Walk-In

Pygmalion in the classroom, Expanded

Counselling Services: Making the Most ofedition. Irvington.

One Hour. Australian and New Zealand

Rycroft, P. (2018). Capturing the Moment inSupervision. In M. F. Hoyt, M. Bobele, A.
Slive, J. Young & M. Talmon (Eds.),
Single-session

therapy

Slive, A. & Bobele, M. (2014). One Session ata time: When you have a Whole Hour. In M.

appointment: Administrative, clinical, andF. Hoyt & M. Talmon (Eds.) (2014),

supervisory

Capturing the moment: Single sessionofwalk-in

DOI: 10.1017/aft.2012.4

oraspects

byJournal of Family Therapy, 33(1), 27-38.

one-at-a-time

services (pp. 347-365). Routledge.

therapy and walk-in services (pp. 95-119).

XX
25

SINGLE SESSION THERAPY MINDSET

Crown House Publishing Limited.

& M. Talmon (Eds.), Single-session therapy

Slive. A. & Bobele, M. (2018). The Three Top

by walk-in or appointment: Administrative,

Reasons Why Walk-In Single Sessions

clinical,andMake Perfect Sense. In M. F. Hoyt, M.

one-at-a-time

Bobele, A. Slive, J. Young & M. Talmon

Routledge.

supervisory
services

aspects(pp.

of

72-90).

(Eds.), Single-session therapy by walk-in or

Story, K. (2018). Coming In for Tune-Ups: A

appointment: Administrative, clinical, andFamily’s Experience of Episodic Long-Termsupervisory

Single-Session Therapy at the Bouverie

aspectsofone-at-a-time

services (pp. 27-39). Routledge.

Centre, Melbourne. In M. F. Hoyt, M.

Slive, A., McElheran, N. & Lawson, A. (2008).

Bobele, A. Slive, J. Young & M. Talmon

How Brief Does It Get? Walk-In Single(Eds.), Single-session therapy by walk-in or

Session Therapy. Journal of Systemic

appointment: Administrative, clinical, andTherapies,

supervisory

27,

5-22.

DOI:

10.1521/jsyt.2008.27.4.5
Söderquist, M. (2018).

aspectsofone-at-a-time

services (pp. 202-220). Routledge.

Coincidence Favors

Talmon, M. (1990). Single-session therapy:

the Prepared Mind: Single Sessions with

Maximizing the effect of the first (and often

Couples in Sweden. In M. F. Hoyt, M.

only) therapeutic encounter. Jossey-Bass.

Bobele, A. Slive, J. Young & M. Talmon

Talmon, M. (2014). When less is more:(Eds.), Single-session therapy by walk-in or

maximizing the effect of the first (and often

appointment: Administrative, clinical, andonly) therapeutic encounter. In M. F. Hoyt

supervisory& M. Talmon (Eds.), Capturing the

aspectsofone-at-a-time

services (pp. 270-290). Routledge.
Soo-Hoo, T. (2018).

moment: Single session therapy and walk-in

Working Within the

Client’s Cultural Context in Single-Session
Therapy. In M. F. Hoyt, M. Bobele, A. Slive,
J.

Young

Single-session&

M.

therapy

Talmon27-40).

Crown

House

Publishing Limited.
Talmon, M. (2018).

The Eternal Now: On

Becoming and Being a Single-Session
Therapist. In M. F. Hoyt, M. Bobele, A.

appointment: Administrative, clinical, andSlive, J. Young & M. Talmon (Eds.),

supervisory

Single-sessionofwalk-in(pp.

or

aspectsby(Eds.),

services

one-at-a-time

services (pp. 186-202). Routledge.
Stewart, J., McElheran, N., Park, H., Maclaurin,
B., Fang, C., Oakander, M. & Robinson, A.

therapybywalk-inor

appointment: Administrative, clinical, andsupervisory

aspectsofone-at-a-time

services (pp. 149-155). Routledge.

(2018). Twenty-Five Years of Walk-In

Talmon, M. & Hoyt, M.F. (2014), Moments are

Single Sessions at the Eastside Family

Forever. In M. F. Hoyt & M. Talmon (Eds.),

Centre: Clinical and Research Dimensions.

Capturing the moment: Single session

In M. F. Hoyt, M. Bobele, A. Slive, J. Youngtherapy and walk-in services (pp. 463-485).

XX
26

Cannistrà.

Crown House Publishing Limited.

Norton.

von Glasersfeld, E. (2001). The Radical
Constructivist

View

of

Science.

Foundations of Science, 6(1-3), 31-43. DOI:
10.1023/A:1011345023932
Young, J. (2018). Single-Session Therapy: The
Misunderstood Gift that Keeps On Giving.
In M. F. Hoyt, M. Bobele, A. Slive, J. Young& M. Talmon (Eds.), Single-session therapy
by walk-in or appointment: Administrative,
clinical,andone-at-a-timesupervisory
services

aspects(pp.

of

40-58).

Routledge.
Young, K. (2018). Change in the Winds: The
Growth of Walk-In Therapy Clinics in
Ontario, Canada. In M. F. Hoyt, M. Bobele,
A. Slive, J. Young & M. Talmon (Eds.),
Single-session

therapybywalk-inor

appointment: Administrative, clinical, andsupervisory

aspectsofone-at-a-time

services (pp. 59-72). Routledge.
Young, J. & Rycroft, P. (1997). Single session
therapy:

Capturingthemoment.

Psychotherapy in Australia, 4 (1), 18–23.
DOI: https://doi.org/10.1017/aft.2012.8
Young, J., Rycroft, P. & Weir, S. (2014).
Implementing

SingleSession

Therapy:

Practical Wisdoms from Down Under. In M.
F. Hoyt & M. Talmon (Eds.), Capturing the
moment: Single session therapy and walk-in
services (pp. 121-140). Crown House
Publishing Limited.
Watzlawick, P., Beavin, J. H. & Jackson, D. D.
(1967).

Pragmatics

of

Human

Communication. A Study of Interactional
Patterns,

Pathologies

andParadoxes.

International Journal of Brief Therapy and Family Science
2022 Vol. 12, No.1, 27-39< Original Paper: Research and Experiment>

The Effect of Depression Label on Verbal Communication
Saeko Kamoshida1) Nagisa Sando2) Koubun Wakashima3)
1)

Graduate School of Education, Tohoku University

2)

Tohoku Bunkyo University

3)

Tohoku University

ABSTRACT．This study examines the effect of the diagnosis of depression (depression label) on verbal communication. We set a
situation in which the subject listened to another person’s problem for seven minutes, who they met for the first time. The subjects
were 20 women (M=21.4, SD=1.7), and the independent variables were the presence (labeled group) or absence of a “depression
label” (unlabeled group), which conveyed if the person was a depression patient. The dependent variable was the subjects’ verbal
index (Sando, 2016). The data were analyzed using a 2×5 chi-square test. No significant difference was found in Sando’s (2016)classification (χ2 (4) = 4.134, n.s.). Therefore, we classify and reanalyze the utterances including those in the “Other” category, as
defined by Sando (2016). Results showed that the “labeled group” was less used to “Compliment” than the “unlabeled group” (χ2(3) = 12.887, p<.05). These findings indicate the risk that depressed person with depression label are rejected more by others thandepressed person without depression label in non-continuous relationship, such as first meeting. We further discuss the effects of thedepression label and related issues.
KEY WORDS：depression，label，diagnosis，verbal communication

Introduction

Research on the interaction between a

According to a report by the National Institutedepressed person and othersof Mental Health (NIMH, 2017), an estimatedResearch related to the interaction between

17.3 million people, or 7.1% of all adults in the

depressed people and others has been previously

U.S., have experienced at least one episode of

conducted,

major depression. The number of depressed

psychological distress and depression in apatients and patients diagnosed with depression

depressed person's spouse, family members,

tends to only increase (Ministry of Health, Labor

children, roommates, and others (Benazon,and Welfare, 2017). Depression affects patients

1998; Coyne et al., 1987; Coyne, Burchill &as well as the people around them; it becomes

Stiles, 1990; Howes et al., 1985; Joiner, 1994;

more serious in interpersonal relationships

Joiner, Alfano & Metalsky, 1992; Katz, Beach &(Sugiyama, 2002；Joiner et al., 1992；1993).

Joiner, 1998; Sato, 2006; Takeshima & Matsumi,

CORRESPONDENCE TO: Kamoshida, Saeko. Graduate2013),

School of Education, Tohoku University. 27-1. Kawauchi, Aoba

between depressed people and others (Benazon,

Ward, Sendai City, Miyagi Perfecture, 980-8576, Japan.

1998；Coyne et al., 1987；Coyne, Burchill &e-mail：saeko.kamoshida.s1@dc.tohoku.ac.jp

Stiles, 1990；Howes et al., 1985；Joiner，1994；

27

such

studiesasonassessingverbalsubjective

communication

XX
28

Kamoshida.et al.
Kamoshida

Joiner & Metalsky, 1995 ； Joiner, Alfano &Sando’s (2016) hypothetical method was to set

Metalsky，1992；Katz, Beach & Joiner, 1998；

up a situation in which the subject talked about

Sato, 2006 ； Takeshima & Matsumi, 2013),

a problem of a depressed friend. The participants’studies on verbal and non-verbal communication

advicebetween others and depressed people (Sando,

Specifically,

2016；Kamoshida et al., 2021) can be broadly

negative emotions such as blame and anger,classified.

“Coping”

wasdivided into six categories.
“Criticism”
which

which

suggests

expresses
overcoming

Coyne et al. (1987) indicated that about 40%

mechanisms with little evidence, “Optimism” isof people who had depressed spouses had

simply a positive counteracting statement,

psychologicalrequired“Involvement” which tells the depressed person

psychotherapeutic intervention. Howes et al.

that subject will be involved in solving the(1985) indicated that people who spent threeproblem, “Mix” and “Others”. The subjects whomonths with a depressed roommate showedinteracted with depressed friends with ahigher depression scores than the control group.

depression label, were on a higher rejection

Takeshima and Matsumi (2013) examined thecognitionbutstated“Involvement”

andinteractions between students and their peers. A

suppressed“Optimism,”

contrasting

theirprevious study suggested that depression

behavior towards the unlabeled. Haley (1963)

suppresses the anger and aggressive behavior ofdescribes illness (symptoms) as a paradoxicalothers. Hence, to elucidate such negative effects

communication. Specifically, a person withfromcommunication,

symptoms blames the illness for their behavior,interactions between others and people ineven though it is the subject who is responsible

depression have been examined. Recent studies

for their behavior. In other words, the presenceon communication between depressed personsof a disease (symptom) label makes it

diagnosed with depression and others who

impossible to blame the behavior that isinteract with them (Sando, 2016；Kamoshida etcontrolled by symptoms. Sando (2016) alsoal., 2021) have also been previously conducted.

mentions that when a friend has a depression

thedistress

perspective

that

of

label, others are constrained to make supportive
Research on the interaction between a person

self-involvement statements rather than direct

who has been diagnosed with depression

negative statements to the depressed person.

(depression label) and others

Kamoshida et al. (2021) experimented to

In a study on the interaction with accordance

examine the effects of depression label on theto the diagnosis of depression (depression label),verbal and non-verbal behaviors of others. It sets

Sando

questionnaire

a situation in which the depressed person was

experiment using the assumption method on thelistened to by a subject who they met for the firstinfluence of depression label on the verbal

time in a non-continuous relationship. This

responses of others in lasting relationships.

experiment focused on the direction in which the(2016)

conductedaEFFECT OF DEPRESSION LABELXX
29

subject was trying to develop a conversation in

Kamoshida et al. (2021) set a situation in which

response to the content of the consultation. In

a depressed person met the subject for the first

addition, the utterances were categorized based

time and listened to their worries about theiron brief therapy, such as “Reframing,” “Do

study. The effect of the presence or absence of asomething different” and “Do more.” The results

depression label on the participant’s responseshow that subjects who listened to people withstatements (Sando, 2016) was examined.

depression label used the answer “Do more”,

Sando (2016) mentioned that when thesuch as conveyed rest more, compared tosubject talked to a depressed person with a label,subjects who listened to unlabeled people.

the subject was constrained to make supportive

Besides, this experiment focused on the

self-involving statements, instead of direct

Japanese ending of the word “Ne” (Watanabe &negative comments. Therefore, we hypothesize

Wakashima, 1998), which is used relatively

that we can obtain the same results as Sando

unintentionally among linguistic aspects to(2016), even in the first meeting. Specifically,

encourage more involvement in the conversation.

the others who talked to depressed persons with

The number of participants who listened to adepression label (Labeled group) will makedepressed person was lower than those for a

supportive

person who was not depressed. There was no“Involvement” statements and will make fewer

difference in non-verbal communication, such as“Optimism” statements than those who talked tosilent time, gaze time, or number of smiles.

the unlabeled depressed persons (Unlabeled

Sando (2016) examines the effect of depression

group).

label in lasting relationship. however, there are

Hypothesis: The labeled group has significantly

many situations in which people were exposed

more

to a depression label in non-continuous

significantly fewer “Optimism” statements thanrelationships, such as first meeting. Therefore,

the unlabeled group.

statements“Involvement”

classifiedstatements

as

and

we presume that the depression label may haveaffected communication during the first meeting.

