Professor University of Miyazaki Miyazaki-city, Miyazaki, Japan
Abstract Body Internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD), developed in the UK, has demonstrated outcomes comparable to face-to-face cognitive therapy while requiring much less therapist time per client (Clark et al., 2023). A central question for global dissemination is whether this high efficacy can be retained when treatment materials are translated and culturally adapted for different languages and clinical contexts. This presentation describes the translation and cultural adaptation process for Japanese iCT-SAD and summarizes evidence from sequential evaluations in Japanese clinical settings.
Translation and adaptation were conducted via forward translation, clinician review, back-translation, and iterative reconciliation, with systematic documentation of culturally sensitive modifications (e.g., language and metaphors, social systems and norms, and locally familiar examples). The Japanese treatment materials were first evaluated using a guided self-study approach with six Japanese clients with SAD, showing promising preliminary improvements in social anxiety and related outcomes (Yoshinaga et al., 2021). Within this evaluation, client feedback informed refinements to wording, examples, and task instructions. The finalized Japanese iCT-SAD program was subsequently tested in a single-arm pilot study delivered alongside routine psychiatric care, demonstrating promising initial efficacy and acceptability (Yoshinaga et al., 2023). Clinical outcomes observed in this pilot study were comparable to those reported in studies of the English-language program in the United Kingdom and Hong Kong. I will also present a successful treatment case involving a client with prolonged social withdrawal (hikikomori) who presented with SAD, illustrating the applicability of iCT-SAD for hard-to-reach groups (Sakai et al., 2024). Finally, I will present findings from our randomized controlled trial comparing Japanese iCT-SAD plus routine psychiatric care versus routine psychiatric care alone in Japanese clinical settings (Yoshinaga et al., 2024 [protocol]).
Together, these findings inform culturally adapted, scalable cognitive therapy pathways for SAD in Japan and offer a model for broader dissemination across countries and cultures.
