International Journal of Brief Therapy and Family ScienceVol. 5, No. 2, 2015
                                      

CONTENTS
Original Paper: Research and Experimen ttSolution-focused group therapy for drug users
in Japanese prison: nonrandomized study
Kenji Yokotani Katsuhiro Tamura .......................................................................................... 42-61
The effects of social support reciprocity between parents and adolescents on
independency and depression of undergraduate students
Norimasa Itakura Genta Koide ............................................................................................... 62-72

Original Paper: Practice
A case report about the Support for the step Family accepted child evacuated from
Fukushima after the grate disaster in japan.
Michiko Ikuta .......................................................................................................................... 73-77

International Journal of Brief Therapy and Family Science
2015 Vol. 5, No.2, 42-61< Original Paper: Research and Experiment >Solution-focused group therapy for drug users in Japanese prison: nonrandomized study
Kenji Yokotani 1) 2) Katsuhiro Tamura 2)
1)

Niigata Seiryo University, Faculty of Social Welfare

2)

Niigata Prison, Treatment Section

ABSTRACT. Objective: Solution-focused brief therapy (SFBT) has shown treatment effects for a range of clients but not specificallyfor drug users in Asian populations. We exploratively examined the treatment effects of SFBT on drug use. Methods: Participants
were 60 inmates in a Japanese prison who were convicted of a drug-related offense. They were non-randomly assigned to the SFBT
group, treatment as usual (TAU) group, or mail feedback (Mail) group. They completed the Stimulant-Relapse Risk Scale and theCenter for Epidemiologic Studies Depression Scale before the start and after the end of these programs. Results: The SFBT andTAU groups showed more improvement on the Stimulant-Relapse Risk Scale than the Mail group did. However, the two groups did
not show improvement on the depression scale. Conclusions: SFBT is applicable to Asian drug users. The practical application of
SFBT in Asian populations is discussed.
KEY WORDS: Japan, methamphetamine, prison, solution-focused brief therapy, substance abuse

Core Concept of Solution-focused

Brief

Therapylimited except for a few remarkable studies(Froeschle,

Smith,&

Ricard,

2007;

Li,

Solution-focused brief therapy (SFBT) was

Armstrong, Chaim, Kelly, & Shenfeld, 2007;

developed inductively by two social workers,

Smock et al., 2008). Hence, the present study

Steve De Shazer and Insoo Kim Berg (deaims to clarify the treatment effects for drug

Shazer et al., 1986). The technique focuses onusers

solutions rather than problems. To help clients

control trials.

exploratively

using

non-randomized

have

supported

develop their own solutions, therapists utilize
clients’ strengths and set achievable futuregoals in a collaborative manner (Berg & Miller,

Effectiveness of SFBT
Many

studiesthe1992). Goal achievement scores are frequently

effectiveness of SFBT for several clinicalused in SFBT and regarded as a treatment index

problems (see review, Corcoran & Pillai, 2009;(e.g., Berg & Reuss, 1998). However, evidence

Gingerich & Peterson, 2013). For example,

about the treatment effects for drug users is

randomized control trials have shown that asingle session of SFBT improves positive

Niigata Seiryo

emotions of university students (Grant, 2012)

University, Faculty of Social Welfare, 1-5939, Suidocho,

and general treatment outcomes for clinicalChuo-ku, Niigata-shi, Niigata, 951-8121, Japan

participants (Richmond, Jordan, Bischof, &e-mail:yokotani@n-seiryo.ac.jp

Sauer, 2014). A meta-analysis also suggests that

CORRESPONDENCE

TO:

Yokotani42Solution-focused group therapy for drug users

43

SFBT is especially effective in decreasing

compare efficacy of SFBT with alternative

emotional

depressive

therapies. Third, goal achievement scores were

symptoms (Kim, 2008). These studies suggest

not analyzed, although many therapists usedthat SFBT is especially effective for depressivethese measures (e.g., Gingerich & Peterson,

symptoms.

2013; Smock et al., 2008). Fourth, depressive

problems,

such

as

symptoms and drug-relapse risks were not
SFBT for Adult Substance Abusers

assessed as outcome measures together, even

Even though SFBT has provided manythough depressive symptoms are a key measure

practical approaches for substance abusers

in SFBT (Kim, 2008) and common comorbidity(Berg & Reuss, 1998; Yokotani & Tamura,in substance abusers (e.g., Grant, 1995). The

2014), the treatment effects for them were

present study aims to overcome these four

limited. Naturalistic studies without control

limitations.

groups have implied that individual SFBT
might be effective in reducing drinking (deShazer & Isebaert, 2004). Two randomized

Aims of the Present Study
To overcome the first limitation and extend

control studies also found that group SFBTSFBT studies

improves depressive symptoms (Smock et al.,recruited inmates convicted of drug-related2008) and marital satisfaction (Li et al., 2007)

crimes in a Japanese prison. SFBT has beenin people who abuse substances, but theseutilized in many correctional facilities (Lee,studies did not report treatment effects relating

Uken,

specifically

includingtosubstance

abuse.

One

&

to

Asian

participants,

Sebold,2007;

Walker,adult

prisons(Lindforsswe2009),&

randomized control study found treatment

Magnusson, 1997); thus, SFBT could be

effectsthroughfeasible in a Japanese prison. To overcome thequestionnaires (Froeschle et al., 2007), but thesecond limitation, we compared the treatment

participants in this study were limited toefficacy of SFBT to positive and negative

healthy female eighth-grade students.

control groups. A treatment as usual (TAU)

of

SFBT

on

drug

use

group was included as a positive control, which
Abusers

LimitationsofPrevious

SFBT

Studies

involved 6 months of anonymous groupmeetings and skills training. These programs

Previous SFBT studies had four limitations.

are popular and have shown treatment effects

First, the participants were generally fromfor drug users (Gossop, Stewart, & Marsden,

Western communities, even though SFBT could

2008; Hawkins, Catalano, & Wells, 1986). Mailbe effective regardless of cultural differences

feedback was included as a negative control.

(Lee & Mjelde-Mossey, 2004). Second, theThe mail feedback (Mail) group completed 3

experimental design did not include a positive

months of feedback through letters without

control group, which made it difficult toface-to-face communication. Although mail

44

Yokotani.

feedback has shown treatment effects for

Ministry of Justice, 2006) and (2) repeat

addictive behavior (Walters & Neighbors,offenders. This is because first-time drug-use

2005; Yokotani & Tamura, 2015), the shorter

offenders usually receive only suspended prison

3-month treatment duration could weaken thesentences (95% from 1948 to 2006), whereas

effects of mail feedback on drug use when

repeat drug-related offenders receive sentencescompared to a 6-month treatment (McLellan,

without parole (79% of second-time reoffenders

Lewis, O’Brien, & Kleber, 2000). To overcome

and 93% of third-time reoffenders; Research

the

goal

and Training Institute of the Ministry of Justice,achievement scores within the SFBT group. To2009). As a result, inmates in Japanese prisons

overcome the fourth limitations, we measured

convicted of drug-related offenses are typicallyparticipants’ drug-related relapse risk andrepeatdepressive symptoms together.

drug-related problems.

thirdlimitation,

wemeasuredillegal

drug

users

with

severeThe present study was designed to test three

The 187 male inmates convicted of ahypotheses: group SFBT will be effective in

drug-related offense in a Japanese prison

decreasing drug use (Froeschle et al., 2007).

received instruction of the Mail group whenHence, like in the TAU group, the drug-related

they entered prison. During our group therapies,

relapse risk should improve in the SFBT group

54 participants were randomly assigned to themore than in the Mail group (1). Furthermore, aMail group and received the mandatory mailprevious study suggested that SFBT is effective(see Figure 1 for details). Five of these 54 could

especially for depressive symptoms (Kim,not receive feedback because of an ongoing

2008; Smock et al., 2008). Thus, SFBT should

criminal investigation, so they were excluded.

improve clients’ depressive symptoms more

Seven and five participants also received TAU

than the Mail feedback (2). Finally, SFBT isand SFBT, respectively, so these 12 participants

expected to promote clients’ personal goal

were excluded. The remaining 37 participants

achievements (Berg & Miller, 1992). Therefore,

were analyzed as the final Mail group.

the goal achievement scores for the SFBTOne month before the start of TAU and SFBT,

group at the final stage will be higher than theall 187 male inmates received information

scores at the initial stage (3).

about the SFBT and TAU as professional
therapy meetings and Narcotics Anonymous

Methods

group meetings. Twenty participants voluntarily

Participants

applied for the SFBT (see Figure 1 for details).

We recruited inmates in a Japanese prison

Three were excluded because of limited

convicted of a drug-related offense. People

seating and their schedule; the remaining 17

imprisoned for drug-related offenses in Japan

received SFBT. Five of these 17 received mailare (1) mostly individual users (97% from 2001

feedback at the same time, so they wereto 2005; Research and Training Institute of the

excluded from analysis, leaving 12 participantsSolution-focused group therapy for drug users

45

in the final SFBT group. Similarly, 27

had received a sentence of 3.2 (1.6) years, andparticipants voluntarily applied for TAU. Nine

had entered 4.1 (2.6) adult prisons. In a

we excluded because of limited seating andJapanese prison, inmates cannot access illegal

their schedule; the other 18 received TAU.

drugs. Hence, they were regarded as sober

Seven of these 18 received mail feedback at theduring imprisonment. Most of them hadsame time, so they were excluded from analysis,completed only junior high school or hadleaving 11 participants in the final TAU group.

dropped out of high school. Among the 60

In sum, 60 participants were included in ourparticipants, two were from Iran and the otheranalysis (Figure 1).

58 were from Japan. Fifty (83.3%) wereTable 1 shows the basic demographic

imprisoned mainly because of drug-relatedcharacteristics of the 60 male inmates. On

offenses (for violating the Stimulants Control

average, they were 44 (SD = 11.8) years old,

Act [n = 47], Narcotic and Psychotropic Drugs

46

Yokotani.