MethodHowever, although Kamoshida et al. (2021)

Survey period

conducted an experiment assuming the effect ofdepression label on the relationship at the first

June 2019 - December 2019
Subjects

meeting, they analyzed the results from different

We analyzed 20 females, (M = 21.4 years, SDvariables than Sando (2016) did. Hence, we= 1.7), excluding the 2 those who responded “Icannot compare Sando (2016) and Kamoshida et

don’t believe the depression label” in theal. (2021).

operation check sheet.

Here, we report the response statements of theAn application was distributed among

subjects in Kamoshida et al. (2021), which

university students. The subjects were recruited

overcomes these limitations. The experiment offrom university classes and snowball samplingXX
30

Kamoshida.et al.
Kamoshida

was conducted. Subjects were recruited on thethe paper in time for the deadline” referring tocondition that they were of the same sex as thestudies

consultant. The

todepressed people (Beck, 1967; Joiner &participate in the experiment after being

Metalsky, 1995; Holmes, Hagan & Joiner, 2013;

informed that they might be required to talk to a

AI-Mosaiwi & Johnstone, 2018). The woman

highly depressed person for seven minutes, theirwho

privacy would be protected, and they were being

collaborator was trained to provide a depressive

recorded on a videotape. 10 subjects were

response to the consultation. In the depressive

randomly assigned to each group (Labeled

response, the depressed person asked others forgroup: M = 21.5 years, SD = 1.7; Unlabeledreassurancegroup: M = 21.3 years, SD = 1.6).

“reassurance-seeking,” and used “but” to cancel

Procedureout the opinions of the subject to express

Depression label“negative evaluation seeking,” in which thesubjects

were

asked

describing

was

the

preparedas

repeatedly,

characteristics

anofexperimental

represented

byIn the labeled group, we said, “The person

depressed person rejects others’ affirmation

who is going to talk is a sophomore female

while seeking reassurance. They also unified to

student attending graduate school, who has been

use the self-attributive denial (Beck, 1967) for

diagnosed with depression. However, based on

negative events such as “I am bad” and linguistic

her current physical condition, we havefeatures such as “I am” and “absolutely” (AI-determined that she will be able to cooperate

Mosaiwi & Johnstone, 2018). In addition, about

with the survey. Please be assured that thethree hours of training were conducted

experiment is safe and secure. We have told her(conducted in March and June 2019) to lower theto tell us as much as she can about what isgaze, nod or respond less, and speak slowly

troubling her. There are no restrictions on(Holmes, Hagan & Joiner, 2013) as non-verbal

communication; please feel free to respond.”

behaviors. Based on the above, a consultation

The unlabeled group said, “The person who isgoing to talk is an ordinally sophomore female
student attending graduate school. We have told

was conducted.
Experimental procedureThe

experimentwasconducted

ina

her to talk about her current problems to the

behavioral laboratory with one-way mirrors at a

extent that she can. There are no restrictions on

university. The experimenter was presented incommunication; please feel free to respond”.

an observation room across a one-way mirror.

Contents of consultation

The subject sat in a chair in the behavioral

We prepared the content of the consultation on
depressive communication with three graduate
students engaged in psychology. We prepared “aconsultation

about

being

physicallylaboratory, and the experiment was recorded ona videotape.
We set up a situation in which the subject

andlistened to a problem from a person who theymentally exhausted and not being able to finish

met for the first time, for seven minutes. The

XX
31

EFFECT OF DEPRESSION LABEL
duration

of

seven

minutes

was

set

in

screening scale for depression before theconsideration that the effect of depression label

experiment, and as in Coyne (1976), it was

could be examined and that it would not be a

decided not to conduct the experiment onburden to the subjects. All experiments were

subjects with high depression who scored more

conducted in a behavioral laboratory. All

than 55 points.

subjects were asked to explain the study, fill out(2)Multiple

a consent form, complete the Japanese version(MMSS) (Terasaki et al., 1991)

Mood

Scale,

Short

Versionof the Zung Self-Reported Depression Scale

In this study, participants were asked to rate(SDS) (Zung, 1965), a depression screening

their current mood state using a four-point scale

instrument to control the degree of depression ofof “not at all (1 point),” to “clearly (4 points)” in

the subjects, exclude highly depressed subjects

relation to eight factors related to emotionalfrom the analysis, and the Multiple Mood Scale,states:Short Version (MMSS) (Terasaki, Koga, &“Loving”. It was used to examine the effects on

Kishimoto, 1991). Next, the label was given, andmood before and after the experiment (i.e.,the subject was asked to “place the chair on the

before and after teaching and communication).

wall where he/she wanted it and decide where to

This was not used in the analysis because it did

sit. At the end of seven min, the experimenter

not correspond to the purpose of this study.

moved back to the laboratory, stopped the video(3)Operation check sheet“Anxious,”

Hostile,“Polite,”andrecording, and terminated communication. The

We asked the participants to indicate whether

subjects were asked to move to another room,

they believed the labels they were taught andand then they were asked to complete the shortwhether they were aware that they were in a realversion of the MMSS again. Finally, as aconsultation situation and were not acting.

debriefing, an explanation of the experiment andProcedures for analyzing speech content

a operation check were conducted. In the

Data for linguistic analysis

operation check, the participants were evaluated

The data analysis was conducted for sevenfor the credibility of their perception of theminutes after the speaker began to talk about her

actualproblems.

consultation.

Subsequently,

theexperiment was terminated.
Ethical considerations

Coding and analysis of verbal communication
First, we created a protocol for the seven

The Tohoku University Graduate School ofminutes of conversation data to be analyzed.

Education’s Ethics Committee granted ethical

Next, the data dividing into unit of speech based

approval for this study (ID: 19-2-005).

on Ito’s (1991) definition of sentence. When the

Scalessame person speaks continuously, a silence of(1 Zung Self-Reported Depression Scale (SDS)

one second or more is considered a break. The(Zung, 1965)

kappa coefficient was calculated between the

The SDS (Zung, 1965) was used as a

two raters for the classification of speech units,

XX
32

Kamoshida.et al.
Kamoshidaand the agreement was high, k=0.874. Next, thethe total number of utterances (N=1301), theresponse utterances of the subjects wereones excluding exclamations such as “um,” “ah,”classified based on the utterance categories ofand “yes” and those corresponding to fact-

Sando (2016). The response utterances werechecking (N=707) were used for the analysis

categorized into six categories：①Blame, ②(N=295). In addition, since none of the

Coping, ③ Optimism, ④ Involvement, ⑤utterances in this study corresponded to “Blame”

Mix，⑥Other (Table1).

(N=0), they were not used in the analysis.

Next, we selected one of the conversationaldata, calculated the kappa coefficient between
the raters, two graduate students who wereTable 1．U tterances categories（S ando，2016，p．59，Table3- 1）

IBM SPSS Statistics 27 was used forstatistical analysis.
T able 2．Example of Utterances that was discussed

L8-61

Subject expresses negative emotions, such as blame, anger,
and so on, in response to the depressed person'sBlame

negative comments.
Or they are making negative evaluations.
Ex）"You're overreacting", "T hen, you should die"A sudden offer of a coping strategy that

Copinghas little evidence or is optimistic.
Ex）"You shouldn't die", "You should m ake up with friend"

But no one can do everything perfectly,
so if you can't plan it out, don't be upset.

L8-62 One time, I guess, in my own way.
L8-63

If you can do one of them, I don't thinkanyone can do it perfectly right away.

L8-64 Let's just start with what we can do first.
L8-65 I think it can be a feeling.

A statement that simply counteracts
a depressed person's negative statement

Optimismwith a positive one.

IBM SPSS Statistics 27 was used for

In response to the depressed person's negative comments,

statistical analysis. First, we confirmed the

Subjects states that subject will be involved in solving

Involvement

the problem.
Ex）"I'll talk to you about it if it's okey with you""Let's figure out a way to make up together"
One that contains more than one (2 or more) ofMix

the above categories.
Ex）"D on't think about dying. D on't worry, we'll m ake up.""That's not true, Mr. A wants to make up with you too"

Other

Data analysis

Ex）"You can m ake it up", "T hat's not true, you'll be fi ne"

Anything that did not categorise of the above categoriesEx）"W hy did you fi ght? ", "Oh m y god"

participants’ depressive state bias. A t-test was
conducted. The independent variables were thelabel and unlabeled groups. The dependent
variable was the SDS score. Next, a 2×5 chisquare test (test of differences in proportions)licensed clinical psychologists and specialized

was conducted. The independent variables werein communication, and found a low agreement

the label and unlabeled groups. The dependent

rate of k=0.579; therefore, the raters discussed

variable was the subject's statements classified

and recorded the data. When the kappa

according to the categories of Sando (2016).

coefficient was calculated using the sameprocedure, the agreement rate was as high as

Resultsk=0.838; therefore, the grading was performed

Confirmatory analysis of bias in SDS scoresby one experimenter. The following are some

A t-test was conducted. The results showed no

examples of utterances that caused disagreement

significant bias (t(1, 18)=0.842, n.s.). Hence, theamong the raters (Table2).

following subjects were used for analysis in thisTo

removeasmanycommunicative

characteristics of each subject as possible, out ofstudy.

XX
33

EFFECT OF DEPRESSION LABELClassification of response statements tounlabeled group. The dependent variable wasdepressive person.

the utterances of “Other” statements classified

A 2×5 chi-square test (test of differences inproportions) was conducted (Table3). The
results showed no significant bias (χ2(4)=4.134,n.s.). Mixes (N=4) like coping with optimism,

by the KJ method (Table4).
Table 4．Utterances categories of “Others”
Something that is emotionally close to you.
Ex）"Well, it's hard when there are 30 people, isn't it?"

Empathy”It's difficult "It makes you feel incredibly anxious when
you don't have something concrete to settle on”

and so on, were combined with others.

Something that praises or shows affirmation.
Ex）”I think it's great”

Compliment”It occurred to me that it's also very kind of

Table 3．2×5 chi-square test

you to feel sorry for it.”
Anything that discloses events from the subject's own past．

LabeledUnlabeled

Total

Self

Ex）”I'm an economics major.”(N =264)(N =330)(N =594)

disclosure”There was a time when I was having a lot of trouble

46(17.4%)

68(20.6%)

114

with my club activities, and at that time...”CopingOne that contains more than one (2 or more)of the above categories.

MixEx）"I think it's hard to read books, isn't it?

Optimism4(1.5%)

3(0.9%)

7

Involvement82(31.1%)

87(26.4%)

169

Mix

3(1.1%)

1(0.3%)

4=12.887, p<.05), and the labeled group used

300

“Compliment” fewer times than the unlabeled

Other

129(48.9%) 171(51.8%)

Labeled=the group with depression label

I have a graduation thesis to write, too."

The results showed a significant bias (χ2(3)group (p<.01) (Table5).

Unlabeled=the group without depression label

Table 5．2×4 chi-square test

Microscopic classification of “other” (Sando,

LabeledUnlabeledTotal2016) responses.

