In response to the establishment of a Naikan Therapy certification system, this research was conducted to systematize the knowledge and skills which should be included in educational programs for Naikan therapists. The purpose of this study was to clarify how the first generation of Naikan therapists understood and dealt with the difficulties that the second generation of therapists reported as novice practitioners （Takahashi & Lee, 2020）. An interview survey was conducted with 4 Naikan therapists, each of whom had been practicing for more than 20 years. As a result of the KJ Analysis, the following 8 categories were generated: 1） the ideal therapist; 2） the frame of Naikan; 3） Naikan responses; 4） therapist’s conflict; 5） therapist’s learning; 6） the existence of the Association of Naikan Training Institutes; 7） the training of young therapists; 8） the crisis of Naikan Therapy. Based on these categories, the following topics are discussed: making sense of the Naikan framework; responses during Naikan Therapy; the basics of interviewing; conflicts between Naikan clients and therapists—what therapists should be aware of; the need for therapists to train young Naikan therapists; and, related to this last point, a review of function of the Association of Naikan Training Institutes.

  This report describes a case of Naikan Therapy administered to a patient diagnosed with attention deficit hyperactivity disorder （ADHD）. In view of ADHD characteristics such as inattention and impulsivity, it was expected that Intensive Naikan would be very stressful, but the patient was able to complete the treatment through the adoption of a receptive and flexible mode of relating on the part of the Naikan therapist, which became a turning point in the treatment. After one year of Naikan-Based Cognitive Therapy in addition to the Naikan therapy, YG personality tests and semi-structured interviews were used to examine psychological changes in the patient and their interpersonal relationships in the workplace. The results suggest that Naikan Therapy along with continuous participation in day care could have a long-term positive impact upon the patient’s self-image, and upon their ability to manage some aspects of their condition.