Table 1

Participants’ Demographic and Drug Use Characteristics
SFBT (n = 12)

TAU (n = 11)

Mail (n = 37)

M

SD

M

SD

M

SD

F

38

8.9

42.7

11.3

47.6

12.1

3.4n*

3.0

1.1

4.9

2.3

2.9

1.4

7.2n**

3.1

2.1

4.4

3.7

4.4

2.4

1.0n

Years of education

9.7

1.8

10.3

2.1

10.0m

1.5

0.3o

Number of sessions

9.2

4.0

10.4

2.2

5.8

0.7

Age
Present

sentence(years)Numberofprisonterms

attended

Drug use

χ2

Paint thinner

75%

55%

68%

1.2

Cannabis

75%

82%

51%

4.0

Stimulants

92%

91%

95%

0.2

Starting age
Paint thinner

14.5a

1.5

14.3d

0.8

14.8g

1.5

0.4p

Cannabis

18.3a

1.9

19.4e

4.9

22.1h

7.4

1.3q

Stimulants

20.1b

4.6

20.9f

5.7

22.1i

7.1

0.4r

Paint thinner

19a

30.2

43.2d

45.8

35.8j

37.8

0.8s

Cannabis

2c

1.1

38.5a

82.3

18.2k

34.4

1.1t

Stimulants

65.2b

47.3

47.0f

45.1

41.8l

37.9

1.3u

Averagedrug

use

per month

Note. SFBT = solution-focused brief therapy; TAU = treatment as usual; Mail: mailfeedback. an = 8, bn = 11, cn = 7, dn = 6, en = 9, fn = 10, gn = 25, hn = 19, in = 35, jn = 23, kn= 17, ln = 34, mn = 36, ndf = 2, 57, odf = 2, 56, pdf = 2, 36, qdf = 2, 33, rdf = 2, 53, sdf = 2, 34,t

df = 2, 29, udf = 2, 52; *p < .05, **p < .01.

Act [n = 2], or Cannabis Act [n = 1]). The other10

participants

were

non-drug-related

offenses

imprisoned
(such

as

for

The resulting duration of drug use is aroundtheft)

23 years (current age – starting age ofcommitted under the influence of drugs.
The most common illegal drugs in Japan arethinners,cannabis,andand 47.4 (41.4) times per month, respectively.

stimulants(methamphetamine and/or amphetamine) but

stimulants use). Taking into account their heavyuse, they could have used these drugs
repeatedly, rather than temporary, during theduration (e.g., McLellan et al., 2000).

not heroin and other opiate (Research andTraining Institute of the Ministry of Justice,

Design and Procedures

2009). Hence, we measured their usage about

The prison we sampled is located in thethese drugs. The participants’ average age when

Hokuriku (Northeast) area of Japan, designed

starting to use paint thinners, cannabis, andfor repeat offenders, and houses approximately

stimulants was 14.7 (SD = 1.4), 20.6 (6.1), and

750 prisoners. The 12 biweekly SFBT sessions

21.5 (6.4) years, respectively. Their mean

were conducted from March 2014 to August

frequency of using paint thinners, cannabis, and2014, and the 12 biweekly TAU sessions were

stimulants was 33.4 (SD = 37.5), 19.7 (48.0),

conducted from March 2014 to September 2014.

Solution-focused group therapy for drug users

47

The SFBT and TAU groups each had morning

Outcome measures (before start and after

and afternoon sessions. Hence, four groupend of each program). Participants answered

therapies were conducted in the prison during

the following measures within one week before

this

for

the start of the program. They also answered

approximately 90 minutes. The Mail groupthe same measures within one week after the

included a former (n = 34) and latter group (n =program ended.

period.

Eachsessionlasted20). The former group received six biweekly

The Correctional Stimulant Relapse Risk

mailings from March 2014 to May 2014. The

Scale (C-SRRS) is used to assess drug-related

latter group received the same letters from June

relapse risks (Yamamoto, Todoriki, & Nishida,2014 to August 2014. Eighty-three percent of2011). This scale has been modified from theparticipants (n = 10) in the SFBT group andoriginal SRRS (Ogai et al., 2007) for use in

81% (n = 9) in the TAU group took part inprisons. The C-SRRS is a 41-item questionnaire

more than 70% (8) of the sessions. Ninety-four

in Japanese. The responses are scored on apercent of participants (n = 35) in the Mail

5-point scale (strongly disagree [1], disagree

group received more than 70% (5) of mailings.

[2], neutral [3], agree [4], and strongly agree

The institutional board of the prison and the[5]). The C-SRRS comprises 6 subscales:

ethics committee of a local university in Japananxiety and intention to use drugs [AI] (11approved the study. Participants completed theitems; e.g., If I have a large sum of money, I

following questionnaires before the start andwant to buy drugs), emotional problems

after the end of their treatment program.

[Emotion] (10 items; e.g., I cannot control my

Measuresfeelings), positive expectancy about drugs [PE]

Assessing past frequency of illegal drug use(5 items; e.g., If I use drugs, I would feel(baseline only).

invigorated),

compulsivity

towarddrugs

Participants responded to three questions that[Compulsion] (4 items; e.g., I want to get drugs

assessed their frequency of stimulant use: (1)even through illegal activities), awareness ofHave you ever used stimulants before? (Yes ordrug dependence [Aware] (4 items; e.g., I neverNo): If yes, (1.1) at which age did you start

think about using drugs), and denial of drugusing stimulants? (1.2) And how often did you

harm [Denial] (7 items; e.g., If I use drugs, theuse stimulants in a month (a continuous

drugs

measure: if you use stimulants daily, theperformance [converted item]). This scale has

number would be 30; if you use stimulants once

been extensively validated in Japanese prisonsa week, the number would be 4; and if you use

in a study involving 60 Japanese correctional

stimulants once in two months, the number

institutions and 712 drug-related prisoners

would be 0.5). Participants also responded to(Yamamoto et al., 2011). Moreover, it has been

similar questions about paint thinner andreported that the AI and Emotion subscales arecannabis use.

positively

might

negatively

correlated

affectwith

mynumber

job

of

48

Yokotani.

drug-related offenses, and that PE is negatively

regarded as their goal achievement score. The

correlateddrug-use

SFBT group received the same question in the(Yamamoto et al., 2011). The baseline score in

final session and again wrote a response andourgave a numerical rating.

withsampleage

showedoffirstsatisfactoryalphacoefficients for total C-SRRS (α = .93), AI (.91),
Emotion (.93), PE (.87), Compulsion (.92), andAwareness(.84),

butnot

DenialIntervention
SFBT group. The 12 SFBT sessions aimed(.58).

to construct participants’ personal goals and to

Therefore, we interpreted the results of theenhance their motivation to achieve their goals

Denial scale with caution.

(Yokotani & Tamura, 2014). Seven sessions

The Center for Epidemiological Studies

were categorized as goal setting (#2 goal

Depression Scale (CES-D) is used to assesssetting, #3 lifestyle when clients quit drugs, #4

depressive(1977)

coping style when clients quit drugs, #5 social

developed the original version of the CES-D,

resources that help clients in achieving theirand Shima, Kano, Kitamura, and Asai (1985)

goals, #9 personal knowledge about safe anddeveloped the Japanese version. It is a 20-itemrisky situations, #10 ways to overcome risky

scale with items such as: “You felt depressed.”situations, #11 ways to overcome relapse). The

Responses are scored on a 4-point scale (lessotherthan one day [0], 1–2 days [1], 3–4 days [2],motivation enhancement (#1 motivation to

5–7 days [3]). The CES-D can be used to assesschange, #6 social resources that motivate

both healthy and depressive people and has

clients to change, #7 benefits of change (cost of

been validated internationally (Santor, Zuroff,

status quo) versus benefits of status quo (cost ofRamsay, Cervantes, & Palacios, 1995). Thechange), #8 commitment to change versus

baseline score in our sample showed acommitment

satisfactory alpha coefficient (α = .83).

resolve and policy for the future). Personal goal

symptoms.

Radloff

fivesessions

towerecategorized

non-change,

#12

as

clients’

Additional outcome measures (for SFBT

setting and enhancement of the motivation togroup only). To measure a goal achievement

achieve their goals could be linked withscore, the SFBT group received an imaginationachievement of their personal goal.

question (adjusted miracle question: “After you

Furthermore, the sessions were well matched

are released from prison, you will continue towith the core components of SFBT (Berg &live your best in freedom for a long period of

Reuss, 1998; Gingerich & Peterson, 2013). For

time. Three years after your release, you will

example, the programs include goal setting (#2),

finally achieve your dream life in society.

scaling question (#2, #12), utilization ofPlease describe your dream life.” Participants

exception (#4, #9, and #10), focus on what is

wrote about their dream life and then rated their

better (#3), and compliments (all feedback).

current lifestyle on a scale from 1 (far from the

Furthermore, the adjusted imagination question

dream life) to 10 (dream life). This score was(#2) was used. The therapists’ not-knowing

Solution-focused group therapy for drug users

49

position was also consistent with other manuals

Intervention for College Students (#3, #4, #6;(e.g., Pichot & Dolan, 2014; Pichot et al., 2009).

Dimeff, Baer, Kivlahan, & Marlatt, 1999) and

The details and rationale for these sessions arein other studies (#1; Lee, Neighbors, Kilmer, &described elsewhere (Yokotani & Tamura,

Larimer, 2010; #5; Walker, Roffman, Stephens,2014).