(N =129)(N =171)(N =300)

The contents of the “Other” responses

Empathy26(20.2%)

21(12.3%)

47(N=295) obtained in this study were classified

Compliment**

23(17.8%)55(32.2%)

78

76(58.9%)94(55.0%)

170

4(3.1%)

1(0.6%)

5

using the KJ method (Kawakita, 1967). To

Selfeliminate arbitrariness, two graduate students

disclosure

who were licensed clinical psychologists andMix*p <.05, **p< .01, ***p< .001

specialized in communication classified all theLabeled=the group with depression label

conversation data, and we tried to make the basis

Unlabeled=the group without depression labelof the classification as clear as possible. As aresult,three

categories

were

obtained:

Discussion“Empathy”, “Compliment”,“Self-disclosure”,

The purpose of this study was to examine theand “Mix”.Table4 shows the characteristics ofeffect of the presence or absence of depression

each category as the basis for the extracted

label on first meeting others on the subject's

classification.

response utterances (Sando, 2016).

Next, we conducted a 2×4 chi-square test

There was no difference in response(test of differences in proportions). The

utterances (Sando, 2016), between the labeled

independent variables were the label andand unlabeled group. Therefore, this hypothesis

XX
34

Kamoshida.et al.
Kamoshidais not supported.

continuous relationship, and the response

The reasons why the hypothesis was notsupported, unlike Sando (2016), were that therefrained from compliment. Therefore, this was
avoided.

relationship in this study was the first meeting,

Two aspects of this result can be suggested.

and the study used face-to-face communication.

First, the subjects did not convey compliment

In contrast to the questionnaire survey, it isstatements because they did not have a positive

assumed to involve more subtle communication

impression of others with depression label,than that defined by Sando (2016). Face-to-facewhich is a direct inference. For example,

communication may have occurred while

Yoshioka and Misawa (2012), who examined

observing others and developing the topic

causal attributions of mental illness on social

through interaction. Therefore, it can be said that

distance, showed that evaluating depression as

the content of the utterances in this study was

dangerous increased social distancing. In

relatively more categorized as “Other,” and it

communication, Howes and Hokanson (1979)

was expected to be examined microscopically.

and Gotlib and Robinson (1982) have shownIn

examinedthat others use silence and direct negative

communication in lasting relationships, but thisexpressions toward the depressed persons they

study did not examine in non-continuous

meet for the first time without depression label.

relationships. Therefore, no significant in non-Thus, it can be seen that depression andcontinuous relationship.

depressive disorders are, in general, relatively

addition,

In

this

Sando

study,

many(2016)

utteranceswereeasy to be evaluated negatively.

categorized as “Other”. Thus, we reanalyzed theOn the other hand, Haley (1963) states that

content of the responses classified as “Other” inothers cannot reject the behavior of a person

Sando(2016). We reclassified the data using thewith a disease (symptom). Sando (2016) found

KJ method (Kawakita, 1967). It was classified

that people with depression label were notinto four categories: “Empathy,” “Compliment,”

communicate rejection even though they had“Self-disclosure,” and “Mix”. The results

rejection perceptions. Therefore, the results ofshowed that the ratio of the four categories was

Sando (2016) can be interpreted in the same way

examined with and without depression label, andas those of Haley (1963). However, in this study,

the labeled group showed fewer “Compliment”

the results showed that the participants were able

statements.

to show avoidance. In other words, the restraint

This contrasts with the results of Sando

of others, which is the inability to reject the(2016). In Sando (2016), when there wasactions of those with depression label, seems todepression label on others in lasting relationship,

be demonstrated only when the relationshipthe response was supportive speech included incontinues. Thus, it is possible that in the present“Involvement” statements. However, in thisstudy, the others were able to show avoidance

study, depression label others in a non-despite the accompanying depression label.

XX
35

EFFECT OF DEPRESSION LABEL
Second, subjects might have been fearful ofwhich is to shorten the distance with the othermaintaining the relationship or worsening theperson and to directly touch the matter with thesymptoms when they conveyed compliments toother person, and it is also said to be politenessa person with depression label. Namiki et al.

of “sympathy” or “solidarity.” Therefore, it can(2015) found that managers felt “unsure of how

be assumed that in the unlabeled group, subjects

to treat” and “confused about how to treat” thosewere told that they were listening to an “ordinary

who returned to work after depression. It is

graduate student,” had a relatively smaller FTA

possible that the situation of “not knowing how

than the labeled group, even though the content

to treat them” was reproduced in this study, andof their consultations was similar, and that they

that

were

were evaluated to be at a lower risk of becoming

suppressed because they considered “what to say

distant. In other words, depression label may

to them.

have caused the subjects to evaluate the content

therespondents'

compliments

Additionally, the effect of the suppression ofof the others as lacking proximity needs, and tocompliments on the interpersonal system was

suppressconsidered. Brown and Levinson (1978) and“Compliment”. Kamoshida et al. (2021) foundTakiura (2008) explain politeness theory, whichthat when depression label was not attached, theis a basic stance in interpersonal relationships

endingand a means of communicating the distanceconversation, varied depending on the attitude of

between the other person and oneself. In

the others, but when depression label waspoliteness theory, speech strategies are used toattached, there was no variation in the way theminimize face-threatening acts (FTA), which

subjects interacted with the ending particle “Ne,”indicate the desire for dialogue between twoeven if the attitude of the others changed.

people. Among these, negative politeness

Therefore, based on the results of Kamoshida etstrategies

politenessal. (2021), depression label in a first-meetingstrategies (PPS) have been proposed. PPS isrelationship may cause a sense of social distanceused when the speaker evaluates others as

between the subjects and others.

(NPS)

and

positiveverbalparticle

expressions

“Ne,”

which

such

as

encourages

having a relatively high desire for proximity and

Finally, we discuss the impact of this study’s

when the speaker attempts to approach others.

results on others with depression in actual

Meanwhile, NPS is used when others adjust to

clinicalengage in social distancing. In particular,

suppression

compliments are classified as PPS and are usedinteractions with depression label will reduce thewhen the speaker evaluates the interaction ofsense of acceptance of patients with depression.

others as having a desire for proximity in the

Sugiyama (2002) defined “perceived-being-

relationship or when the other's FTA is estimatedaccepted” as the perception and emotion that one

to be relatively small. It is said to befeels about the existence of others who support

characterized by the empathy of the expression,

one, and that one is valued and supported bysituations.
ofWe

believecompliments

that
in

the

others’XX
36

Kamoshida.et al.
Kamoshida

others with a certain level of understanding,criticism. However, how this affects a depressed

warmth, and approval. He proposed a model inperson is still unclear. Therefore, it is necessary

which depressed people have low perceived

to examine the effects of not using “Compliment”

acceptance towards themselves, leading to

as a way of interacting with a depressed person

depression

in non-continuous relationship, such as the first

mediatedbynegativemoodtendencies and negative self-evaluation. In

meeting.

addition, depressed people and patients are said

One of the challenges of this study is that it

to be in a complicated state of mind. Specifically,used a between-subject design. Thus, thethey feel abandoned by others, they cannot be

communication style of each participant was not

together comfortably (Roberts et al., 1996), andcontrolled. In the future, it will be necessary tothey cannot be satisfied by others’ satisfaction

examine the effect of label after controlling for(Joiner et al., 1992; 1993). Therefore, it can be

the communication styles of the subjects throughinferred that depression label suppress directa within-subject design.

compliments to patients with depression fromothers, which may lead to a decrease in the
depressed person's sense of acceptance andpositiveself-evaluation. As

This study is a reanalysis of data from a paper

model

of

published by Kamoshida et al. (2021) in the

betweenaJapanese journal of family psychology. It wasdepressed person and others, there is the “cycle

also presented at the 13th Annual Conference ofof depression” (Joiner & Schmit, 1998), in

the National foundation of brief therapy. The

which the depressed person confirms excessive

contributors to this study, including the researchaffection for significant others, only to becollaborators, are gratefully acknowledged forrejected by significant others and maintainall their help. We would like to thank Editage

depression (Joiner & Schmit, 1998). In addition,(www.editage.com)

the interaction model of depression (Coyne,

editing.

interpersonalcommunicationaAcknowledgement

for

Englishlanguage1976), in which the depressed persons’depression is maintained when significant others

Reference

become verbally supportive but nonverbally

AI-Mosaiwi, M., & Johnstone, T. (2018). In an

rejective. In addition to these models, thisabsolute state： Elevated use of absolutist

study’s findings indicate the risk that persons

words is a marker specific to anxiety,with depression label are more likely to be

depression and suicidal ideation. Clinicalrejected by others than depressed persons

Psychological Science, 6(4), 529-542.

without depression label in a non-continuous

Beck, A. T. (1967). Depression, clinical,

relationship. Thus, we can speculate that in thisexperimental,

andtheoreticalaspects.

kind of relationship, subjects may reinforce thePhiladelphia ： University of Pennsylvania

depression of the depressed person throughPress.

XX
37

EFFECT OF DEPRESSION LABEL
Benazon, N. (1998). Predicting negative partner

after prolonged exposure to a mildlyattitudes toward depressed persons: An

depressed individual. Journal of Personality

empirical

and Social Psychology, 49(4), 1110-1113.

evaluation

of

three

theories.

Dissertation Abstracts International: Section

Ito, T. (1991). An Examination of the Basic

B: The Sciences and Engineering, 59(3-B),

Representational Dimensions of Nonverbal

1358.

Behavior. Journal of Experimental Social

Brown, P., & Levinson, S. (1987). Politeness:
Some

Universals

inLanguage

Usage.

Psychology, 31, 1-11. [in Japanese] 伊藤哲
司 (1991). ノンバ-バル行動の基本的な表出次元の検討. 実験社会心理学研究, 31,

Cambridge University Press.
Coyne, J. C. (1976). Depression and the
response of others. Journal of Abnormal
Psychology, 85, 186-193.

1-11.
Joiner, T. E., Jr. (1994). Contagious depression：
Existence, specificity to depressed symptoms,

Coyne, J. C., Kessler, R. C., Tal, M., Turnbull, J.,

and the role of reassurance-seeking. Journal

Worthman, C. B., & Greden, J. F. (1987).

of Personality and Social Psychology, 67,

Living with depressed person. Journal of

287-296.

Counseling and Clinical Psychology, 55(3),347-352.

I. (1992). When depression breeds contempt:

Gotlib, I. H., & Robinson, L. A. (1982).
Response

Joiner, T. E., Jr., Alfano, M. S., & Metalsky, G.
Reassurance-seeking,self-esteem,

and

to

depressed

individuals ：rejection of depressed college students by

Discrepancies

betweenself-reporttheir roommates. Journal of Abnormalandobserver-rated behavior. Journal of Abnormal
Psychology, 91, 231-240.

Psychology, 101, 165 -173.
Joiner, T. E., Jr., Alfano, M. S., & Metalsky, G.

Haley, J. (1963). Strategies of psychotherapy.

I.

(1993). Caught in the crossfire ：New York：Grune & Stratton. [in Japanese] (高Depression,

石昇 訳 (2001). 戦略的心理療法. 黎明書

enhancement, and the response of others.

房).

Journal of Social and Clinical Psychology, 12,

Homes, J. L., Hagan. C. R., & Joiner. T. E. Jr.

self-consistency,

self-

113-134.

(2013). Interpersonal processes in depression.

Joiner, T. E., & Metalsky, G. I. (1995). A

Annual Review of Clinical Psychology, 9,prospective test of an interpersonal theory of355-377.

depression：A naturalistic study of college

Howes, M. J., & Hokanson, J. E. (1979).
Conversational and social responses todepressive interpersonal behavior.

Journalof Abnormal Psychology, 6, 626-634.

roommates. Journal of Personality and Social
Psychology, 69, 778-788.
Joiner, T. E., Jr., & Schmit, N. B. (1998).
Excessive

reassurance-seeking

predicts

Howes, M. J., Hokanson, J. E., & Loewenstein,depressive but anxious reactions to acute

D. A. (1985). Induction of depressive effectstress. Journal of Abnormal Psychology, 107,

XX
38

Kamoshida.et al.
Kamoshida533-537.

が感じる困難に関する質的検討.早稲田

Katz, J., Beach, S. R. H., & Joiner, T. E., Jr.
(1998). When does partner devaluation
predict

emotional

distress?

大学臨床心理学研究, 15(1), 73-79.
National Institute of Mental Health (2017).

