This is the third report in a series of studies on systematizing the knowledge and skills required for Naikan therapists for the purpose of developing an educational program. The first report identified the difficulties faced by the second generation of Naikan therapists when they were new therapists（Takahashi and Li, 2020）; the second report considered the first generation of Naikan therapists（from whom the second generation learned the therapy）and discussed the difficulties they encountered when conducting Naikan interviews, and the methods they developed for facing these difficulties（Takahashi and Li, 2021）. This paper, the third in the series, reports on a survey conducted with the Japan Association of Naikan Training Institutes which had the the aim of understanding the actual situation at several Naikan training centers, based on the findings identified in the first and second reports. Based on the results obtained from the Naikan Training Institute, the following issues are discussed from the perspective of the future of Naikan: how to set up a framework for intensive Naikan, becoming a Naikan therapist and being a Naikan therapist, responding to clients as a Naikan therapist, the flow and framework of the interview, and responses during Naikan interviews.

  This is an account of the experimental ‘Naikan-Morita Therapy’ that we have conducted for several patients at our psychiatric hospital since 2019, in which Naikan Therapy is substituted for the initial ‘bed rest’ phase of Morita Therapy. We have found that this combined form of therapy provides similar benefits to patients who undergo stage 1 of Morita Therapy with bed rest, while also offering them additional benefits. In the following, we will first discuss the similarities and differences between Naikan Therapy and Morita Therapy; then we will explain the significance of using Naikan as the first stage of Morita therapy; and finally, we will provide one case report of a patient’s experience with Naikan-Morita Therapy.

  We examined the effectiveness of Naikan Therapy for reducing stress related to the Covid-19 pandemic. We performed Naikan therapy for 12 patients who visited our hospital during the pandemic, and we asked them to complete the General Health Questionnaire-12 (GHQ12), and a separate questionnaire for Covid-19. The results showed a significant improvement in the overall GHQ12 score. In addition, all of the questionnaire items showed significant improvement, except for item 4. The results suggest that Naikan Therapy is effective in reducing stress related to Covid-19.

  It is said that many find it difficult to continue with ‘daily Naikan’ practice. Maeshiro（1999）described ‘one-day Naikan’ as a method to make such continuation easier. In line with his approach, we have been offering ‘dispersive Naikan’: one-day Naikan practice, conducted in a Japanese-style room in a private psychological consultation clinic, and offered on five separate occasions over the course of a year. This has enabled clients who have previously experienced intensive Naikan Therapy to experience one-day Naikan on an individual and continuous basis.

  Participants brought both ‘everyday’ and ‘extraordinary’ situations to their sessions, gaining different insights from those of the intensive Naikan sessions. We believe that this form of one-day Naikan, conducted in a psychological consultation room with sessions dispersed over the course of a year, is a useful way to deepen the effects of intensive Naikan, and thus to support Naikan clients.

  Meals are one of the factors that influence Naikan Therapy participants. In this study, semi-structured interviews were conducted with 10 intensive Naikan Therapy participants and 1 meal maker, and analyzed using the KJ method, considering the perspectives of both the Naikan participants and the meal maker. The results from the Naikan Therapy participants suggested that the meals ‘evoked a sense of being loved,’ constituted a ‘change of place and feeling,’ and were a ‘trigger for recall and reflection.’ Meanwhile, we found from the interview that the meal maker had a ‘policy toward food’ and both ‘ingenuity and care’ directed toward the participants.

  The significance of the meal is that it provides a change of place and of feelings; that resistance to Naikan is eased by the feeling of love related to the meal; and that it is a trigger for recall and reflection. The participants seemed to feel that the meal maker’s ingenuity was more than enough. We believe that this is also related to the structure of the meal during Naikan Therapy.

  Since resistance sometimes occurs in Intensive Naikan Therapy, we introduced the ‘Oitachi Record’ (a record of personal history), as a way for clients to reflect on their whole lives prior to beginning to work with the three questions. The Oitachi Record felt to clients like an intake, and it served as a warm-up for the three tasks of Naikan Therapy, thus reducing clients’ resistance to them. For clients who could immerse themselves in the writing and concentrate upon it deeply, this engagement seemed to reduce other expressions of resistance as well. It is important for Naikan therapists to consider changes in Zeitgeist that might influence the forms in which resistance can arise, and to devise ways to reduce resistance to Intensive Naikan Therapy.