Wakana, & Berghuis, 2006). Participants wrote

TAU group (positive control group). Three

down their answer to each question. Positive

types of TAU sessions were conducted: (1)responses were given following the feedback

Narcotics Anonymous (NA) group meetings on

guidelines developed by Miller and Rollnick“new life” (#2), “free talk” (#4), “the past year”(2012). Participants received feedback in the(#6), “powerlessness” (#8), and “aims” (#10).

mail only and did not receive in-person(2) A personal lecture from a representative of

feedback.

families with addiction (#9). (3) Skills training:

Therapists. An associate professor of social

conditional reflex control (#1), the Kawakita

welfare with a PhD and district leader of SFBTJiro method to discuss how to prevent drug use

in Japan conducted the SFBT sessions. He had(#3), role playing to stop drug use (#5), anddeveloped a manual for conducting grouprole playing in risky situations (#7, #11, #12).

SFBT with drug-related offenders (Yokotani &NA group meetings corresponded with open

Tamura, 2014). TAU was conducted by three

discussion meetings (e.g., Riordan & Walsh,types of therapists. The NA meeting was1994). Skills training corresponded with coping

conducted by four people in the Japanese NA

skills (Hawkins et al., 1986).

group: two were employed by the NA

Mail group (negative control group). The
Mail

group

treatment

severaltwo were members of the home. The personalquestions and information focused on thelecture was given by a representative of

merits and demerits of stopping drug use (#1),

families with addiction. Skills training wasconditional reflex control (#2), identification of

conducted by a staff member who manages

risky

environmental

nearly all treatment programs conducted in thecoordination to avoid drug use (#4), self-help

prison. He regularly receives skills training andgroups to maintain abstinence from drug use

presents treatment effects. The mail feedback(#5), and coping skills to avoid risky situations

was also provided by this staff member.

situations(#3),

included

residential care home in Japan and the other(#6). The feedback given corresponds to thatused in the Brief Alcohol Screening andStatistical Analysis

50

Yokotani.

Table 2Comparison of Treatment Effects across SFBT, TAU, and Mail Groups

AI
Emoti

SFBT

TAU

Mail

n = 12n = 11n = 37

Pre

Post

M

28.4

25.0a

SD

9.4

10.3

M

26.5

24.3a

SD

11.9

12.0

M

16.1

14.1a

on
PE

d
0.3

0.2

0.3

Pre

Post

28.0

21.3 e

10.5

8.4

20.8

17.1e

10.7

10.7

13.7c

12.3e

6.4

8.5

8.0c

4.5e

d

Pre

Post

d

0.7

21.6f

21.0i

0.1

11.9

10.0

17.2f

17.0i

9.7

7.8

11.1f

10.8i

6.1

6.2

5.2f

5.1g

0.3

0.2

SD

6.5

7.1

Compu

M

8.0

7.3a

lsion

SD

5.5

4.5

5.5

1.2

2.7

2.7

Aware

M

12.1

13.2a

11.3c

10.1e

13.6f

15.0g

SD

4.3

4.1

4.1

4.1

5.4

4.3

M

17.3

14.4a

16.6c

21.6e

15.2f

14.2g

SD

7.4

7.3

5.9

8.7

5.9

6.6

C-SRR

M

108.6

98.6a

98.0c

87.1e

84.2f

83.4g

S

SD

28.9

31.6

33.6

34.0

24.2

23.2

CES-D

M

17.2a

14.3a

17.5d

14.5e

12.6g

9.5j

SD

12.0

13.1

15.4

15.1

11.2

5.8

M

2.7c

5.6a

SD

4.8

1.9

Denial

GAS

0.1
-0.3
0.4
0.3
0.2

1.0
0.3
-0.7
0.3
0.2

0.0

0.0
0.0
-0.3
0.2
0.0
0.4

-0.9

Note. SFBT = solution-focused brief therapy; TAU = treatment as usual; Mail = mailfeedback; AI = anxiety and intention to use drugs; Emotion = emotional problems; PE =positive expectancies about drugs; total C-SRRS = total Correctional Stimulant Relapse
Risk Scale; CES-D = Center for Epidemiological Studies Depression Scale; GAS = goal
achievement score. an = 9, bn = 10, cn = 11, dn = 8, en = 6, fn = 36, gn = 32, hn = 34, in = 33,

n = 25, kn = 31.

j

An analysis of covariance (ANCOVA) was
used

to

calculatecomparative

Even though the Mail group was larger than thetreatment

SFBT and TAU groups, we did not specificallyefficacy across the three treatment groups,

weigh the Mail group in the ANCOVA, because

controlling for baseline scores and the number

the power analysis could take into account aof sessions attended. Holm’s adjustment for

disproportional amount of the Mail group. We

multiple comparisons was used to compare

used HAD (no abbreviation) version 12.01

group differences between the three groups.

(Shimizu, Murayama, & Daibo, 2006) and

Paired t-tests were used to compare goal

G*Power version 3.1.9.2 (Faul, Erdfelder,achievement scores between the initial and final

Buchner, & Lang, 2009) to conduct thesestages of SFBT. Pearson’s correlations wereanalyses.

used to calculate associations between pairs ofvariables. Levels of significance and significant

Results

tendencies were set at .05 and .10, respectively.

Descriptive Statistics and Selection of

Solution-focused group therapy for drug users

51

Table 3

Summary of Treatment Effects across the SFBT, TAU, and Mail Groups
Outcome

Factors

F

p

AI

Model

19.3

***

Group

5.5

**

.205

2, 43

Attendance

11.2

**

.208

1, 43

Pre-score

69.4

***

.618

1, 43

Model

18.7

***

Group

4.0

*

.158

2, 43

Attendance

9.8

**

.186

1, 43

.568

1, 43

Emotionpartial 2dfPre-score

56.5

***

Model

18.66

***

C-SRRS

Group

3.8

*

.156

2, 42

Attendance

7.2

*

.147

1, 42

Pre-score

67.0

***

.615

1, 42

Model

22.5

***

Group

5.7

**

Attendance

3.2

Pre-score

74.0

***

Model

10.6

***

Group

1.0

.048

2, 43

Attendance

1.7

.040

1, 43

Pre-score

38.2

***

.471

1, 43

Model

16.4

***

Group

1.0

.047

2, 42

Attendance

1.6

.039

1, 42

Pre-score

56.0

***

.571

1, 42

Model

3.2

*

Group

1.8

Attendance

4.2

Pre-score

1.8

Model

8.9

Group

0.2

.016

2, 29

Attendance

0.0

.001

1, 29

Pre-score

26.5

.478

1, 29

PE

Compulsion

Aware

CES-D

*

SFBT < Mail*, TAU < Mail*

4, 42
SFBT < Mail*, SFBT < TAU*

4, 42
.216

2, 42

.073

1, 42

.638

1, 42

SFBT < TAU*

4, 43

4, 42

4, 42
.081

2, 42

.092

1, 42

.042

1, 42

***

***

SFBT < Mail**, TAU < Mail**

4, 43

total

DenialMultiple comparisons

4, 43

4, 29

Note. SFBT = solution-focused brief therapy; TAU = treatment as usual, Mail = mailfeedback; AI = anxiety and intention to use drugs; Emotion = emotional problems; PE =positive expectancies about drugs; total C-SRRS = total Correctional Stimulant Relapse
Risk Scale; CES-D = Center for Epidemiological Studies Depression Scale. *p < .05, *p< .01, ***p < .001.

Covariates

groups.

Table 1 shows the characteristics of the

The SFBT group was significantly

participants. There were no significant

younger than the Mail group (Holm’sgroup differences in age of first illegal

adjustment for multiple comparisons, pdrug use for paint thinners, cannabis, or< .05). The TAU group received a longer

stimulants. Likewise, average use per

average sentence than both the SFBT

month

not

and Mail groups (both comparisons p

significantly different across the three< .01). However, neither age nor sentence

of

these

drugs

was

52

Yokotani.

length was significantly correlated withgroups improved more on the AI subscale

our outcome measures. Therefore, we didthan did the Mail group. The ANCOVA

not include them as covariates.

also showed significant group differences

In addition, the SFBT and TAU groups
attended more frequently than the Mailgroup.

Furthermore,thesessions

attendedwasnumberofsignificantly

correlated with outcome measures (e.g., r

29.0

26.0

a

covariate.

21.6
21.0

SFBT
(Experimental)

TAU(positive control)

Mail(negative control)

Figure 2. Comparative treatment effects on anxiety and intention to use drugs (AI,subscale of the Correctional Stimulant Relapse Risk Scale) across the three treatmentgroups: SFBT (solution-focused brief therapy), TAU (treatment as usual), and Mail

Table 2 shows baseline assessment of
the

21.3

21.0

of the C-SRRS). Therefore, we did include
as

Post

23.0

20.0

attended

Pre

24.0

sessions attended and the Aware subscalesessions

25.0

25.0

22.0

of

28.0

27.0

= -.38, p < .001 between the number of

number28.4

28.0

outcomemeasures.

There

were

(mail feedback).

110

significant group differences in the AI,
Emotion, PE, and Compulsion subscalesof the C-SRRS, total C-SRRS, and CES-D.

108.6

105

100

These results suggest that the three95

groups differed in drug-related risks and90

mental health at baseline.

85

98.6

98

Pre
Post

87.1
84.2

83.4

80

Comparison of Treatment Effects across
SFBT, TAU, and Mail Groups
treatment groups, with group differencetheindependent

variableandpost-treatment score (post score) as thedependent variable. Outcome scores atbaseline(pre-score)andnumberofsessions

attended

were

includedascovariates.