Prospective

National Survey on Drug Use and Healthmoderating effects of reassurance-seeking

Methodological Summary and Definitions.

and self-esteem. Personal Relationships, 5,

https://www.nimh.nih.gov/health/statistics/m

409-421.

ajor-depression (2021 年 9 月 14 日 閲覧)

Kamoshida, S., Takagi, G., Sando, N., &Rad, S. (1928). The problem of melancholia

Wakashima, K. (2021). The effect ofInternational.Journal of psychoanalysis, 9,Depression label on verbal and nonverbal

420-438.

communication

withothers.

Japanese

Roberts, J. E., Gotlib, I. H., & Kassel, J. D.

Journal of Family Psychology, 35(1), 1-13.

(1996). Adult

attachment

securityand[in Japanese] 鴨志田冴子・高木源・三道な

symptom of depression： The mediating role

ぎさ・若島孔文 (2021). うつ病ラベルがof dysfunctional attitudes and low self-esteem.

他者の言語・非言語コミュニケ-ションへ

Journal of Personality and Social Psychology,

与える影響.家族心理学研究, 35(1), 1-13.

70(2), 310-320.

Kawakita, J. (1967). Idea Method for Creativity

Sando, N. (2016). A Clinical Psychological

Development. Chuokouron Shinsha： Tokyo.

Study on Conflictive Communication in[in Japanese] 川喜多二郎 (1967).『発想法Significant

創造性開発のために』.中央公論新社：東Depressed People: Focusing on Verbal

京.

Communication.

Relationships
Graduate

IncludingSchoolof

Ministry of Health, Labour and Welfare. (2017).

Education, Tohoku University Dissertation,

Patient Survey. 2021-4-25. [in Japanese] 厚(2015). [in Japanese] 三道なぎさ (2016).

生 労 働 省 (2017). 患 者 調 査 .

抑うつ者を含む重要な二者関係におけるhttps://www.mhlw.go.jp/toukei/saikin/hw/ka

葛藤的コミュニケーションに関する臨床

nja/17/index.html (令和 2 年 4 月 25 日閲

心理学的研究－言語コミュニケ-ション

覧)に注目して－

Namiki, N., Mastumoto, T., Suyama, H., Kaneko,

東北大学大学院教育学研究科平成 27 年度博士論文.

Y., Ito R., Sato, H., & Higami, K. (2015). A

Sato, K. (2006). An Attempt to Modify thequalitative study of the difficulties felt byInteraction Model of Rejection-Depression by

managers in the return to work of depressed

Personality Trait Words with Extrinsic

people. Waseda University Journal of Clinical

Meanings for Depressed People.Journal of

Psychology, 15(1), 73-79. [in Japanese] 並木

northeastern

伸賢・松元智美・巣山晴菜・兼子唯・伊藤Research, 10, 1-11. [in Japanese] 佐藤宏平

理紗・佐藤秀樹・樋上巧洋・鈴木伸一(2006). 抑うつ者に対する言外の意味を(2015).うつ病者の復職において管理職者持つ性格特性語による拒絶－抑うつの相Educational

Psychology

EFFECT OF DEPRESSION LABEL
互作用モデル修正の試み－

東北教育心理学研究, 10, 1-11.

XX
39

writing and letter writing. Proceedings at the
15th Annual Meeting of the Japanese

Segrin, C., & Dillard, J. P. (1992). The

Association of Family Psychology, 15.

[ininteractional theory of depression： A meta-

Japanese] 渡 部 敦 子 ・ 若 島 孔 文 (1998).

Analysis of research literature. Journal ofInterpersonal words！-日記文と手紙文をSocial and Clinical Psychology, 11, 43-70.

比較して- 日本家族心理学会第 15 回大Sugiyama, T. (2002). A study of the effect of

会発表抄録集, 15.

“sense of being accepted” in depression andYoshioka, K., & Misawa, R. (2012). Validation

its modeling.Journal of Japanese Clinicalof a model of the effects of stigma on mental

psychology, 19, 589-597. [in Japanese] 杉山

illness. Journal of Health Psychology, 25(1),崇 (2002). 抑うつにおける「被受容感」の93-103. [in Japanese] 吉岡久美子・三沢良効果とそのモデル化の研究. 心理臨床学(2012). 精神疾患に関するスティグマの研究, 19, 589-597.

影響モデルの検証. 健康心理学研究,

Takeshima, K., & Matsumi, J. (2013). Social

25(1), 93-103.

Interaction with Peers in Children with

Zung, W. W. K. (1965). A self-rating depression

Depressive Symptoms: An Assessment Study

scale. Archives of General Psychiatry, 12, 63-

Based on Behavioral Observation. The

70.

Japanese journal of educational psychology,
61, 158-168. [in Japanese] 竹島克典・松見淳子 (2013). 抑うつ症状を示す児童の仲間との社会的相互作用-行動観察に基づ
くアセスメント研究-

教育心理学研究,61, 158-168.
Takiura, M. (2008). Introduction to Politeness.
Kenkyusha.[in Japanese] 滝浦真人 (2008).
ポライトネス入門.株式会社 研究社.
Terasaki,M., Koga, M., & Kishimoto, Y. (1991).
Development of the Short Version of theMultidimensional Emotional State Scale.
Proceedings at the 5th Annual Meeting of theJapanese Psychological Association, 435. [inJapanese] 寺崎正治・古賀愛人・岸本陽一(1991). 多面的感情状態尺度・短縮版の作
成.日本心理学会第 5 回大会発表論文, 435.
Watabe, A.,
Interpersonal&

Wakashima,words!

K.

Comparing(1998).
diaryInternational Journal of Brief Therapy and Family Science
2022 Vol. 12, No.1, 40-61< Original Paper: Research and Experiment >Development of the Risk Assessment Scale for Ijiri:
A Study on Reliability and Validity Kazuma Sakamoto 1)
1)

Graduate School of Education, Tohoku University

ABSTRACT. Ijiri is one of the collective games using communication among peers, and is an act that annoys the target without any
intention to hurt the actor's side. Because Ijiri is an in-group play, it has norms that constrain the target to respond compliantly, and therisk that the acdtor will continue to attack the target unintentionally. The purpose of this study was to develop a tool to measure ijiririsk and to examine its reliability and validity. Ijiri risk was measured from the following two parts: part A) invasiveness to the target,
and Part B) cognitions related to action supression of the target. A web-based questionnaire survey was administered to 913
participants (327 males, 583 females, and 3 others; mean age = 29.25 years). As a result of exploratory factor analysis, two factors
were extracted for Part A and four factors for Part B. The results of the confirmatory factor analysis showed that the goodness-of-fit
indices for the Part A and Part B factor structure models were adequate. The results of the reliability analysis showed that the alphacoefficients for each factor were sufficient, confirming their reliability. The following two hypotheses were examined for
criterion-related validity: 1)The higher the Part A - Invasiveness scale, the higher the scores for the stress cognitive scores and thestress response scores, 2)The higher the score on Part B - Action suppression scale, the higher compliant reactive behavior scores. The
results of the correlation analysis supported the two hypotheses and demonstrated the validity of this scale.
KEY WORDS: ijiri, assessment tool, reliability, validity

Introduction

1. What is Ijiri?

As social beings, it is always an important

Ijiri is one of the collective games using

concern for us to position ourselves in a group

communication among peers, and is an act thatand to build coexisting relationships with others.

annoys the target without any intention to hurt

As social trends that respect diversity take shape,

the actor's side (Sakamoto, 2021). For example,

we are expected to live in harmony with others

it is communication that targets one person in a

who differ in diverse aspects such as values,

group of friends and plays at making that person

characteristics, and culture at work and at school.

a laughingstock, a collaborative effort to create

In this context, communication strategies tohumor in the group (Honda, 2011; Doi, 2008;

avoid the occurrence of conflicts are becoming

Mochizuki, 2017). Humor is a whole series ofincreasingly important. Ijiri is one suchprocesses: 1) the social context that presupposes

example.

the occurrence of humor, 2) the occurrence and

CORRESPONDENCE TO: Sakamoto, K. Graduate

perception of incompatibility between an event

School of Education, Tohoku University. 27-1 Kawauchi, Aoba

and its context, 3) the emotional response to theWard, Sendai City, Miyagi Prefecture, 980-8676, Japan.

incompatibility, and 4) the vocal and behavioral

e-mail: sakamoto.research.psychology@gmail.com

expression of laughter (Martin, 2007). There are40

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

41

three main types of humorous behavior: 1)

Ashforth, 2002). For example, teasing can be"Joke," which is a complete story with aused as an expression of "intimacy" by inverting

preamble and a punchline, 2) "Accidental,"

the meaning of the two conflicting messages

which is an unintentional misstatement or(Terrion & Ashforth, 2002). This is based on themisuse of language, and 3) "humor that occurs

mode of "play" because it is used to indicate anaturally in conversation" (Martin, 2007). Ijiri ismeaning that is inverted from what theincluded in "humor that occurs naturally inprovocative act literally means. Second, teasing

conversation.

is also used to convey blame or frustration and

There are various types of humor thatto induce behavior modification while avoiding

naturally occur in conversation, among which

offending the target (Keltner et al, 1998). Rather

ijiri is considered to be one of the "teasing" types

than inverting the sense of blame or frustration(Long & Graesser, 1988; Sakamoto, 2017).

that the provocative message represents, theTeasing is an act that simultaneously contains ofplayful message is used to reduce its severity

two messages: provocative and playful (Maki,

while maintaining the same direction. Thus, it is2008). Provocativeness is a message intended tobased on the "non-play" mode. In fact, it hasannoy the target and elicit further responses, andbeen demonstrated that the reactive behavior of

often takes an aggressive form (Maki, 2008). In

receivers differs between teasing for intimacy inaddition, playfulness is a message intended tothe "play" mode and teasing for influence in the

imply that the behavior may not be a true"non-play" mode. (Keltner et al, 1998). In otherprovocation or aggression, and is expressedwords, the differences in communication modes

through nonverbal messages such as smiles andindicate that teasing is perceived as having an

gestures (Maki, 2008). Sakamoto (2017)

entirely different meaning. Thus, teasing is used

qualitatively analyzed the message structure of

in multiple modes, such as "play" andijiri and showed that teasing, like teasing,"non-play.

contains

messagesofprovocation

andplayfulness, making ijiri one form of teasing.

On the other hand, ijiri is a communication
behavior used only in the "play" mode. Ijiri is a

So what are the conditions that distinguishcollaborative process for creating enjoyableijiri from teasing? It can be said that there is acommunication within a group, and is used as adifference in the communication mode in which

communication strategy for avoiding in-groupthey are used. Communication mode is a

conflict for recent youth with a friendship stylelabeling for communication that indicates whatthat prioritizes conflict avoidance (Okada,

each

act

is

Communication"non-play,"

done

as

(Bateson,1972).

