In this review, outcome studies on the effect of cognitive behavioral therapy (CBT) for people with depression that have been conducted in Japan were systematically reviewed. The effect sizes calculated on the basis of 12 outcome studies indicated that there was a moderate effect (d=0.78) as measured by self-rating scales in 12 studies, and a large effect (of=1.35) as measured by clinicians' assessments in 4 studies. In addition, studies suggested that CBT improves depressive symptoms, as well as social functioning. The dropout rate among patients in therapy was 17.8%. Occupations of those administering CBT were psychologists (91.7), physicians (41.7%), nurses (33.3%), and others (16.7%), indicating that psychologists were playing an important role in Japan for the practice of CBT for treating depression. It is suggested that there is an urgent need to include CBT for the treatment of depression, conducted by psychologists that have received specialized training, in therapeutic interventions that are covered by the health insurance system of Japan.

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The present article reports effects of cognitive behavioral group therapy (CBGT) on adults with depression, using a controlled clinical trial. The cognitive behavioral group therapy consisted of 12 sessions developed by psychologists, consisting of Beck's cognitive therapy and problemsolving therapy. Participants (n=10) received this treatment from a psychologist, including pharmacotherapy (treatment as usual; TAU) combined with the cognitive behavioral group therapy program (TAU+CBGT group). The other participants (n=10) received only pharmacotherapy (TAU group). The Beck Depression Inventory-II (BDI-II) which measures depression was completed by the participants at 3 times (pre-, mid-, and post) during the cognitive behavioral group therapy program. The results revealed that after the therapy, depression in the group receiving cognitive behavioral therapy with pharmacotherapy improved significantly more than in the treatment-as-usual group. These results suggest that for adults with depression, the administration of pharmacotherapy combined with cognitive behavioral group therapy managed by a psychologist may be more effective than treatment with pharmacotherapy only.

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The present study examined effectiveness of combined cognitive behavioral group therapy (CBGT) and medication for patients with major depression. The cognitive behavioral group therapy program, which consisted of 12 structured sessions including psycho-education, self-monitoring, behavior activation, challenging and restructuring negative thinking, was conducted by clinical psychologists at Hiroshima University Hospital. At baseline, termination of treatment, and 12-month follow-up, patients (N-74) completed the Beck Depression Inventory (BDI) , the Hamilton Rating Scale for Depression (HAM-D) , the Global Assessment of Functioning scale (GAF) , the 36-item Short-Form Health Survey (SF-36) , the Automatic Thought Questionnaire-Revised (ATQ-R) , and the Dysfunctional Attitudes Scale (DAS). The post-treatment scores on the 4 measurement instruments were significantly lower after the treatment. In addition, the scores on the Global Assessment of Functioning scale and 36-item Short-Form Health Survey were significantly higher than the baseline scores. In other words, the patients improved on all measurements of psychosocial functioning and mood symptoms. Their improvement in depressive symptoms, psychosocial functioning, and dysfunctional cognitions were sustained at 12 months following the completion of the group-cognitive behavioral therapy.

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The purpose of the present study was to explore the effect of cognitive behavioral group therapy on depression, social functioning, and the difficulties that employees face when returning to work after sick leave taken to obtain treatment for depression. Participants (N=22) were diagnosed as having unipolar depressive disorder, and were on sick leave. The therapy consisted of 10 weekly 90-minute sessions of closed cognitive behavioral group therapy; the therapist, the therapist's assistant, and a supporter in the therapy were all psychologists. Before and after the treatment, the participants completed the Automatic Thoughts Questionnaire-Revised (ATQ-R), the Tri-axial Coping Scale-24 (TAC), Kikuchi's Scale of Social Skills (KISS) , the Beck Depression Inventory-II, the Social Adaptation Self-evaluation Scale (SASS), and the Difficulty in Returning to Work Inventory (DRW). The results revealed that depression and social functioning scores improved significantly after cognitive behavioral group therapy. On the other hand, the employees still had difficulties in returning to work. This suggests that it is necessary to develop and implement more components of treatment or change the timing of the treatment, in order to reduce difficulties employees face when returning to work.