This

analysis

TAU(positive control)

Mail(negative control)

Figure 3. Comparative treatment effects on the total scores of the Correctional

An ANCOVA was used to compareas

SFBT(Experimental)

indicatedsignificant group differences for the AI,
Emotion, and Denial subscales as well as
the total C-SRRS score (Table 3).
Figure 2 shows that the SFBT and TAU

Stimulant Relapse Risk Scale across the three treatment groups: SFBT (solution-focusedbrief therapy), TAU, (treatment as usual), and Mail (mail feedback).

in AI when controlling for pre-score andnumber of sessions attended (Table 3).
Multiple comparisons also suggest that
the SFBT and TAU groups showedsignificantly greater improvement on the
AI subscale compared to the Mail group.
Similarly, the SFBT and TAU groups
improved more on the Emotion subscalethan did the Mail group. The ANCOVA
also showed significant group differences

Solution-focused group therapy for drug users

in Emotion when controlling for pre-score

53

Power Analysis of Treatment Effects

and number of sessions attended (Table

We analyzed the power of total group3). Multiple comparisons also suggest

differences (SFBT, TAU, and Mail) andthat the SFBT and TAU groups showed

experimental (SFBT) or positive control

significantly greater improvement on the(TAU) versus negative control group

Emotion subscale compared to the Mail

(Mail) differences. On the one hand,group.

powers of total group differences wereIn addition, the total relapse risk scale

small (see partial η2 in Table 3). We set

showed similar results. The SFBT andthe risk of type 1 error at .05 and found

TAU groups improved more on the overallthat the powers of total group differences

C-SRRS than did the Mail group (Figure

for AI, Emotion, C-SRRS, and Denial3). The ANCOVA also showed significant

were .20, .14, .13, and .23, respectively. To

group differences on the C-SRRS whenreach a power above .80, we would havecontrolling for pre-score and number ofneeded 244, 380, 399, 222 participants forsessions attended (Table 3). Multiple

these measures, respectively.

comparisons also suggest that the SFBTOn the other hand, after we controlled

and TAU groups showed significantly

for the effects of covariates (pre-score andgreater improvement on the C-SRRS

thecompared to the Mail group.

differences between SFBT or TAU andAlthough the SFBT and TAU groups

Mail

numbergroupsofattendances),reached

power

on

the
the

were not significantly different in terms

post-scores. Even though we adjusted theof AI, Emotion, or C-SRRS, the SFBT

risk of type 1 error to 0.013 for multiple

group showed more improvement incomparisons, the power of the differences

terms of Denial than did the TAU groupbetween SFBT and Mail groups was 1.00

(Table 3). The ANCOVA and multiple(AI), .99 (Emotion), .99 (C-SRRS), and .99

comparisons support this pattern. SFBT

(Denial). Similarly, the power of the

improveddifferences

Denial,whereasTAU

aggravated Denial.
The

between

TAU

and

Mail

groups was .99 (AI), .99 (Emotion),

ANCOVA models

PE,and .99 (C-SRRS). Although for Denial,

Compulsion, and Aware subscales were

the differences between TAU and Mailsignificant, but these models did not

had a small power (.18), the differences

reportbetween SFBT and TAU had sufficientsignificant

group

of

the

differences(Table 3). Similarly, the ANCOVA models

power (.97).

of the CES-D did not show significant
group differences (Table 3).

Comparison of Goal Achievement Scoreswithin the SFBT Group

54

Yokotani.

6

5.6

Discussion

5
4

The present non-randomized trial

3

2.7

exploratively examined treatment effects

2of SFBT on drug use as compared to1

negative (Mail) and positive (TAU)

0
Initial stage

Final stage

Figure 4. Goal achievement scores for the SFBT (solution-focused brief therapy) groupcontrol groups. As hypothesized (1), theat initial and final stages.

SFBT group showed more improvement

Goal achievement scores for the SFBT

on the AI and Emotion subscales as wellgroup at the final stage were significantly

as the overall C-SRRS than did the Mail

higher than scores at the initial stage

group. Furthermore, the SFBT and TAU(Figure 4; paired t = 2.5, p < .05, df = 8).

groups showed similar improvement

Goal achievement scores were also
correlated

withseveraloutcomeregarding these scales. Power analysis
also supported these improvements.

measures. Goal achievement scores at the

Surely, our non-randomized trial included

initial stage were negatively correlatedbiases at baseline, which made ourwith age (r = -.56, p = .09, df = 8),

findings suggestive rather thaninstances of imprisonment (r = -.62, p

conclusive (Van Breukelen, 2006).

= .05, df = 8), and age of first stimulant

However, our data support the claimuse (r = -.74, p = .02, df = 7). Goalthat treatment effects of SFBT areachievement scores at the final stage

comparable to popular therapies, such as

were

the

anonymous meetings (Gossop et al., 2008)

post-test Compulsion subscale (r = -.60, p

and skills training (Hawkins et al., 1986)= .08, df = 7), Denial subscale (r = -.75, p

for adult drug users. Our findings help to= .02, df = 7), and total C-SRRS (r = -.59,

bridge the gap between practical

p = .09, df = 7).

protocols of SFBT (Pichot & Dolan, 2014;

negatively

correlated

withPichot et al., 2009) and empirical data

Power Analysis of Goal Achievement(Corcoran & Pillai, 2009; Gingerich &Scores within the SFBT Group

Peterson, 2013) regarding drug use andTo

assess

the

power

of

goal

achievement scores within the SFBT
group, we set the type 1 error at .05.
Mean

and

standard

deviationofsupport the applicability of SFBT for
addictive behaviors.
The present group SFBT shared thetheoretical orientation and manydifferences between pre and post scores

techniques with previous

were

implementations of group SFBT for

2.96

and

2.30,

resulting in a power of .91.

respectively,

substance abusers (Froeschle et al., 2007;

Solution-focused group therapy for drug users

55

Li et al., 2007; Smock et al., 2008), butachievement scores at the initial stage

the current program also had specific(pre-treatment) were negatively

differences. The present program (24correlated with age and instances ofweeks) was longer than that of previous

imprisonment. These data suggest thatstudies (6–16 weeks). The program also

elderly prisoners who have been

involved more troubled participants

imprisoned many times might have(methamphetamine/amphetaminedifficulty achieving their goals comparedabusers, middle-aged men with a 20-year

to young, first-time prisoners. Goal

drug use history, imprisoned patients)

achievement scores at the final stage

than previous studies (cannabis and(post-treatment) were negatively

alcohol abusers [Li et al., 2007],

correlated with several relapse-riskeighth-grade healthy students [Froeschle

scales. These data could be interpreted as

et al, 2007], or outpatients [Smock et al.,an indication that subjective achievement

2008]). The present participants wereof a dream life was associated withalso sober during treatment because theysubjective relapse-free survival in a free

had no access to the drugs in prison.

society. The SFBT group significantly

Furthermore, the Japanese prisonincreased their goal achievement scores,

environment prepared neither a one-way

reflecting more positive goal-oriented

mirror room (Li et al., 2007; Smock et al.,emotions and perspectives (e.g., Grant et2008) nor additional meetings withal., 2012).

participants’ family members (Froeschle

In contrast to our hypothesis (2) andet al, 2007). These differences mightprevious studies (Kim, 2008; Smock et al.,explain the treatment effects. For

2008), our data did not indicate any

example, a previous study suggested thatsignificant improvement in depressive

the length of treatment was related tosymptoms after treatment, although all

relapse rates of substance abusersof our treatments improved participants’(McLellan et al, 2000); thus, the present

depressive symptoms to a certain extent

long programs might have produced(Cohen’s d ranged from 0.2–0.4). The

these positive treatment effects morepresent program fixed the theme of eacheasily than the previous short ones.

session and limited the range of themes

In line with our hypothesis (3), SFBT

within drug-related solutions, limiting

sessions improved goal achievement

the program’s effects to drug-related

scores. The significant improvement ofrelapse. More spontaneous and flexible

goal achievement scores indicates thatthemes might be more effective in

SFBT was a successful treatment (Berg &decreasing depressive symptoms (e.g.,

Reuss, 1998; de Shazer et al., 1986). Goal

Smock et al., 2008).

56

The Asian inmates of the present study

Yokotani.

the effects of the mail feedback (e.g.,also indicated that SFBT was helpful for

Walters & Neighbors, 2005). Second, thethem, especially when related to issues

limited sample size and disproportionate

with their significant others (Lee &amount of participants in the Mail group

Mjelde-Mossey, 2004). For example, one

increased the risk of statistical errors. In

prisoner experienced difficulties tofact, the power of total group differences

imagine an ideal life in free society

was too small to be conclusive. Third, thebecause his stay in prison had beenoutcome measures included only

longer than the time in freedom. However,questionnaires, so we do not know

when the therapist asked this prisoner,

whether the participants started using“If your friend from childhood were still

drugs again after returning to free society.

alive (he was dead because of an

Fourth, we did not intervene in theiroverdose), how would he advise you tocurrent relationship with significant

live?” he could easily imagine his ideal

others, although we included their pastlife from his past friend’s perspective.

relationship with others. Fifth, we did not

Another prisoner felt difficulty to stopmeasure their duration of sobriety, whichusing drugs even for one day. However, hemight affect drug-related risks. Future

managed to stop using the drug for two

studies need to implement randomized

weeks when he planned to visit the grave

controlled designs with sufficient sampleof his grandmother. He assumed that his

size for severely affected clients.

“clean” (not contaminated by drug) body

Furthermore, follow-up studies involving

is appropriate to meet her spiritually.

relapse rate would be valuable (Yokotani

Asian people live in an interdependent& Tamura, 2015).

society, which makes it easier for them to

Despite these limitations, our pilot

create their goals and solutions in the

study had a value as a starting point forcontext of social relationships (Lee &therapeutic trial in Japanese prisons.

Mjelde-Mossey, 2004).