2007a; Doi, 2008; Mukai, 2010). Thus, inmodes

include"play,"

situations where ijiri takes place, there is a peer

"fantasy,""sacrament",andpressuretoinvertthemeaningofthe"metaphor" . Teasing is used in more modes

provocation into an expression of intimacy

compared to ijiri (Keltner et al, 1998; Terrion &based on the mode of "play". In fact, the42Sakamoto.

rejection or aversion to ijiri as "non-play" is a

Ijiri is used on a daily basis among

violation of peer pressure and a trigger forcontemporary Japanese youth and has a variety

in-group exclusion (Moriguchi, 2007; Doi,of effects on individuals and groups. Prior

2008; Mukai, 2010; Nakano, 2018; Koiwa,

studies have shown the positive and negative

Komatsu, & Wakashima, 2020). Even when thefunctions of ijiri. First, one of the positive

actor has malicious intent and truly intends tofunctions of ijiri is in-group conflict avoidance

harm the target, the actor skillfully manipulates

functions (Okada, 2007; Doi, 2008; Mukai,

the way the message is presented to "disguise"2010). In Japan, since the 1980s, a social trend

the mode of communication as if it were a "play.

has been formed to respect diversity rather than

" (Kimura, 2017). Disguise is a situation in

uniformity, and people are expected to accept

which a participant in one situation manipulates

and coexist with others who differ from them inthe communication mode perceived by othervariousparticipants and acquires a different definition

characteristics, and cultural backgrounds (Doi,of the situation themselves (Goffman, 1974). In

2008). Since differences with others can trigger

other words, ijiri is designed and executed based

conflicts within a group, it is said that modern

on the mode of "play" regardless of the intention

adolescentsof the actor.

superficial and enjoyrable interactions, and by

The

characteristics

of

ijiri

can

be

aspectssuchconnectwithaspersonality,

othersthroughfocusing on these interactions, they divert

summarized in the following three points: 1) it isattention

from

the

differences

performed as a play within a group, 2) thethemselvesandprovocative behavior elicits reactive behavior

manifestation of conflicts (Okada, 2007; Doi,by making the receiver feel troubled, and 3) it is2008; Mukai, 2010). As we have seen, ijiri is a

designed to be received as a meaning that inverts

form of in-group play that creates enjoyable

the meaning originally indicated by theinteractions and helps to avoid in-group conflictprovocative behavior. This is also defined in this(Doi, 2008). As a result, smooth symbiotic

study in order to focus on the subjective

relationships with others are established throughexperience of being target of ijiri. Based on the

ijiri, and ultimately participants in ijiri enjoy aabove three characteristics, this study defined

sense of self-affirmation and group belonging

the experience of being target of ijiri as(Mukai, 2010). Thus, ijiri is an important aspect

comform to the following three conditions: 1)of the interpersonal foundation for Japanese

you perceived it as social playing within a peer

youth.

othersandbetween

avoid

the

group, 2) you perceived that the actor had noOn the other hand, the negative function ofmalicious intent to hurt you, and 3) you were

ijiri has also been shown. First, even if there istroubled by the ijiri to varying degrees.

no intention to hurt the actorside and a messageof playfulness is shown, ijiri may function as a

2. Ijiri's positive and negative functions

provocation or attack and hurt target(Doi, 2008;

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

43

Mukai, 2010; Honda, 2011; Sakamoto, 2017). In

openly express their displeasure or anger

humorous behaviors such as ijiri and teasing,(Moriguchi, 2007; Mukai, 2010). Bind is awhere two contradictory messages, provocative

function of language that does not uniquelyand playful, are presented simultaneously, there

determine the response of the receiver of ais always an "ambiguity" in the message (Maki,message, but limits the range of choice2008). The "ambiguity" is the characteristic that

(Hasegawa, 1991). In fact, Moriguchi (2007)

whenshows that target may be hurt by ijiri but

conflicting

messages,

such

as

provocativeness and playfulness, are presented

continue

to

react

compliantly

without

simultaneously, the message can be interpreted

expressing it. Communication is mutually bind,in multiple ways, either provocatively or

the reactive behavior of the target influences theplayfully (Shapiro et al, 1991). That is, there isnext actor's choice of action, and the exchange

always a possibility that ijiri will be interpreted

between actor and target unfolds as a single

as provocative or aggressive behavior by thesystem (National Foundation of Brief Therapy,

receiver, regardless of the actor's intentions or2016). In other words, the target's compliant

the way the message is presented (Bateson,

response based on the mode of "play" may

1972; Shapiro et al, 1991; Martin, 2007; Maki,

induce further ijiri by the actor, and there is a2008). In fact, there have been several reported

risk of escalating ijiri. In addition, target's

cases where ijiri has harmed target and caused

compliant reactive behavior is one of the factors

serious consequences. For example, Nakano

that may cause some third parties to belittle the(2018), who investigated workplace ijiri,

seriousness of the problem. Assessment ispresents a case in which a subordinate felt sonecessary because the suppression of open

much emotional distress from his boss's ijiri that

expressive behavior by the target increases thehe had suicidal ideation. Also in Japan, arisk of ijiri.

second-year high school boy committed suicide
in Yamaguchi Prefecture in 2016, suffering

3. Necessity to develop assessment tools

from repeated ijiri (Kadowaki, 2019). Since ijiri

Ijiri is a communication behavior that carries

is performed as a "play" within a group, it doessignificant risk, and it is important to assess its

not appear to be a problem from a third-party

risk factors. However, target's mental distressperspective. However, ijiri that functions as aand cognitions related to action suppression are

provocation or aggression and cause mental

internal and unobservable by others. Therefore,

distress to target is a serious problem andit is considered necessary to develop aurgently needs to be addressed.

self-administered questionnaire as a tool to

Second, because ijiri is a "play" within themeasure these factors. Tools for assessing risk

group, it has the function of bind target tofactors for ijiri have not yet been developed. The

behave according to the mode of "play". This

purpose of this study was to develop andmakes it difficult for target to reject ijiri or to

examine the reliability and validity of a scale

44

Sakamoto.

measuring two aspects of ijiri's target: 1) mental

1936; Niina et al., 1990). In other words, there is

distress and 2) cognitions related to action

conceptual agreement between the concepts ofsuppression.

mental invasion and stress in that internal

In order to measure two risk factors related toequilibrium is disrupted by external factors.

ijiri in this study, the scale consists of the

From the above, it is predicted that thefollowing two parts: 1) Part A Invasivenessinvasiveness of target by ijiri, stress perception

Scale, which measures mental distress for target,and stress response to ijiri be positively

and 2) Part B Action suppression scale, whichcorrelated. In addition, the cognition related tomeasures cognition related to behavioral

behavioral inhibition of target is considered toinhibition for target. The mental distress target

be related to the reactive behavior to ijiri. In themeasured in Part A can be caused by any

playful situation of ijiri, the target is requested tohumorous behavior that includes messages of

accept the ijiri, respond back in an amusing

provocativeness and playfulness. Thus, the Part

manner, and play a role in enlivening the

A scale is not limited to ijiri, but is positioned as

situation (Doi, 2008). In light of this, it isa scale that can measure psychological distressexpected that cognitions related to behavioral

for all humorous behaviors such as teasing andinhibition of target will be positively correlated

sarcasm. On the other hand, the cognition

with compliant reactive behavior toward ijiri.

related to the behavioral inhibition of target,

Based on the above, the two hypotheses in thiswhich is measured in Part B, only occurs whenstudy are as follows

target is bound to the mode of "play," which is
unique to ijiri. Therefore, the Part B scale is

1. The higher the Part A - Invasiveness scale,positioned as a scale that can be used only forthe higher the scores for the stress cognitive

the phenomenon of ijiri.

scores and the stress response scores.

The mental invasion of target caused by ijiri

2. The higher the score on Part B - Action

is considered to be related to the concept ofsuppression scale, the higher compliant reactive

stress. Mental invasiveness is the impairment or

behavior scores.

burden on the mind caused by some otherperson's intervention (Kikuchi, 2004; Okuyama
et al., 2016). Stress also refers to a series ofprocesses in which internal equilibrium is

MethodSurvey period
The survey was conducted in August 2020.

disrupted by a stressor from the external
environment, leading to a stress response (Selye,

Participants

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

45

Table1 Basic characteristics of participants and ijiri episodes (1/3)

N

%

Age
≦20s

67

7.34

21~25

131

14.35

26~30

273

29.90

31~35

442

48.41

Male

327

35.82

Female583

63.86

Others

3

0.33

Sex

Relationship with the actor
Younger generation / subordinate

12

1.31

Same grade students / colleague

714

78.20

Seniors / Supervisors

167

18.29

Family7

0.77

Others13

1.42

Physical characteristics

478

52.35

Favorite thing

86

9.42

Name

139

15.22

Topics of Ijiri (multiple responses: N =1940)

Age

19

2.08

Past happening

208

22.78

Love Experience

133

14.57

Failures

212

23.22

Quirks190

20.81

Fashion97

10.62

Occasional action

315

34.50

None of the subject

30

3.29

Others33

3.61

Directly mentioned

640

70.10

Indirectly mentioned

149

16.32

Spread around

241

26.40

Given a nickname

304

33.30

Blamed66

7.23

Exaggerated imitation

221

24.21

Ignored

64

7.01

26

2.85

Ways of Ijiri (multiple responses: N =2025)

Reacted in an unusual way that would not normally be taken inthat situation
Apathetic reaction

37

4.05

Praised like a joke

113

12.38

Be pranked

39

4.27

Unreasonable request

114

12.49

Others11

1.20

We included 913 participants (327 males,

Table 1, Table2, and Table3.

583 females, and 3 others). Participants ages
ranged from 18 to 35 years (mean age = 29.25

Procedureyears, SD = 4.72 years). The characteristics of

We conducted a questionnaire survey using a

the Participants and the episodes are shown incrowdsourcing service. An explanation of the

46

Sakamoto.

Table2

Basic characteristics of participants and ijiri episodes (2/3)

N％

Before entering elementary school

17

1.86

1st to 3rd grade elementary school

133

14.57

4th to 6thrd grade elementary school

219

23.99

Junior high school students

258

28.26

High school students

112

12.27

Universities, Graduate Schools, Vocational Schools

77

8.43

After employment

97

10.62

Situation where only actor and target are present

219

23.99

Surrounded by acquaintances

763

83.57

Surrounded by strangers

97

10.62

Pretending not to see something

225

24.64

Watching enjoyably from the sidelines

469

51.37

Further encouraged Ijiri

111

12.16

Tried to stop Ijiri

33

3.61

Pay no attention

237

25.96

No bystanders

81

8.87

Others

11

1.20

Anger

280

30.67

Aversion

328

35.93

Ijiri episode start period

The Situation of Ijiri (multiple responses: N =1079)

Reactions of surrounding people (multiple responses: N =1167)

Emotions toward Ijiri (multiple responses: N =2185)

Fear

90

9.86

Sadness

272

29.79

Joy

31

3.40

Surprise60

6.57

Confusion

291

31.87

Proudness

6

0.66

Embarrassment

457

50.05

Guilt

20

2.19

Enjoyment

168

18.40

Boredom

148

16.21

Other

34

3.72

Have no Chara

672

73.60

Have Chara

241

26.40

Have Chara or notstudy and informed consent were provided on

The survey was anonymous. The following

the first webpage of the questionnaire. The page

information was provided on the questionnaire

was designed such that respondents could only

cover page to ensure informed consent andproceed to the response page after checking theconsideration of invasiveness: “Responses are“I agree to participate in the survey” box.

voluntary and can be refused or interrupted. The
refusal or interruption of responses will not

Ethical consideration

cause any disadvantage to the survey cooperator.

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI
Table347

Basic characteristics of participants and ijiri episodes (3/3)

M

SD

Degree of friendship

3.61

0.55

Amount of conversation

3.07

1.18

Frequency of revenge

2.19

0.87

Number of actors

2.76

1.03

Degree of attention of bystanders

2.75

1.42

Frequency of Ijiri

2.22

0.982

Responses will be processed statistically andproceed to the next question without checking

individuals will not be identified. Survey results

the box.” Checking the box would close thewill not be used for any purpose other thansurvey. The survey was designed to beresearch purposes. A clinical psychologist willterminated when a skipped reading was

be available if the respondent wishes to consult

identified.

with someone as a result of the survey.” In

3. Items to check the agreement between

addition, we stated at the top of each screen ofrecalled episodes of the experience of being athetarget of ijiri and the definition.

questionnairethatparticipants

could

immediately stop answering if they felt sick orThis item examined whether the subject

wished to end the survey to prevent participants

could recall an episode based on the definition

from experiencing psychological pain. Thisof the experience of being a target of ijiri. Threestudy was approved by the ethics review

items were rated on a four-point scale. The

committee of the Graduate School of Education,

survey was designed to end if the respondents

Tohoku University (Approval ID: 20-1-010).

answered “1 - Not at all,” indicating that they
were not able to recall episodes based on the

The questionnaire
The content of the questionnaire for thisstudy is presented below.
1. Cover pageThe participants answered four items: gender,

definition.
4. Items related to the recalled episodes of ijiri
These items examined the participants’recalled episodes of the experience of being atarget of ijiri. This scale was intended to haveage, occupation, and grade.

the participants recall the episode in detail

2. Instructional manipulation checkbefore answering the questions. Therefore, itThis item checked for the minimization of

was not used in the analysis of this study.

participants' efforts (e.g., skipping instructional

Respondents were asked to answer 17 questions:text) when conducting an online survey. One

1) the time of the episode, 2) the place ofitem was rated on a two-point scale. Afterinvolvement with the actor, 3) the actor's

providing a definition of the “experience of

position, 4) the degree of closeness with thebeing a target of ijiri,” it stated, “This question isactor, 5) the amount of normal conversation

to ensure that you did not skip over thewith the actor, 6) whether the position was everquestionnaire. Please ignore this question andreversed, 7) the topic of ijiri, 8) how the ijiri was

48

Sakamoto.

conducted, 9) the number of actors, 10) the

The procedure for creating the items was ascontext, 11) the degree of attention paid by thefollows. The extant literature addressing ijiri andaudience, 12) the reactions of the audience, 13)

involving distressed targets was reviewed andthe degree of patterning of the ijiri, 14) the

20 items were created by the author (Doi, 2008;

emotional reactions to the ijiri, 15) the chara in

Moriguchi, 2007; Doi, 2009; Mukai, 2010;

the group, 16) the course of the ijiri episode, andKimura, 2017; Nakano, 2018; Sakamoto, 2018).

