The Role of Context in the Case of Taro

Abstract

Muto and Mitamura (2015) are to be highly commended for publishing the case study of Taro. The article is notable for its emphasis on documenting what is behaviorally observable and reliably quantifiable. The authors' commitment to scientific rigor is laudable. Japanese psychotherapists are strongly advised to use this article as a model of evidence-based treatment in their descriptions of psychotherapy sessions. On the other hand, the reviewer would have liked to see more discussions on contextual factors around Taro, his presenting problems, and his therapy, including therapeutic relationships, Taro's emotions in therapy sessions and the therapist's responses to them, possible conflicts in Taro's family, as well as organizational issues around Taro and his symptoms in his workplace. Measurement tools are available to reliably quantify these variables. Incorporating these measures into the therapist's work with Taro would help readers better understand the therapeutic process and illuminate the mechanisms of change in the case study.

Introduction to Case Study Special Issue -- Case Studies in Japan: Two Methods, Two Worldviews, Part 2

“…That ACT is one of the more contextual approaches in behavioral therapy is certainly one of the factors associated with the affinity that many Japanese people feel toward it. Muto (2015) quoted Haruki Murakami's sentiments toward the notion of Japanese literature as 'high culture' in order to respond to Kanazawa's (2015) comments about the paucity of descriptions of the therapeutic relationship and the emotional interactions between therapist and client. Muto's point was that the emotionality of such aspects is often used to intentionally emphasize the sort of 'Japaneseness' from which he tries to maintain a distance.…”

“…However, there is a potential risk in eliminating the intrinsically social, and therefore also cultural, nature of interpersonal and emotional engagements in therapy. Kanazawa's (2015) request for more description of the climate of the , pp. 230-238, 12-31-15 [copyright by author] therapeutic relationship and the nature of the emotional interaction between therapist and client is based on the findings from psychotherapy process-outcome empirical research; it is not just a response to pressure to conform to a Japanese standard of clinical psychology.…”