Although Japanese prisons did many

Our study had five limitations. First,

treatments, effects of these treatments

our three groups were not randomly

were basically secret. Hence, comparative

assigned, so the effects of SFBT on drug

discussion about them was difficult. To

use remain unclear (Van Breukelen,move out of the habitual secrecy, the2006) and a cautious interpretation of thepresent study revealed the data in public

findings is warranted (Miller & Chapman,and compared treatment effects in a2001). In particular, the Mail group did

Japanese prison. Our study could serve

not participate voluntarily. Theiras a precedent for public announcement

low-level motivation might have lessenedof treatment effects in Japanese prisonsSolution-focused group therapy for drug users

57

and provide comparable data set with

Working with the problem drinker: A

another therapy. Accumulation of thesesolution-focused approach. New York,data could produce generalizable findings

NY: WW Norton.

and foster randomized controlled study
near the future in Japanese prisons.
Our non-randomized trial examined
the treatment effects of SFBT compared

Berg, I. K., & Reuss, N. H. (1998).

Solutions step by step: A substanceabuse treatment manual. New York,
NY: WW Norton.

to positive and negative control groups.

Corcoran, J., & Pillai, V. (2009). A review

Our findings exploratively suggested thatof the research on solution-focused

SFBT could be effective for drug users intherapy. British Journal of Social Work,a prison environment. These findings are

39(2), 234–242.

consistent with previous drug-related

doi:10.1093/bjsw/bcm098

findings (Berg & Reuss, 1998; de Shazer

de Shazer, S., & Isebaert, L. (2004). The& Isebaert, 2004; Froeschle et al., 2007;

Bruges model: A solution-focused

Li et al., 2007;; Pichot & Dolan, 2014;

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Pichot et al., 2009; Smock et al., 2008;of Family Psychotherapy, 14(4), 43–52.

Yokotani & Tamura, 2014) and add pilot

doi:10.1300/J085v14n04_04

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de Shazer, S., Berg, I. K., Lipchik, E. V. E.,

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Nunnally, E., Molnar, A., Gingerich, W.,

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Faul, F., Erdfelder, E., Buchner, A., &Lindforss & Magnusson, 1997; Walker,

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Declaration of Conflicting Interests
The authors disclosed no conflicts of interest
withrespecttotheauthorship

and/orpublication of this article.
Funding
The present study was funded by the Nikkoso
Foundation for Safe Society (SZ2014A004).
Acknowledgements
We

thank

the

prisoncooperation and assistance.

staffs

for

their

61

International Journal of Brief Therapy and Family Science
2016 Vol. 6, No.2, 62-72< Original Paper: Research and Experiment >The effects of social support reciprocity between parents and adolescents on
independency and depression of undergraduate students
Norimasa Itakura 1) Genta Koide 2)
1)

Gifu University Faculty of education

2)

Nagoya University hospital

ABSTRACT. The effects of social support reciprocity between parents and adolescents on undergraduate students’ independency anddepression were investigated. The results indicated that independency increased and the depression score was significantly lower inthe group that received and provided more support, compared to the group that received and provided less support. The results ofmultiple regression analysis indicated social support from adolescents to fathers had negative correlations, whereas, in men, social
support from adolescents to mothers had positive correlations with depression scores. Moreover, in women, social support frommothers to adolescents had positive correlations with dependency on parents. Overall, social support from adolescents to fathers had
positive correlations with independency.
KEY WORDS: Reciprocity, Parent-adolescent relationships, Independency, Depression

Introduction

Ochiai and Satou (1996) suggested that

In recent years, adolescents that postpone“equality in the parent-child relationship”

becoming independent, such as NEETs andimplies that psychological weaning has beenthose with social withdrawal have beenachieved. Moreover, Usami, Kozuka, Hiraizumi,

increasing.

postpone

Morikawa, Huruyama and Wakashima (2011)

becoming independent fail to achieve economic

have indicated through cumulative family

and psychological independence, and are totally

research using Family Relationship History

dependent on support from their parents (e.g.,

Graphs (FRHG) that children acquire power in

Kato & Takagi, 1980 ; Wakashima, 2009)

the family after adolescence. Furthermore,

Psychological weaning is a concept used for

Kozuka (2013) has demonstrated that a type

explainingoffamily structure with a power-balance andparent-child relationships in adolescence. It

strong ties between family members was

implies that young people from 12 to 20 years

related to low stressors inside and outside of theof age become eager to leave their familyfamily.

control for independence (Holingworth, 1928).

parent-child

Adolescents

the

that

developmental

aspectsThe

establishment

of

an

equal

relationshipisconsidered

important in independence and mental health of
CORRESPONDENCE TO: Itakura Gifu University, Facultyadolescents.
Psychological weaning is a concept used forof education, 1-1, yanagito, gifu-shi, Gifu, 501-1193, Japan

explaining

e-mail:1takura313@gmail.com

62

the

developmental

aspectsofSocial support reciprocity between parents and adolescents

63

parent-child relationships in adolescence. It

support providers, whereas excessively large

implies that young people from 12 to 20 years

benefits (i.e. received support is much moreof age become eager to leave their family

than provided) causes a sense of guilty andcontrol for independence (Holingworth, 1928).

dependence on support providers. Buunk andOchiai and Satou (1996) suggested that

Doosie (1993) indicated that individual health“equality in the parent-child relationship”

would improve if the amount of received andimplies that psychological weaning has been

provided social support were equal. Whenachieved. Moreover, Usami, Kozuka, Hiraizumi,

applying

Morikawa, Huruyama and Wakashima (2011)

relationships, the balanced condition could be

have indicated through cumulative family

considered a reciprocal relationship between

research using Family Relationship History

parents and children, i.e. parents and children

Graphs (FRHG) that children acquire power inmutually provide and receive support.

the family after adolescence. Furthermore,abovefindings

toparent-childThis study examined correlations between

Kozuka (2013) has demonstrated that a typereciprocityofsocialfamily structure with a power-balance andconsideredtobestrong ties between family members was

relationships, independence and depression,

related to low stressors inside and outside of thefrom the perspective of adolescents. Ochiaifamily.

The

support

equal

in

which

is

parent-childestablishment

of

an

equal

(1996) suggested that parent-child relationships

relationshipisconsideredin the latter half of adolescence, change fromimportant in independence and mental health ofthe parents supporting children to an equal

adolescents.

relationship, as a result of children acquiring

parent-childStudies on social support have suggested thattrust and approval from parents. Reciprocal

individuals should be perceived as both passive

relationship in which adolescents receive andsupport receivers and active support providers

provide social support from and for parents is(Acitelli & Antonucci, 1994), which is an index

regarded as an equal parent- adolescentof equal parent-child relationships. Antonucci

relationship that would increase adolescents’and Jackson (1990) have indicated when the

independence. On the other hand, excessive

amount of social support received by a personsocial support from parents might inhibit theis much higher than which is provided (unequal

development

conditions),ofadolescents more dependent. It has been

indebtedness, whereas when the situation isdemonstrated that independent adolescents

reversed, they become disturbed and feel thatprovide more support to their parents thantheir independence threatened. According to La

dependent adolescents (Lang & Schütze, 2002).

Gaipa (1990), excessively small benefits (i.e.

Moreover, even when there is reciprocity ofprovided support is much more than received)social support, mental health might be inhibitedcauses a sense of burden and frustration inwhen “the amount of both acquisition andtheydevelop

a

sense

of

independence

and

make

64

Itakura.

provision is small” (Katauke & Shoji, 2000).

fatheradolescent, and motherAccording to the family systems theory, parents

relationships, and the effect of each type ofand children interact with each other. However,socialmost studies on parent-child relationship haveadolescents and on depression were explored.

supportontheadolescent

independenceofbeen conducted on the assumption that parents
support their children. As a result, children’s

Methods

effect on parents and support provided byParticipants

children to parents have not been investigated

Questionnaires

weredistributed

duringto date (e.g., Cummings, Davies, & Campbell,

university classes. There were 222 respondents

2002). It has been indicated that emotional(boys=104, girls=118, mean age=20.9 years,

support from family sometimes increases the

SD=0.74) after excluding respondents giving

risk for illnesses in children that have a highobviously incomplete responses.

level of stress (e.g. Jones & Moore, 1990). It is

2. Measurespossible that excessive support from family for(1)adolescents under negative conditions, andadolescents scalesconsidering adolescents as weak because they
have

a

risk

for

illnesses,

declinetheir

SocialsupportbetweenparentsandFour social support scales were developed toassess“socialsupportfromfatherstoindependence and maintain their negativeadolescents,” “social support from mothers tofeelings. The negative feelings in adolescentsadolescents,” “social support from adolescentsmight be improved by an increase in theirtodependence, by providing support to parents,

adolescents to mothers,” by referring to Social

instead of being provided with support by

Support Scale for the Social Support Scale forparents. Therefore, it is considered important toCollege Students (Shima, 1991). Participants

improveandwere required to respond to items using a

decease depression to maintain high reciprocity.

five-point scale consisting of 1 (Never), 2

Based on the above perspectives, two(Rarely), 3 (Sometimes), 4 (Often), and 5

awarenessofindependence

fathers,”

hypotheses were developed. H1: participants(Always).

with high social support scores both from

(2)

and

“socialsupportfrom

Awareness of independence scaleparents to adolescents and from adolescents to

Awareness of independence was assessed byparents would show higher independence andusing the scale developed by Kato and Takagi

lower depression. H2: participants with high(1980). The scale consists of 37 items.

socialtoParticipants were required to respond to theadolescents and low social support scores fromitems using the five-point scale; 1 (Very untrue),adolescents to parents would show higher

2 (Untrue) , 3 (Neutral), 4 (True) and 5 (Verydependencetrue).

supportandscoresfromdepression.

parents

Furthermore,

reciprocity of social support was classified intoSocial support reciprocity between parents and adolescents

65

Table1. Factor analysis of social support from parents to adolescents scales
33 9 94F 8 E F 47 8E68 FE 364 8-(
2 C4 8 FE 4 I 4 E 47 8 4 7 46 I 87 8 45 F8E
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2

0%

C4 8 FE 6 9 F 8 I 8 1988 78C 8EE87
C4 8 FE 4 8 4CC I F 8 I 8 1 4 8 E 8F
7
C4 8 FE C 4 E8
7 C FE
C4 8 FE 8 47 68 F 8 I 8 1 4 8 E 8 786 E E
C4 8 FE 8 47 68 F 8 I 8 1 4 8
4 8 4F E C 5 8 E
C4 8 FE F8 8 F
F F 8F 8
C4 8 FE E CC F 8 I 8 1 4 8 EF4 8E
C4 8 FE 4 I 4 E 78 EF4 7 988 E
C4 8 FE 8 C 8 I F
I
C4 8 FE 8 8 499 4F 8 9 4F 4 7 8 4 4F E 9 8 5 F 8 E
C4 8 FE EF8 F
F4 45 F E6
4 7 C4 F F 8 5
C4 8 FE 64 8 9 7 8
C4 8 FE E I F8 8EF
55 8E 4 7 F8 8EFE
C4 8 FE 4FF8 7
8 I 8 14
C4 8 FE 8 8 C 8E8 FE
5 F 74 E 4 7 4 8 E4 8E
C4 8 FE C F F 547 C FE 4 7 C 5 8 E.