17) other characteristics of the ijiri episode. The

During item development, items related toconcept of "Chara" in 15) is not an integrated

violations of identity and to negative emotions

self-image like "identity," but rather a way ofwere created. The items were then reviewed by 6

viewing the self-image as a collection of

graduate students majoring in psychology,

fragments of one's personality (Doi, 2009).

including the author, and 1 researcher in clinical

Chara is an important concept in this study

psychology, and 16 items were thus adopted.

because it defines the role of ijiri.

8. Risk Assessment Scale for Ijiri Part B -(Ogiue,2008).
5. Operational check

Action suppression scale
Based on previous research, we created 31

This item investigated the degree to which

items to measure the cognitions related to theparticipants could recall specific details about

behavioral inhibition of the target, rated on athe episode of the experience of being a target of

5-point scale. The procedure for creating the

ijiri, rated on a 4-point scale. The survey wasitems was as follows. Among the previous

designed to end when participants answered “1 -studies on ijiri, the author reviewed those

Not applicable at all,” thus confirming that theydescribing cases in which the target elected towere unable to accurately recall the event.

respond

6. Items for evaluating the recalled episodes

invasive ijiri, and thus formulated 35 items

compliantly

whileexperiencing

These two items determined the degrees of(Moriguchi, 2007; Doi, 2008; Ogiue, 2008;

enjoyment and distress of the recalled episode,

Mukai, 2010; Nakano, 2018). At the time ofrespectively, rated on a 4-point scale. This scale

item development, we created items related to

was intended to have the participants recall theperceptions of: 1) in-group roles, 2) risks of

episode in detail before answering the questions.

rejecting ijiri, 3) benefits of accepting ijiri, andTherefore, it was not used in the analysis of this4) the inability to control the situation whenstudy.

being targeted by ijiri. The items were then

7. Risk Assessment Scale for Ijiri Part A -reviewed by 6 graduate students majoring in

Invasiveness scale

psychology, including the author, and 1

Based on previous research, these 16 items

researcher in clinical psychology, and the 31

were developed to measure the participants’

items were thus adopted.

recalled invasiveness regarding the experience

9. “Impact”, “Disturbance”, and “Threat”

of being a target of ijiri, rated on a 5-point scale.

factors of the cognitive rating scale of stress.

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

These

15

items

measured

impact,49

PTSD-like stress responses and includes 15

disturbance, and threat among cognitive rating

items rated on a 4-point scale.

scales of stress created by Okayasu (1992), rated

11. Response to jokes in specific situations

on a 4-point scale. The participants responded toscale

the cognitive assessment of stress in the recalled

An item created by Hayama & Sakurai (2010)

experience of being a target of ijiri.

was used to measure response behavior to jokes.

10. Comprehensive Stress Response Inventory

Respondents were asked to describe how they

Asai et al. (2013) developed a scale toresponded to the recalled experience of being ameasure stress reactions. It comprises twotarget of ijiri.

subscales: the general stress response scale andAnalytical method

the disaster-specific stress response scale. The

In this study, in examining the factor

disaster-specific stress response scale measures

structure, an exploratory factor analysis was

50

Sakamoto.

Table 5. Confirmatory Factor Analysis results for thePart A - Invasiveness Scale
Model 1Model 2

χ1125.140***

127.728***

df

89

58

CFI

0.933

0.995

RMSEA

0.113

0.036

90% CI

0.107-0.119

0.028-0.045

SRMR

0.035

0.013

BIC

32018.091

31231.997

2

Note: CFI, comparative fit; RMSEA, root mean square error of
approximation; SRMR, standardized root mean square
residual; and BIC, Bayesian information criterion; ***p <.001

conducted on the created scale to confirm theFirst, we examined the factor structure of thefactor structure, and then a confirmatory factor

Part A - Invasiveness scale. Exploratory factor

analysis was conducted to examine the validity

analysis with the maximum likelihood methodof the factor structure model. In confirmatory

and Promax rotation was conducted for 16 items,

factor analysis, following some previous studies

for which ceiling and floor effects were not(Mitsutake et al., 2011; Asai et al., 2013; Ode,identified. From the scree plot, it was2020), the goodness of fit of the model isdetermined that a two-factor structure wasmodified with reference to the modification

appropriate. When items were extracted based

index to the extent theoretically comprehensible.

on factor loadings of .35, one item was excluded,

Specifically, covariance is added between errors

and 15 items were extracted for 2 factors (Tablefor items of the same factor. Modification of the1). The first factor examined items related tomodel based on the modification index is statednegative emotional reactions to ijiri, such as “1.

to be available in Kano (2002) to the extent that

I hate Ijiri,” “6. Ijiri is a pain,” and “5. I get

it is theoretically comprehensible.

irritated when I am subjected to Ijiri.” Therefore,
we named the first factor,

Results“Negative Emotional Response.” The second

Factor structure of the Risk Assessment Scalefactor investigated items related to the influence

for Ijiri

and violation of selfhood and identity by ijiri,

We examined the factor structure of the risk
assessment scale for ijiri created in this study.

such as “13. Ijiri destabilizes the way I perceive
myself,” “9. Ijiri undermines my identity,” and“11. Ijiri affects my identity.” Therefore, we

1. Factor structure of the Risk Assessment

named the second factor “Identity Violation.”

Scale for Ijiri: Part A - Invasiveness scaleTheinter-factor

correlation

was

r=.827

DEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

51

Table 6 Results of Exploratory Factor Analysis of the Part B - Action Suppression Scale（Factor Patterns after Maximum Likelihood Method and Promax Rotation）
Ⅰ

Ⅱ

Ⅲ

Ⅳ

24. Depending on my reaction, it would be awkward to be there.

.888

23. Depending on my reaction, the mood of the place would be bad.

.830

.023

.127

-.184

.060

-.122

25. Depending on my response, some problems may occur.

.131

.818

.065

.189

-.243

29. Depending on my reaction, my relationship with the actor will suffer.

.797

.019

.133

-.141

19. Depending on my reaction, the place would be boring.

.768

.002

-.171

.264

15. Depending on my reaction, people will think I'm an wet blanket.

.737

-.028

-.109

.244

3.

.568

-.124

.070

-.036

16. I have to escape ijiri in the right way.

.546

-.022

-.015

.339

22. Ijiri is initiated dependeing on the mood of the person you are talking to.

.482

-.141

.259

-.069

7.

.461

-.009

.164

.094

30. By accepting ijiri, I can enjoy myself.

-.041

.910

-.121

-.057

21. There are positive effects of receiving ijiri.

.083

.896

-.184

-.073

13. I am attached to ijiri.

-.040

.883

-.190

-.101

8.

By accepting ijiri, I made more friends.

.017

.856

-.071

-.067

4.

By accepting ijiri, I have a sense of belongingness.

.008

.635

.104

.087

26. Accepting ijiri has helped me have a good relationship with my peers.

.134

.633

.094

.042

20. I accept ijiri because I am the Chara in receiving ijiri.

.053

.561

.220

-.007

28. It is my role in the group to accept ijiri.

-.041

.511

.309

.108

5.

Ihave no choice but to accept ijiri.

-.154

.448

.245

.264

1.

I am used to accepting ijiri.

-.277

.448

.161

.218

27. I gave up on resisting ijiri.

.159

-.108

.662

-.001

9.

Ijiri is inevitable.

.060

.268

.504

.011

14. I can not make ijiri stop.

.304

-.038

.452

-.102

31. Rejecting ijiri is bothersome.

.266

.021

.393

.056

Ⅰ．Risk Aversion（α＝.921）

Depending on my reaction, there may be a conflict.

Depending on my reaction to ijiri, I would be subjected to more ijiri.

Ⅱ．Gaining Profit（α＝.915）

Ⅲ．Sense of Helplessness（α＝.742）

Ⅳ．Prioritizing Role-playing（α＝.861）
2.

I must create a pleasant atmosphere through my reaction to Ijiri.

-.026

.039

-.050

.812

6.

I have to liven the atmosphere with my reaction to ijiri.

.058

.014

-.041

.741

10. Preserving the atmosphere is more important than my feelings toward ijiri.

.092

.124

.142

.550

12. The audience were anticipating my reaction to ijiri.

.253

.216

.035

.376

inter-factor correlation

Ⅰ

Ⅱ

Ⅲ

Ⅳ

Ⅰ

ー

.326

.605

.608

ー

.406

.691

ー

.508

Ⅱ
Ⅲ
Ⅳ

ー

Deleted items
11. Depending on my reaction to ijiri, the atmosphere would be interrupted.
17. Accepting ijiri gives me a sense of satisfaction.
18. The process of initiating ijiri is beyond my control.

(p<.001).

Scale was inadequate (GFI=.868, CFI=.933,

In addition, confirmatory factor analysis was

RMSEA=.113, SRMR=.035). To improve theconducted to confirm the goodness of fit for the

goodness of fit, the model was modified byfactor model (2 factors, 15 items) of the Part A -adding covariance between the errors of theInvasiveness Scale. Results indicated that theitems of the same factor, with reference to thegoodness of fit for the Part A - Invasivenessmodification index. Results revealed that the

52

Sakamoto.

Table 7 Results of Confirmatory Factor Analysis of thePart B - Action Suppression Scale
Model 1Model 2

χ2398.259***

1197.958***

df

344

289

CFI

0.871

0.943

RMSEA

0.081

0.059

90% CI

0.078-0.084

0.055-0.062

SRMR

0.077

0.065

BIC

68242.971

67417.590

2

Note: CFI, comparative fit; RMSEA, root mean square error of
approximation; SRMR, standardized root mean square
residual; and BIC, Bayesian information criterion; ***p <.001

goodness of fit of the modified model wasappropriate. When items were extracted based

adequate (GFI=.982, CFI=.995, RMSEA=.036,

on factor loadings of .35, 2 items were excluded,

SRMR=.013) (Table2). Thus, the 15 items of theand 28 items were extracted for 4 factors (Table

two factors were designated as the Risk

3). The first factor included items exploring theAssessment Scale for Ijiri: Part A - Invasivenessrisk of being disadvantaged depending on one's

Scale. The mean scores for each factor werereaction to ijiri, such as, “24. Depending on my3.429 (SD=.1.135) for Negative Emotional

reaction to Ijiri, I would have difficulty being

Response and 2.986 (SD=1.167) for Identity

there,” “23. Depending on my reaction to Ijiri, I

Violation.

could

spoil

the

atmosphere,”

and

“25.