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The present article reports the cases of 3 young people with depressive disorders who received cognitive behavior therapy. The participants, a 9-year-old girl and two 12-year-olds (a boy and a girl), were diagnosed at pre-treatment as having dysthymic disorder, in addition to anxiety disorders. An 8-session cognitive behavior therapy program was given to the participants by clinical psychologists. A post-treatment diagnostic interview soon after the treatment revealed that all 3 participants no longer had diagnoses of dysthymic disorder. This improvement was observed to be maintained at the time of a 3-month follow-up. Both of the 12-year-olds showed clinically significant improvement based upon a cut-off point on a self-report depression scale. All 3 participants also no longer had principal and additional anxiety disorders. This case study might provide preliminary evidence for advancing cognitive behavior therapy for Japanese children and adolescents who have been diagnosed as having depressive disorders.

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"Depressive rumination" has been defined as persistent, cyclic, thinking focused on negative aspects of past experiences. Although it has been found that a high tendency to ruminate relates to vulnerability to depression, recent research has reported that a low tendency to ruminate could have a buffering effect on depressive schemas, which would, in turn, lead to a decrease in depression. Little research has been conducted on age-related quantitative and qualitative changes in rumination. The purpose of the present study was to investigate age-related differences in rumination, comparing an undergraduate sample and a sample of adults in their thirties and forties, by examining participants' level of rumination and the buffering effect. The adult sample was found to show a lower tendency to ruminate than the undergraduate sample, and also showed the buffering effect. These results suggest that as individuals get older, they have a reduced tendency to ruminate, and are more likely to cope effectively with negative cognitions. Clinical implications for prevention of depression are also discussed.

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The aim of the present study was to reinvestigate effects of multiple exemplar training procedures on establishment of generalized contextual control over the transformation of stimulus function with 4-member stimulus equivalence classes, instead of 3-member stimuli equivalence classes as in Kishita et al. (2012, in Japanese). Three 4-member stimulus equivalence classes, each consisting of 4 topographically distinct visual stimuli (line, circle, triangle, square) were established for 9 undergraduate students using a match-to-sample (MTS) task. Following the match-tosample training and testing, participants were provided with many trials in which behaving in accordance with transformation of function was differentially reinforced or punished, depending on the presence of a class of physical features of the stimuli. Finally, new equivalence classes were established, and a test for generalized contextual control was presented. The results revealed that 7 of the participants who were included in the analyses demonstrated contextual control over derived transformations of the stimulus functions; among them, 4 showed generalized contextual control. The multiple exemplar training procedure used in the present study may produce generalization of contextual control over the transformation of stimulus function as in Kishita et al. (2012, in Japanese).

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The present research was aimed at testing the utility of the Implicit Relational Assessment Procedure 2010 (IRAP) as a behavioral assessment methodology for cognitive defusion. In the present test of the validity of this procedure as a tool for clinical assessment, a commonly used cognitive defusion technique, word repeating, was focused on, and how rapid vocal repetition of one word affected response latencies during the Implicit Relational Assessment Procedure was examined. Participants (university students, average age 19.8 years) were assigned randomly to either a cognitive defusion group (n=15) or a control group (n=16), and completed the Implicit Relational Assessment Procedure before and after the intervention. The results revealed that the cognitive defusion group's response latencies on the consistent and inconsistent trials were shorter than the control group's. Specifically, the cognitive defusion group's response latencies on the inconsistent trials showed a significant decrease after the intervention. The findings are discussed in terms of the potential therapeutic application of the Implicit Relational Assessment Procedure.

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The phobia that involves the belief that an individual's own body emits a foul odor that make people react in a negative way is called Jiko-shu-kyofu in Japanese; similar conditions have been termed "olfactory reference syndrome" (ORS) in Western medical reports. However, this phobia is not clearly defined in DSM or ICD, and only a few cases applying cognitive behavioral therapy (CBT) to individuals with this condition have been reported. The present study analyses the process of a cognitive behavioral therapy intervention for a patient whose life activities had been restricted by olfactory reference syndrome. Assessment results showed that his inappropriate behavior was a result of his cognitive pattern of continually interpreting external stimuli as "I emit a foul odor", and by his avoidance of social situations. Hence, the cognitive behavioral therapy intervention including cognitive restructuring, behavioral experiments, and social skills training (SST) , had the goal of reducing his inappropriate behavior and adjusting his social activities. During approximately 4 months, 16 active intervention sessions with the man resulted in a reduction in his inappropriate behavior and an expansion of his social activities. These case results suggest that cognitive behavioral therapy may be effective for individuals with olfactory reference syndrome.

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