(3)

4F 8 6 F 5 F

%

(

%
%
%
-

33 9

)
)
))
)(
)
)%
)
)
(
(

F 8 E F 47 8E68 FE 364 8-%

0%

2 C4 8 FE C 4 E8
7 C FE
2 C4 8 FE 6 9 F 8 I 8 1988 78C 8EE87
2 C4 8 FE E CC F 8 I 8 1 4 8 EF4 8E

2 C4 8 FE 8 47 68 F 8 I 8 1 4 8
2 C4 8 FE 4 I 4 E 78 EF4 7 988 E

4 8 4F E C 5 8 E%

2 C4 8 FE 4 I 4 E 47 8 4 7 46 I 87 8 45 F8E
2 C4 8 FE 8 C 8 I F
I
2 C4 8 FE 8 8 499 4F 8 9 4F 4 7 8 4 4F E 9 8 5 F 8 E

2
2
2
2

C4 8 FE E I F8 8EF
55 8E 4 7 F8 8EFE
C4 8 FE F8 8 F
F F 8F 8
C4 8 FE 64 8 9 7 8
C4 8 FE 8 8 C 8E8 FE
5 F 74 E 4 7 4 8 E4 8E

)
(
)
)(
)%

%
)
)
)%
(
()
(
(%
(
-

%
))

(

(
8 4 8
4F )

Depression scale.

effects

were

4F 8 6 F 5 F

excluded.

8 4 8 ))
4F ()

Next,

factorDepression was assessed by using theanalysis was conducted on social support

Japanese version of Self-Rating Depression

scales (from fathers to adolescents, from

Scale (SDS) developed by Zung (1965), andmothers to adolescents, from adolescentstranslated by Hukuda and Kobayashi (1973).

to fathers, and from adolescents toProcedures

mothers) using the maximum likelihood

The survey was conducted during university

methodclasses. Prior to the survey, students were

results indicated that all the social

notified of the purpose of the survey and that

supportall data would be statistically processed.

structure (Table1, 2). The Cronbach’sMoreover, they were assured that their privacy

coefficient

would be protected, and that they were

sufficient high reliability; from father to

expected respond voluntarily. They were also

adolescents: α

told that their responses would only be used foradolescents: α=.91, from adolescents toresearch purposes. Furthermore, participants

fathers: α=.94, and from adolescents towere informed that they did not have to respondmothers:

to any items that were difficult, and that they

analysis was conducted on the Awarenesscould stop responding at any time.

of Independence Scale using the principle

withvarimax

scaleshad

alphaα=.93.

ofarotation.
single

each

scale

The
factorwas.94, from mothers toFurthermore,factorfactor method and promax rotation.

Results

Results indicated a three-factor structure.

1.

Contents of items in each factor were

Factor analysis of the scales
First, the mean value and standard

judged as similar to the results ofdeviation of each item were calculated

previous studies (Kato & Takagi, 1980).

and items indicating ceiling or floor

Therefore,

we

adoptedFactoras

66

Itakura.

Table2. Factor analysis of social support from adolescents to parents scales
11 7 25 6 46 C C 72C96 142 6
02 92 72 6 C F 96 C96 86C 6C9 8 8 5
042 6 72 6 C F 96 C96 2 6 C 65
0 2 6
2 6 C I8 5 C(
08 E6 25E 46 C
2 6 C F 96 C96 92E6 3 6%
0 9 F C6 6 C
2 6 C I9 33 6 2 5 C6 6 C%
0 C6 C
2 6 C IC2 23 C C96 F
2 576 50C
2 6 C F 96 C96 2 6 C2 6
08 E6 25E 46 C
2 6 C F 96 C96 2 6 564)
0 C6 C
2 6 C IC2 23 C C96 5 52)
06E2 2C6
26 C
CE6
))
02CC6 52 6 C F 96 C96 2 6))
0 6C 6 C6249
2 6 C F 92C C96 5 IC F))
0 6C 6 6 5 C9 8 C
2 6 C F 96 C96 665 C96)
08 E6 6 6 C C
2 6 C C96 3 C952 2 5 2 E6 2 6)%
0 E C62 6 C C 8 C C 86C96)
042 6 23 C
2 6 C I286)
096
2 6 C F C9 F 92C C96 2 6 5 8)
08 E6
2 6 C 7 2C 2 5 6E2 2C
7 C96 C96 3 C96(
0 E C62 6 C 7 C62 2 5(%
0 C C
2 6 C I325 C 2 5 3 6
0C 62C
26 C 7 5 6(. 86 E2 6)
2CE6 4 C 3 C 2C % )“independency”, Factor
onparents”,

and

9%
)
)
()
(%
(%

)

%

(
%
%
%

)

)
)
)(
)
)%
)%
)%
)%
)
(
(
()

9%
(
((
((
(
(
)
(
%

)
%
%
%

. 86 E2 6
2CE6 4 C 3 C 2C

as “dependency

Factor

11 7 25 6 46 C C C96
02 92 72 6 C F 96 C96 86C 6C9 8 8 5
08 E6 25E 46 C
2 6 C F 96 C96 92E6 3 6
0 2 6
2 6 C I8 5 C
042 6 72 6 C F 96 C96 2 6 C 65
08 E6 25E 46 C
2 6 C F 96 C96 92E6 3 6
08 E6 25E 46 C
2 6 C F 96 C96 2 6 564
0 C6 C
2 6 C IC2 23 C C96 5 52
0 C6 C
2 6 C IC2 23 C C96 F
2 576 5
0 E C62 6 C C 8 C C 86C96
042 6 23 C
2 6 C I286
02CC6 52 6 C F 96 C96 2 6
0 6C 6 C6249
2 6 C F 92C C96 5 IC F
0C
2 6 C F 96 C96 2 6 C2 6
06E2 2C6
26 C
CE6
08 E6
2 6 C 7 2C 2 5 6E2 2C
7 C96 C96 3 C96
08 E6 6 6 C C
2 6 C C96 3 C952 2 5 2 E6 2 6
0 6C 6 6 5 C9 8 C
2 6 C F 96 C96 665 C96
0 C C
2 6 C I325 C 2 5 3 6
0 E C62 6 C 7 C62 2 5social support scores than the mean wereasclassified into the H group and those with lower“resistance/inner confusion”. Cronbach’sscores were classified into the L group.

coefficient alpha of each scale indicatedCombining H and L groups for social support

sufficient reliability; independency: αfromparentstoadolescents

and

from

.86, dependency on parents: α.88,adolescents to parents formed four groups, i.e.

and resistance/inner confusion: α.72.

HH, HL, LH, and LL. One-way ANOVA was

The coefficient alpha of SDS was α.78.

conducted with scores of the awareness of
independence scale and the depression scale as

2. Attendance group comparisons (hypotheses
testing)
The mean score calculated by adding social

dependent variables (Table3). Independency
indicated significant differences between thefour groups (F (3, 219)=2.89, p.05, η2.04).

support scores from fathers to adolescents andMultiple comparison was conducted using thefrom mothers to adolescents was regarded as

Tukey method, which indicated that the scorethe social support score from parents toof HH group was significantly higher than theadolescents, and the mean score calculated by

LL

adding social support scores from adolescentsdifferences in dependency on parents among

to fathers and from adolescents to mothers was

the four groups (F (3, 219)=5.50, pgroup.

There

were

also

significant.001, η2regarded as the social support score from

.21). Multiple comparison was conducted,

adolescents to parents. Participants with higher

which indicated that the scores of HH and HLSocial support reciprocity between parents and adolescents

67

Table3. Analysis of variance table about group comparisons

5>

3

> =N

> =N

: II < =

H=

3

8

/

<H

H D <H

I

44 H

8 1,(

46 H

81 )

64 H

8 1()

66 H

81

PL<

( (,

*

( )

).

( ()

**

(

*)

.

(*

*,

(

(.

(*

)

*)

(.

*

)

I

(*

I

(

H II

*

.

1

=<

90 *

90

) ,(

<>

I=

IM

H D <>

I=

I

) )*

<H

I

.(

7

= D <HI4 4 266
4 4 14 6264 266

)

)*

*

I

) ,.

( .*

.)

64 16624 4Hgroups were significantly higher than LH andfathers had negative effects on depression (β=LL groups. On the other hand, resistance/inner.43, p.05) (R2=.19, F (3, 115)=6.48, p

confusion did not show significant differences.001).

Totally,socialsupportfromamong the groups. Depression scores also

adolescents to fathers had positive effects on

indicated significant differences among theindependency (β=.42, pgroups (F (3, 219)=6.94, p.001, η2.12).