Depending on my reaction to the Ijiri, it could
2. Factor structure of the Risk Assessment

interfere with everything else.” Therefore, we

Scale for Ijiri: Part B - Action Suppression

named the first factor “Risk Aversion.” The

Scalesecond factor included items related to benefits

Next, we examined the factor structure of thegained from Ijiri, such as, “30. By taking Ijiri, I

Part B - Action Suppression Scale. Examination

am able to have a good time,” “21. There areof the ceiling and floor effects revealed a floor

positive effects of receiving Ijiri,” and “13. I

effect in the item, “17. I find that taking ijiri

have an attachment to Ijiri.” Therefore, wegives me a sense of satisfaction.” Exploratory

named the second factor “Gaining Profit.” Thefactor analysis with a maximum likelihood

third factor

method and Promax rotation was conducted forincluded items related to being unable tothe 30 items for which ceiling and floor effects

control the situation when being targeted by ijiri,

were not identified. From the scree plot, it wassuch as “27. I gave up refusing Ijiri,” “9. Being

determined that a four-factor structure wassubjected to Ijiri is inevitable,” and “14. I can'tDEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

53

Table 8 Correlation coefficient between Part A - Invasiveness Scale and other scales
Impactivity
Negative Emotional
Response
Identity Violation

Disturbability ThreativenessAnxiety

Grumpiness

Autonomic

Special Stress/ Nervousness/ Anger

Neurosis

Response to Disaster.521****.788****.696****.594****.638****.379****.542****.661****.749****.763****.645****.592****.479****.597******** p <.001

make Ijiri stop.” Therefore, we named the third

to the modification index. Results revealed thatfactor “Sense of Helplessness.” The fourth

the goodness of fit of the modified model was

factor included items related to prioritizing theadequate (GFI=.913, CFI=.943, RMSEA=.059,

group over personal emotional reactions, such as,

SRMR=.065) (Table 4). Thus, the 28 items of the“2. I have to create a pleasant atmosphere withfour factors were designated as the Risk

my reaction to Ijiri,” “6. I have to liven things up

Assessment Scale for Ijiri: Part B - Action

with my reaction to Ijiri,” and “The atmosphere

Suppression Scale. The mean scores for each

was more important than my feelings towards

factor was 3.128 (SD=.924) for Risk Aversion,

Ijiri.” Therefore, the fourth factor was named

2.530 (SD=.892) for Gaining Profit, 3.002“Prioritizing Role-playing.” The inter-factor(SD=.876) for Sense of Helplessness, and 2.856

correlation between Factor 1 and Factor 2 was(SD=1.029) for Prioritizing Role-playing.

r=.326 (p<.001). The inter-factor correlation
between Factor 1 and Factor 3 was r=.605

Reliability and Validity of the Risk Assessment(p<.001). The inter-factor correlation between

Scale for Ijiri

Factor 1 and Factor 4 was r=.608 (p<.001). The

The reliability and validity of the riskinter-factor correlation between Factor 2 andassessment scale for ijiri developed in this study

Factor 3 was r=.406 (p<.001). The inter-factor

was examined.

correlation between Factor 2 and Factor 4 was

1. Reliability and validity of the Risk

r=.691 (p<.001). The inter-factor correlation

Assessment

between Factor 3 and Factor 4 was r=.508

Invasiveness Scale(p<.001).

Scale

for

Ijiri:Part

A-First, to examine the internal consistency ofIn addition, confirmatory factor analysis was

the Part A - Invasiveness Scale, the Cronbach's

conducted to confirm the goodness of fit for thealpha coefficients of the two factors werefactor model (4 factors, 28 items) of the Part B -calculated. “Negative Emotional Response,”

Action Suppression Scale. Results indicated thatand “Identity Violation,” scored alpha values of

the goodness of fit of the Part B - Action

α=.963 and α=.932, respectively, indicating

Suppression Scale was inadequate (GFI=.817,

sufficient reliability.

CFI=.871, RMSEA=.081, SRMR=.077). To

Next, to examine the criterion-related

improve the goodness of fit, the model was

validity of the Part A - Invasiveness scale, we

modified by adding covariance between thecalculated the correlation coefficients between

errors of items of the same factor, with reference

the scores of the subfactors of the scale, and the

54

Sakamoto.

Table 9 Correlation coefficient betweeen Part B - Action
Suppression Scale and Compliant Response
Compliant Response
Risk Aversion.456****

Gaining Profit.410****

Sense of Helplessness.390****

Prioritizing Role-playing.565******** p <.001

three subfactors of the Cognitive Assessment of“Risk Aversion,” α=.921; “Gaining Profit,”

Stress Scale and the four subfactors of the

α=.915; “Sense of Helplessness,” α=.742; andComprehensive Stress Inventory scores (Table“Prioritizing Role-playing,” α=.861, indicating5).

sufficient reliability.

Negative

Emotional

Responsewassignificantly positively correlated with Impact

Next, to examine the criterion-related(r=.521, p<.001), Disturbance (r=.788, p<.001),

validity of the Part B - Action Suppression Scale,Threat (r=.696, p<.001), Anxiety/Nervousness

we calculated the correlation coefficients(r=.594, p<.001), Grumpiness/Anger (r=.638,

between the scores of the subfactors of scale andp<.001), Autonomic neurosis (r=.379, p<.001),

the “compliant response” score of the Responseand disaster-specific response to stress (r=.542,

to Joke Scale (Table 6). Risk Aversion had ap<.001).

also

significant positive correlation with compliant

significantly positively correlated with Impact

response (r=.456, p<.001). Gaining Profit was(r=.661,

p<.001),Disturbance(r=.749,

significantly

p<.001),Threat(r=.763,

p<.001),compliant response (r=.410, p<.001). Sense ofAnxiety/Nervousness(r=.645,

p<.001),

Helplessness showed a significant positive

Grumpiness/Anger(r=.592,

p<.001),

correlation with compliant response (r=.390,

Identity

Violationwas

positively

Prioritizing

correlated

withAutonomic neurosis (r=.479, p<.001), andp<.001).

Role-playing

was

disaster-specific response to stress (r=.597,

significantly

correlated

with

p<.001). Thus, hypothesis 1 was supported andcompliant response (r=.565, p<.001). Thus,

the criterion-related validity of the Part A -hypothesis

Invasiveness Scale was confirmed.

criterion-related validity of the Part B - Action

2. Reliability and validity of the Risk

Suppression Scale was confirmed.

positively2

was

supported,

and

the

Assessment Scale for Ijiri: Part B - Action
Suppression Scale

Discussion

First, to examine the internal consistency ofThis study aimed to create a tool to measure

the Part B - Action Suppression Scale,the risk of ijiri. We developed a Risk

Cronbach's alpha coefficients for the four

Assessment Scale for Ijiri, comprising two

factors were calculated. Results were as follows:

subscales; namely, Part A - Invasiveness ScaleDEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

55

and Part B - Action Suppression Scale. We

argues that we should choose topics andexamined its reliability and validity, as well as

wording that do not infringe on face to facilitate

the cut-off value, which is an index forsmooth communication with others. Face is a

extracting those who exhibit stress reactions topositive social value, or self-image, that a person

ijiri. In the following, we will discuss 1) thedesires, similar to the concept of identity

factor structure and reliability/validity of the(Goffman,Part A - Invasiveness Scale, 2) the factor

Positive emotions are generated when face isstructure and reliability/validity of the Part B -retained, and negative emotions are generated

Action Suppression Scale, and 3) the cutoff

when face is violated (Goffman, 1967). Thus, itvalue of Part A regarding the expression ofis presumed that the second factor, Identity

stress response.

Violation, measures the degree of identity andFactor structure and reliability/validity of theface violation, and the first factor, Negative

Part A - Invasiveness Scale

Emotional Response, measures the degree of1967;

Spencer-Oatey,2004).

For the Part A - Invasiveness Scale, anegative emotions associated with identity andtwo-factor structure of negative emotional

face violation. In measuring the invasiveness of

response and identity violation was adopted as acommunication with others, it is useful toresult of exploratory and confirmatory factor

measure two aspects: identity violation, and theanalysis, and the model fit was confirmed. The

correlated negative emotions.

inter-factor correlation was r=.827, indicating a

In addition, reliability analysis showed thatstrong positive correlation. That is, it was shown

Cronbach's alpha coefficient was sufficient,that the invasiveness caused by ijiri comprises

confirming the reliability of the Part A -two aspects: the violation of the target's identity,

Invasiveness Scale. Both Negative Emotional

and a negative emotional reaction. This result

Response and Identity Violation showedsupports previous studies (Doi, 2008; Doi, 2009;

significant

Mukai, 2010; Kimura, 2017; Nakano, 2018;

cognitive rating scale of stress and the

Sakamoto, 2018) indicating that targetedComprehensive Stress Response Inventory. The

individuals feel uncomfortable with ijiri whichcriterion-related validity was thus demonstrated,

stifles authentic behavior or disrupts theirindicating that the negative emotions andidentity. The results are consistent with extant

identity violation caused by ijiri account for

research (Moriguchi, 2007; Doi, 2008; Doi,interpersonal stress. In addition, this study

2009; Honda, 2011; Kimura, 2017; Nakano,showed that the Part A - Invasiveness Scale was

2018; Sakamoto, 2018) contending that ijiri

positively correlated not only with the generalcauses not only primary negative emotions, such

stress response scale, but also with theas anger, disgust, and sadness, but also

disaster-specific stress response scale, which

secondaryasmeasures PTSD-like reactions. Thus, there areembarrassment and discomfort. Goffman (1967)

two routes through which ijiri can function as an

negative

emotions,such

positivecorrelations

with

the

56

Sakamoto.

interpersonal stressor. The first route involves

invasiveness of ijiri must be examined further.

the continued exposure to ijiri, which triggers

The second route is that ijiri rapidly functions as

general stress responses such as anxiety/tension,a major stressor, and the experience of being aanger, and autonomic symptoms. This routetarget of ijiri becomes a traumatic experience,

assumes a vicious cycle in communication,

triggering a PTSD-like stress response. This

whereby ijiri is constantly repeated. This createsroute is considered to be ijiri, which is a strong

an unbalanced relationship between the actor

invasion of the target. Brown and Levinson

and the target, and this relationship induces(1987) proposed the politeness theory andfurther ijiri. Watzlawick, Bavelas and Jacksontermed the act of face violation a Face

(1967) classified communication patterns into

Threatening Act (FTA). The degree of violation

two categories: symmetry and complementary.

of face is estimated by the sum of 1) the social

They noted that when one of the patterns

distance between the speaker and the listener, 2)

escalates,isthe relative power difference between theestablished. Symmetry is a communication

speaker and the listener, and 3) the absolute

pattern in which both parties behave similarly,

ranking of the rudeness of an action in a givensuch as mutual responding, or being humble

culture. Therefore, in ijiri, if the social distancewhen someone is humble. Conversely, abetween the actor and target is far, the powercomplementary communication pattern involves

differential is large, and the degree of rudenessboth parties behaving differently, such as oneof the ijiri is high, then it is considered as anindividual asserts, and the other perseveres. Ijiri

FTA to the target and becomes a significant

iscomplementarystressor. It is necessary to further investigate thecommunication pattern. If there is an escalation

characteristics of ijiri in Japanese culture, and toof complementary communication patterns due

subsequently

to the repetition of ijiri, then the relationshipinvasiveness based on politeness theory.

itself

Factor structure and reliability/validity of theathoughtispathological

to

form

consideredrelationship

a

to

be

an

ongoing

interpersonal stressor. However, if the target
retaliates, or a symmetrical communication
patternisestablished,

there

the

hypothesisofPart B - Action Suppression Scale
Regarding the Part B - Action Suppression

isaScale, the results of exploratory factor analysis

patterninand confirmatory factor analysis showed that thewhich the target gains an advantage, then ijiri

four-factor structure of Risk Aversion, Gaining

may not be a stressor. This is because it prevents

Profit, Sense of Helplessness, and Prioritizing

escalation

complementaryRole-playing was adopted, and the model fit wascommunication pattern in which the target isconfirmed. Ogiue (2008) suggests that mostplaced in disadvantaged position, even if ijiri ispeople understand the risk that resisting bullying

repeated.

thewill induce further bullying and ijiri, which is

escalation of communication patterns and the

supported by Risk Aversion in this study.

complementaryorexaminecommunication

into

The

a

relationshipbetweenDEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI

57

Moreover, in perceiving such risks, the target

perceiving the risks of ijiri and attempting toprioritizes their expected behavior in the

avoid them, 2) perceiving the benefits of ijiri, 3)

situation over their own emotions, and resorts tofeeling helpless against ijiri, and 4) perceiving

chara-based behavior (Doi, 2008; Ogiue, 2008;

one's role in the group and prioritizing it are

Doi, 2009; Nakano, 2018). This is supported byrelated to the compliant response to ijiri. Risk