219)=4.44, p.05) (R2=.08, F (3,.001), whereas social support

The result of multiple comparison indicatedfrom mothers to adolescents had positivethat scores of LH and LL groups wereeffects on dependency (β=.42, p

significantly higher than HH group.

F (3, 219)=21.58, p.001) (R2=.28,.001). Furthermore,social support from adolescents to fathers had
negative effects on depression (β=3. Multiple Regression Analysis
Multiple regression analyses were conducted.01) (R2=.13, F( 3, 219)=8.39, p.48, p.001).

for expressions of the four types of social
support between parents and children as

Discussion

explanatory

1. Hypotheses testing

variables

and

the

scoresofindependency and depression as criterionThe

results

indicatedthatvariables (Table4). The results indicated that inindependency increased in the group thatmen, social support from adolescents toreceived and provided more support,

mothers had positive effects on depression (βcompared to the group that received and.55, p.05), whereas social support fromadolescents to fathers had negative effects on
depression (β101)=3.13, p.66, p.05) (R2.11, F (3,.05). In women, social support

provided

less

support.

Therefore,

Hypothesis 1 was partially supported.
This result also corroborated findings ofprevious

studies(e.g.,

Antonucci&

from mothers to adolescents had positive

Jackson, 1990; Buunk & Doosie, 1993). It

effects on dependency on parents (β=.51, p

is suggested that parent- adolescent2.001) (R =.35, F (3, 115)=15.52, p.001),

whereas social support from adolescents torelationships that provide and receive
mutualsupportareimportant

for

68

Itakura.

Table 4.

Multiple regression analysis for variables predicting independency
and depression of adolescents/ I ED : :2D=

1:D:IE M : :

77

EC :I

IE :=E< DI

77

EC C EI

IE :=E< DI

77

EC :=E< DI IE :I

77

EC :=E< DI IE C EI

6

3 :D

9 EC D

8EI:

N

N

N

5

D= D<M ED : DI

3 :D

9 EC D

6

I:D<

DD

<ED

3 :D

9 EC D

8EI:

*

*

N *

N

N
N

N

ED

8EI:

N
N

N
*

N

0

ED

3 :D

9 EC D

8EI:

N

N

N

N

N

N *

N

*

:

4 EI 77 . 7E< : 7
50

D= D<M*

EI

5

increasing adolescents’ independency.

being supported by parents (Lamborn &Regarding dependency on parents, theSteinberg, 1993). It might be possiblegroup with high social support scoresthat dependency on parents in HH andfrom

HL groups is qualitatively different,

parents toadolescents showedsignificantly higher scores than the group

becausewith low scores. However, the scores werepsychological distance between parents

high in both HH and HL groups. On theand adolescents.

other hand, dependency on parents was
significantly

higherin

HLgroup,

ofthedifference

in

the

Moreover, the depression score in the
HH group was significantly lower thancompared to LH group, which partiallythat

supported Hypothesis 2. It is suggested

supported Hypothesis 1. Depression wasthat dependency is developed when therehigh

are excessively large benefits (La Gaipa,

excessively small; i.e. the support one1990); i.e. the amount of received social

provides is larger than that one receives

support is larger than that one provides.

(e.g., Katauke & Shoji, 2000). It is

It could be possible that excessive social

suggested that when adolescents aresupporttheproviding too much support to theirdevelopment of independence and makes

parents and receiving little support, theadolescents dependent. On the othersense of burden and frustration towards

hand, dependency on parents was also

parents might develop and increasehigh in the HH group, suggesting that

depression.

fromparents

inhibits

in

other

under

groups,when

whichbenefits

partlyweredependence on parents does not always
inhibit independency (Kato & Takagi,

2. The relations between reciprocity of1980). Dependency between parents andsocial support , independency, andadolescents under reciprocal conditions

depression

might increase adolescents’ feelings ofWecomparedreciprocityofsocialSocial support reciprocity between parents and adolescentssupport between father- adolescent andthree-fourths

mother- adolescent relationships, andadmitted that they were not actively

conducted multiple regression analyses toinvolved with their children (Shwalb,

explore the effect of the two types of

Kawai, Shoji, & Tunetsugu, 1997). The

socialfollowing compensatory hypothesis was

supportindependency

on

and

adolescents’JapanesefathersThe

developed: when the marital relationshipresults indicated a positive correlation

breaks down, or is in conflict and couples

between social support from adolescentscannot satisfy their needs in the marital

to fathers on independency. Furthermore,

relationship, parents tend to compensateafor

negative

depression.

of69

correlation

was

shown

their

frustrations

throughtheirbetween social support from adolescents

relationships with their children (e.g.,

to fathers and depression. Shulman and

Engfer,Seiffge-Krenke (1997) suggested that

Youngblade, Rovine, and Volling (1991)

usually fathers keep more distance fromindicatedadolescentrelationship was related to the frequency

childrencomparedthan1988).
theexample,

state

of

a

maritalofchildren’s

whereaschildren. Bell, Bell, and Nakata (2001)

closeness with mothers might inhibit

suggested disagreement between parents

children’s independence.

would create a triangular relationship

Father-adolescent

with

their

are

that included the children, and suchconsidered important for development ofprocesses are observed both in Japan andindependency in adolescents. Moreover,

the U.S. This could be because marital

Usami et al. (2011) indicated that thediscord produces excessive meddling by

power balance between children andmothers with their adolescent children,

fathers is equalized after adolescence,

which inhibits adolescents’ independence.

whereasthat

relationships

involvement

Belsky,mothers, and this distance facilitates
independence,

mothers’

For

with

not.

On the other hand, in women, social

Adolescents are able to experience ansupport from mothers to adolescents had“equalpositive correlations with dependency onparent-childmothersisrelationships”

bysupporting their fathers, which would

parents.

decrease depression.

based

On the other hand, social support from

Girls
on

relationshipsaacquireindependency

stableandtrusting

theirmotherswithmothers to adolescents showed a positive(Mizumoto & Yamane, 2010). It is notcorrelation with dependency. Mothers arealways the case that dependence on

usually involved with adolescent children

mothers inhibits independency and it ismore than fathers (Holmbeck, Paikoff, &possible that appropriate dependency

Brooks-Gunn,

facilitates independency in adolescent

1995).

Approximately

70

Itakura.

women.

ofSocial support from male adolescents topower

betweenparentsandadolescents should also be investigated.

mothers showed a positive correlation
with depression. Previous studies haveindicatedthat

mothers’ power

4. Conclusion

after

Although there are certain limitations

adolescence remains stronger than thatto this study that were described above,of children (Usami et al., 2011). Moreover,the findings of the study are significant

men have higher independency thanfor increasing adolescents’ awareness of

women (Kato & Takagi, 1980). Because

independence and decreasing depression,

their relationships are not equal, it could

throughbe the case that male adolescents support

adolescents and support from adolescentsfor mothers is not based on intrinsic, but

to parents. This study also fulfilled one of

extrinsic motivation, such as mothers’

the shortcomings of previous studies, inrequests. Extrinsically motivated support

which the effects of children on parents

from adolescents to parents might cause

had not been sufficiently investigateda sense of burden and frustration, leading(Cummings et al, 2002).

supportfromparentstoto an increase in depression. Overbeek,
Stattin, Vermulst, Ha, and Engels (2007)

Reference

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Acitelli, L.K., & Antonucci T.C. (1994).

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Psychology, 67, 688-698

withmothers,

and

might

increase

depression.

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Sarason, I.G. Sarason & G.R. Pierce (Eds.),

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International Journal of Brief Therapy and Family Science
2015 Vol. 5, No.2, 73-77< Original Paper: Practice >A case report about the Support for the step Family accepted child evacuated from
Fukushima after the grate disaster in japan.
Michiko Ikuta 1)
1)

Kanagawa University of Human Services

ABSTRACT. This presentation will describe about the a foster home caused by a disaster of Japan. Many families escaped from areaof disaster especially from Fukushima , the area of nuclear disaster. And some of the families, have a situation can’t allow to move,
decided to let their children live far place , at foster parents. National Foundation of Brief therapy/Japan have given free counselingfor them. and all of the case indicated SFA. The most important of this case is the “compliments to Foster Mother”. Therapist
complimented her carefully. About the “hit and bite and kick “, direct Foster Mother below. When the boy hit ex, please ignore andleave from him. But when he “doesn’t”, please hug and talk to him. About the phone, tell the real mother not talk after 9pm andsuggest “indirect compliments” that Foster Mother tell Real Mother about the good point of the boy and Real Mother tell the boy on
the phone. Then, After 1 month after, There is no problem, no hit and bite, and phone 2 times to RM per day. He enjoying to play the“foster brother and father” everyday. He refused to eat vegetables, but eat all now. He feel pleased to help cooking and housekeeping.
The relationship of FM and RM become very good. The therapist praised her effort heartily.
KEY WORDS: The step family who received evacuee child, Mental health about the step child ,Great East Japan Earthquake

Introduction

and system, and I have many experiences ofThis case report will discuss the possibilitiesoffamily-focused,ratherthaninterview researches and counseling activities
Ikuta 2009.

individual-focused, support for those forced to

As a member of National Foundation ofevacuate or accept evacuees after the Great

Brief Therapy, I started offering free unlimited

East Japan earthquake. National Foundation

phone counseling for evacuees staying withBrief Therapy (NFBT) has provided indefinite

their relatives and foster families of childfree counseling service, since April 2011, forevacuees in April, 2011. Some of our clients

evacuee families from the disrupted area due tomentioned that it was the only support offered

the Great East Japan Earthquake (GEJE) toto evacuees living with their relatives. The

their relative’s house, and the host families.

phone counseling was clearly a much-needed

Since NFBT has expertise in problem of family“niche” of evacuee support. By the counselingservices and study, it was studied that the main