Prioritizing Role-playing in this study. However,

Aversion is presumably related to the perception

by acquiring the role of the actor/ target,of punishment when individuals are notcontemporary adolescents have positioned

compliant with ijiri, and Gaining Profit isthemselves in the group and thus acquired a

associated with the perception of reward whensense of self-esteem. Therefore, they are unable

complying with ijiri. The compliant response of

to break the cyclical communication of ijiri

the target is thus enhanced when people perceive(Moriguchi, 2007; Mukai, 2010), which isthat they are avoiding risks and reaping benefits

supported by Gaining Profit in this study. In

by complying with ijiri. The sense ofaddition, targets experienced helplessness due tohelplessness is assumed to be a cognition

the unwillingness to expand the size of the groupformed by the target’s experience of being

in which ijiri occurred and the repeatedunable to control being subjected to ijiri. Ogiue

experience of being subjected to ijiri, even after(2008) states that ijiri is a communication based

taking measures to escape the position (Kimura,on chara, which may be formed altruistically,

2017; Nakano, 2018). The third factor, Sense ofand can forcibly determine the target’s position

Helplessness, supported these previous studies.

and role in the group. In addition, Kimura

The four constructs related to behavioral(2017) contends that situational changes, such as

inhibition of the target, which were assumed

unwanted changes in the stage or the appearance

from previous studies, were extracted in thisof an unexpected audience may render the target

study, and the content validity of Part B was

unable to escape the situation. This is because

confirmed. Hence, ijiri participants proposedly

the audience continues to seek a performanceaccept ijiri and avoid the position of being athat enhances the situation by subjecting thetarget of ijiri by repeated self-presentation.

target to ijiri, although the ijiri exceeds the scope

In addition, reliability analysis showed thatof the target's voluntary self-presentation. Thus,

Cronbach's alpha coefficient was sufficient,

the target unwillingly continues to assume theconfirming the reliability of the Part B - Actionrole of the target of ijiri, thereby increasing

Suppression Scale. In addition, Risk Aversion,

Sense of Helplessness and choosing a compliant

Gaining Profit, Sense of Helplessness, andresponse. Next, Prioritizing Role-playing isPrioritizing Role-playing were all positively

considered to be a cognition regarding in-groupcorrelated with “compliant response” scores onroles in the target. Contemporary adolescentstheindicating

tend to repeat smooth and pleasant interactions

criterion-related validity. This indicates that 1)with others, stay constantly connected, andresponse

to

jokes

scale,

58

Sakamoto.

endeavor to build herd friendships (Okada,measures.

A

challenge

1995; Okada, 1999; Okada, 2007a; Okada,

implementation would be regarding the age of

2007b; Doi, 2008). To maintain herd friendships,

the study subjects. The present study was

individuals must take the hint, maintain the

conducted on adolescent persons aged between

norm within a group of friends as a herd, and act

18 to 35 years. Since ijiri is a characteristic

accordingly (Doi, 2008). In this context, thecommunicative behavior among contemporary

target perceives his own in-group role andadolescents, there is a certain validity to thechooses a compliant response to maintainresearch subjects of this study. However, given

friendships. The target thus prioritizes in-groupthat ijiri has become a problem amongrole-playing over his own hurtful experiences

school-age children, it is necessary to modify

and emotional reactions. This attempt to meetthe scale to suit the target population for clinicalexternal expectations and demands, even byimplementation.

suppressing internal desires, is called overworkplace, this scale can be used as is.

Regarding

in

ijiri

clinicalintheadaptation (Ishizu, 2006). Future studies should

The scale developed in this study provides a

examine the relationship between the Part B -basis for the quantitative examination of

Action Suppression Scale and the tendency torisk-related factors in ijiri. This study isover-adapt. In addition, further research should

academically significant in that it forms theexamine what factors promote each factor of thebasis for further empirical examination of thePart B - Action Suppression Scale, whichsociological concept of ijiri. Thus far, there has

encourage the compliant response behavior ofbeen only anecdotal discussion and no empiricalthe target.

research on the factors that cause ijiri to function
pathologically. Future studies should examine
Conclusion

the relationship of this scale with the content ofIn this study, we developed a scale toijiri, factors of the relationship between the actor

measure the risk of ijiri from two aspects: 1)

and the target, factors of the communication

invasiveness to the target and 2) cognitive

pattern between the actor and the target, and thefactors related to the suppression of expression,

risk-related factors of ijiri.

and its reliability and validity were confirmed.
This scale enables us to measure the subjective
sense of invasiveness of target and cognitive

Acknowledgements
Thisresearchwassupportedbythefactors related to the suppression of expression,

following grant: 2020 graduate student project

which are difficult to measure and observe

research at the Center for Innovation in

objectively. This scale can be employed in

Educational Research and Practice, Graduate

schools and workplaces where ijiri is a problem

School of Education, Tohoku University. We

to enable the early detection of pathological ijiri

greatly appreciate this grant.

and implement preventive and intervention

We

would

like

to

thank

EditageDEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI(www.editage.com)

forEnglishlanguage

editing.

59

Honda, Y. (2011). Gakkou no "Kuuki":
wakamono no kibunn. Iwanami Shoten. (inJapanese).

References

Ishizu, K. (2006). Kazyoutekiou syakudo

Asai, K., Morikawa, N., Hiraizumi, T., Usami,

sakuseinokokoromi.

The

JapaneseT., & Wakashima, K. (2013). Development

Association of Counseling Sciense, 39thofconference, collection of papers, 137．（inComprehensive

StressResponse

Inventory. Annual report Graduate School of
Education.

TohokuUniversity.

62(1),

283-302.

Japanese）.
Kadowaki, M. (2019). "Ijiri" ha "Ijime"
chousakennsyou iinchou tsutometa Dono

Bateson, G. (1972). Steps to an ecology of mind.

Satoshi kyouzyu keisyou. Chugoku Shimbun.

Intercultural Studies, c/o Brockman, Inc.

https://www.chugoku-np.co.jp/articles/-/421

Brown, P., & Levinson, S. C. (1987).

07, 15 April 2022.

Politeness: Some universals in language

Kano, Y. (2002). Rejoinder: Use of Error

usage． New York: Cambridge University

Convariances and the Role of Specific

Press．

Factors.

Doi, T. (2008). Tomodachi zigoku: "Kuuki woyomu" sedai no survival. Chikuma Shinsho.
(in Japanese)

The

Japanese

Journalof

Behaviormetrics, 29(2), 182-197.
Keltner, D., Young, R. C., Heerey, E. A., Oemig,
C., & Monarch, N. D. (1998). Teasing in

Doi, T. (2009) ． Chara ka suru/sareru

hierarchical and intimate relations. Journal

kodomotachi: haizyogatasyakai ni okeru

of Personality and Social Psychology. 75(5),aratana ninngennzou. Iwanami Shoten. (in1231-1247.

Japanese)

Kikuchi, Y. (2004). Clinical psychology act in

Goffman, E. (1967). Interaction ritual: Essays

the medical services: From the viewpoint ofin face-to-face behavior. Garden City, NY:

the subject of act. Kyusyu University

Anchor．

Psychological Research. 5, 183-191.

Goffman, E. (1974). Frame Analysis: An Essayonthe

OrganizationofExperience.

Northeanstern University Press.
tannki ryouhou. Shibundo. ( in Japanese)
situational

factors

definition

of

the

situationandself-presentation. Annual Reports of the

Hayama, D., & Sakurai, S. (2010). Rejection
anddistinction between bullying and “Ijiri”:
from the perspective of relation between

Hasegawa, K. (1991). Kousei syugi: kotoba tosensitivity

Kimura, T. (2017). The dramaturgy about

Tohoku Sociological Society. 46, 33-43.

asKoiwa, K., Komatsu, M., & Wakashima, K.

determinants of listeners’ reactions to(2020). Coping behavior against the inability

aversive jokes. The Japanese Journal of

to “take a hint” in a contemporary adolescent

Educational Psychology. 58(4), 393-403.

group of friends. The Japanese Journal of

60

Sakamoto.

Psychology. 91(5), 312-322.

factor analysis model and hierarchical factor

Long, D. L., & Graesser, A. C. (1988). Wit andanalysis model of nurse's ethical behavior

humor in discourse processing. Discourse

scale. Bulltin of Teikyo University of Science.

processes, 11(1), 35-60.

16, 81-88.

Maki, R. (2008). A review of research on

Ogiue, C. (2008). Netto ijime, Web syakai toteasing and issues for the future. Bulletin ofowarinaki "Chara sennsou". PHP Shinsho.

the(in Japanese).

Graduate

Schoolof

Education,

Hiroshima University. 57, 269-276.
Martin, R. A. (2007). The psychology of humor:
An integrative Approach. Elsevier Inc.
Mitsutake, S., Shibata, A., Ishii, K., Okazaki, K.,

Okada, T. (1995). Friendship, self and friend
image among contemporary college students.
Japanese

Journalof

Educational

Psychology. 43(4), 354-363.

& Oka, K. (2011). Developing Japanese

Okada, T. (1999). Relation between perceived

version of the eHealth Literacy Scale

friendship and self-consciousness among(eHEALS). Japanese Journal of Public

contemporary college students. Japanese

Health, 58(5), 361-371.

Journal of Educational Psychology. 47(4),Mochizuki, M., Sawami, T., Takizawa, J., &Yoshizawa, E. (2017). Characteristics of ijiri432-439.
Okada,

T.

(2007a).

Genndaiseinenno

as compared with teasing and bullying.

shinnrigaku: wakamono no kokoro no

Japanese Journal of Interpersonal andkyozou to zitsuzou. Sekaishiso Seminar. (inSocial Psychology. 17, 7-13.

Japanese).

Moriguchi, A. (2007). Ijime no kouzou.
Shinchosha. (in Japanese).
Mukai, M. (2020). "Ijime no syakai rironn" nosyatei to hennyou suru communication. KG

Okada, T. (2007b). Friendship style, adaptation,and perceived selves in contemporary
college students. The Japanese Journal of
Personality. 15(2), 135-148.

Sociological Review. 3, 3-12. (in Japanese).

Okayasu, T. (1992). The interaction between

Nakano, M. (2018). Zyoushi no "ijiri" ga

personality trait and stressful situations as ayurusenai. Kodansha Gendaishinnsho. (infactor of affecting stress in college students.

Japanese).

The Japanese Journal of Health Psychology.

National Foundation of Brief Therapy. (2016).
Interactional Mind Ⅷ(2015), Hokuzyu
shuppan.

5(2), 12-23.
Okuyama, S., Takagi, G., Kobayashi, D.,
Sakamoto, K., & Wakashima, K. (2016).

Niina, R., Sakata, S., Yatomi, N., & Homma, A.

Development of psychological invasiveness(1990). Development of the psychologicalInventory. Annual report Graduate School ofstress response scale. Shinshin Igaku. 30,

Education,

29-38.

147-156.

Ode, J. (2020). Examination of higher-orderTohokuUniversity.

65(1),

Sakamoto, K. (2017). "Ijiri" koudou noDEVELOPMENT OF THE RISK ASSESSMENT SCALE FOR IJIRI
goyouronnteki

bunnrui:"naiyounosokumen" to "kannkei no sokumen" nichakumokushite.

Bulletinofclinical

psychology center, Graduate school ofeducation, Tohoku University. 15, 85-101.
(in Japanese).
Sakamoto, K. (2018). "Ijiri" bamen no ukete nohannnou koudou seiki madeno sinnri syakai
teki process no kentou. The Japanese
Association of Counseling Sciense, 51st
conference, collection of papers, 103. (inJapanese).
Sakamoto, K. (2021). Examination of therelationship between the topic of Ijiri and theemotional responses: What is risky to teaseabout? Annual Report Graduate School of
Education,

TohokuUniversity,69(2),

141-152.
Selye, H. (1956). The stress of life. New York:
McGraw-Hill.
Shapiro, J. P., Baumeister, R. F., & Kessler, J.
W. (1991). A three-component model ofchildren's teasing: Aggression, humor, andambiguity. Journal of Social and ClinicalPsychology, 10(4), 459-472.
Spencer-Oatey, H. (2000). Culturally speaking.
New York: Continuum.
Terrion, J. L., & Ashforth, B. E. (2002). From
‘I’to ‘we’: The role of putdown humor andidentity in the development of a temporarygroup. Human relations, 55(1), 55-88.
Watzlawick, P., Bavelas, J. B., & Jackson, D. D.
(1967).

Pragmatics

of

human

communication: A study of interactional
patterns, pathologies, and paradoxes. New
York: W. W. Norton & Company.

61