CORRESPONDENCE TO: IKUTA Kanagawa University

factorsofaccommodation well were indicated as follows

Kanagawa

University

of

Human

Services,

1-10-1that

hostfamilies

handledtheir

Heiseimachi, Yokosuka-city, Kanagawa, 238-8522, JAPAN.

that evacuee family had, 1) Initiative 2) a low

e-mail: ikuta@kpb.biglobe.ne.jp

level of reliance on support of information and

73

74

Ikuta.

money. And in addition, host families just

impact of the Fukushima nuclear accident.

wanted to receive the words, “ thank you” fromAccording to his mother, one of the reasons she

evacuees, and “good job!” from their relatives

had decided to evacuate him, even though their(Ikuta, 2014).

home was not in immediate proximity to theThis case report was one of the case of thenuclear plants, was the lack of consensus withfree counseling services, but had specialty

his grandparents, who also lived with them,

about the Foster family of a Child Evacuee

over risk of radiation exposure. Despite A’s

Affected by the Fukushima Nuclear Accident.

mother’s continuous pleading, his grandparents

This presentation will describe about the awould feed him vegetables grown in their yard

foster home caused by a disaster of Japan.

and let him play outside freely. When his

Many families escaped from area of disastermother tried to discuss the matter with them,especially from Fukushima , the area of nuclear

she was told to stop being too sensitive, anddisaster. And some of the families, have athey would end up in arguments. All this led tosituation can’t allow to move, decided to let

his mother believing it was not a safe

their children live far place , at foster parents.

environment for her son. As clearly expected in

National Foundation of Brief therapy/Japan

this situation, A’s grandparents were strongly

have given free counseling for them. and all ofagainst his evacuation.

the case indicated SFA. I’ll present about the

The foster family consisted of three members,

problem and solution of the foster families on

the father in his early 40s, the mother in her latethe case report.

30s, and their son in a higher-grade atelementary school. They saw posts seeking

Methods
We also offered service to a foster family ofa child evacuee, they were struggling with

foster families for child evacuees on Twitter
after the earthquake and volunteered through aprefectural agency.

issues of family dynamics. Because they could
not come for in-person counseling, they

Session #1: Early Junerequested counseling over the phone. The

A was staying up late speaking with his

following is the record of support we provided

mother on the mobile phone his mother had

to the foster family. The foster mother was thegiven him in the bedroom he shared with theone who was calling.

three members of the foster family. According
to the foster mother, most of his conversation

Background:was “attempts to keep his mother on the phone

The child evacuee, A, was a boy at early

longer.” For instance, he would ask his mother,elementary school-age. He was evacuated to a

“What should I wear to school tomorrow?”

prefecture far from his home at the request of

When his mother answered, he would respondhis mother who was concerned about thewithanotherquestion,“Why?”TheA case report about the Support for the step Family

75

conversation would continue this way for two

impressed that she had not just endured thoseor three hours. Even when the foster motherphone calls but was observant enough tosuggested A to go to the living room to take his

recognize A’s “attempts to keep his mother onmother’s phone calls, he would refuse, saying,

the phone longer” and that she was speaking in“I don’t want to be alone.”a calm manner without being carried away by

A also had difficulty getting up in themorning, which was causing the foster mother’semotions as she told me about the situation.
I toldher, “I’m

sure

many

families

exhaustion because she had to try to wake him

volunteered to take him in, and I can clearlyupmotherunderstand why the agency trusted and chose

approximately fifteen times a day, even during

you among them. You have been handling thethe daytime. On some mornings, he would still

situation wonderfully. I could not come up withbe on the phone when he had to leave forany better ways.” I told her that, after all theyschool. The foster mother did not know how tohave done, they had no need to feel guilty forhandle the situation as she did not feel it was

their sense of exhaustion, and suggested

right to let her own son leave without A.

speaking with A’s mother and asking her torepeatedly.

A

calledhis

The whole family had tried to be patient

finish the evening phone calls by 9pm so A

and understanding, believing A must be

could get up in time for school the following

homesick being away from his own family.

morning.

However, after two weeks, all the family

The foster mother said that she was glad tomembers were growing tired. One night, herhave the opportunity to receive assurance fromson even yelled at A, “Shut up! I can’t sleep!”an expert and that she would try speaking with

The foster mother was concerned that A

A’s mother.

might be suffering from trauma over the
nuclear accident and being sent away from his

Session #2: Early September

own family. She asked for advice on whether

In the past three months living with the foster

she should speak to him about his behavior orfamily, A had gradually gotten used to his newshe and her family should accept the situationhome and stopped calling his mother as often.

for the time being. She expressed a sense of

However, they were recently having a new

guilt for feeling burdened by “such trivial

problem of A being extremely defiant andmatters” and said that she might be a cold andviolent with the foster mother. He would hit her

unkind person who was not qualified to be afor no reason, and when she told him to stop, hefoster parent.

would hit and kick her even harder. Her body

I first started by complimenting the client

was bruised all over. Her husband believed it

and her family for enduring A’s long phonemight be a reaction to the environment change,

calls in the same room every night for two

since A was not living with his grandparents

weeks. I also mentioned I was deeply

who had “spoiled” him.

76

Ikuta.

The foster mother consulted with a mother ofstarted getting violent with me, I ignored him

A’s classmate, who was involved in foster

without any reaction, turned my back to him,family support, and was told, “No matter what

and left the room. Meanwhile, when he wasn’t

he does, just accept it with love. Never scold

violent, I praised him for everything, even for

him and give him many hugs.” She also read an

the most trivial things such as finishing his

expert’s opinion on the Internet that said adults

meal and being good at playing with his toys. I

needed to be patient with traumatized children

started doing these on the day I called you. The

and accept their problematic behavior without

following day, he was already much less violent.

any reaction.

In three days, he had completely stopped. A

However, the foster mother did not feel she

looks happier lately, and I’m less harsh to my

could endure A’s harsh bursts of violence any

own son because I’m less stressed. Our days

longer. She felt as if she had failed as a foster

are much more peaceful now.”

mother because she was not loving enough. She
felt she had reached her limit and was nearly

Follow-up: Early December, 2011giving up on fostering A.

A seemed calm and comfortable living with

When I asked her why she had not called

his foster family. The foster mother had learned

sooner, she said, “I was trying to sustain myself.

to sense his feelings and thoughts from subtle

I cried, but I told myself the violence would

clues such as his facial expressions andstop if I remained patient and loving enough.”gestures. She found complimenting him very

I repeatedly offered compliments and listed

effective and had continued to do so often. A

up examples of her patience and excellent ways

had grown really close to the foster father, andof handling the situation. In addition to thethey would sometimes go out alone oncompliments,

following

weekends. Trust was growing among them, andinterventions: 1) To ignore the information she

the foster mother said she felt true affection forreceived from the fellow mother and theA.

I

providedtheInternet; 2) To simply offer no reaction andleave when A starts hitting her: 3) To
compliment A excessively when he shows noproblematic
techniquesbehavior.
were

Parentincorporated

in

Session #4: Late February, 2012
A’s mother had decided to move to thetraining

prefecture where the foster family lived. She

thesewas going to move in with A in prefecturalinterventions.

public housing. A seemed reluctant to leave thefoster family. He said, “Mom can come and live

Session #3: One week after Session #2

with us, too.” When the foster mother told him

According to the foster mother, A had

the date of his mother’s relocation, A stopped

stopped showing any problematic behavior. She

calling and taking calls from his mother. Evensaid, “After I spoke with you, whenever hewhen the foster mother answered the phone andA case report about the Support for the step Family

77

urged him to speak with his mother, A refused.

In addition, in this case, I incorporated parent

He became emotionally unstable and started

training (behavior therapy) into family therapy

speaking in a very rough manner. A’s mother(brief therapy). According to the theory of

seemed too occupied with the job change andbehavior therapy, when the parent “lovingly”

move to pay much attention to her son’s state.

responds to the child’s problematic behavior, it

The foster mother requested advice, so I told

only fulfills the child’s attention-seeking need

her that her decision to believe in A’s

and encourages the same behavior. Therefore,

adaptability and watch over him without

in this case, systematically ignoring the child’sinterfering seemed to be the best way possible.

negative behavior to eliminate it was quite

I also informed her that if he had any problems

effective.

after moving in with his mother, she could callus again or refer his mother to us.

One of the advantages of parent training isthat it offers clear and detailed programs of
instruction on how to bring about the desired

Discussion

results. Moreover, the client can earn a sense of

In this case, the first and foremost priority

achievement as they actually practice thewas to recognize the effort of the client andtechniques they learn and see improvements.

offer her compliments on her excellent work as

It can be extremely stressful, both physicallya foster mother. As seen in other clients, sheand psychologically, to accept and live withand her family were enduring more thanevacuees, even for those of the highest integrity,

necessary because they were too concerned

whether they are relatives or foster families. As

with the feelings of the child evacuee. It wastherapists, we need to help reduce their feelingapparent that the client needed assurance andof guilt and provide them with a holding

advice from an expert.

environment. By providing such support toI chose to offer parent-training intervention
instead of advising the client to “be patient andthose accepting evacuees, we can contribute tocontinuous care and support for evacuees.

accept the child’s problematic behavior” basedon my experience as a psychotherapist at a

Referencechildren’s home. At the children’s home, I had

Ikuta,M. 2009 The Stress in the multi-

met many staff members who was considering

generation cohabitation families. Annual

quitting because they believed they were “notprogress of family psychology, Vol 27, 81-93.

lovingenough”

toacceptchildren’s

Ikuta,M. 2014 A case report about the Support

problematic behavior and, hence, “not qualified

for the step Family accepted child evacuatedto play the mother role.” Advice that lowers

from Fukushima after the grate disaster inself-esteem and self-efficacy of those in thejapan. International Journal of Brief Therapy

mother role leads to burnout and ultimately has

and Family Science, Vol. 4, No.2, 95-98.

negative impact upon the children in their care.

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