How to Treat Failure to Launch:
A CBT and Family Systems Approach

The Program

The world over, sociologists and mental health practitioners are noticing the increasing incidence of young people stuck at the transition between dependent adolescence and independent adulthood.

Called "hikikomori" in Japan (a term now being adopted by many of these individuals, regardless of their country of origin), NEETs (Not in Education, Employment, or Training) in Britain, and known mostly by the label "Failure to Launch" in North America, these individuals tend to have low or depressed mood, high levels of anxiety (particularly social anxiety), and significant avoidant tendencies.

Most live at home with parents, are not employed, have few friends or romantic relationships, and have little clarity about the future or their desires for life. Although potentially meeting diagnostic criteria for depression, social anxiety disorder, or avoidant personality, these individuals represent a distinct and surprisingly numerous population.

When I describe the problem at workshops on unrelated topics, a majority of clinicians report having seen clients in this situation. Yet the research literature is scanty and published treatment protocols are nonexistent. What do you do?

This course provides a description of the problem, assessment guidelines, strategies for getting the client on board with therapy, and, most importantly, a set of interventions that can be tailored to the needs of the individual client, using principles from cognitive behaviour therapy and a family systems approach.

We consider how and when to involve family, what to do when the parents are the ones seeking treatment, and how we can parent and educate young people to avoid this problem appearing in the first place.

Contents

The program includes:

  • What is “failure to launch”?

  • Common characteristics

  • What ISN’T the problem?

  • Demographics (to the extent we know them)

  • Societal risk factors

  • Personal history risk factors

  • Familial risk factors

  • Handling the referral: Who is your client?

  • Top priorities during assessment

  • Assessing the stage of change

  • Detriangulating yourself from parents

  • Handling the assessment-to-therapy transition

  • Accessing the CLIENT’s goals

  • How too-distant goals can be dispiriting

  • Sharpening the work by choosing a FEW goals for initial focus

  • Turning skill deficits into a shopping list

  • Orienting the client to exposure-based work

  • Exposure and anxiety tolerance

  • Working on screen time

  • Lifestyle stabilization: sleep, diet, exercise

  • Strategies to expand the social network

  • Strategies to smooth the path toward work/school

  • Strategies for involving parents

  • Identifying counterproductive patterns in the family

  • Reducing conflict, power struggles, and violence risk in the home

  • … and more!

Course Objectives

By the end of this course, trained and qualified mental health clinicians will:

  • Be able to recognize and describe the basic characteristics of the hikikomori population.

  • Identify many of the family dynamics that can contribute to the problem.

  • Link treatment strategies for these individuals with their presenting risk factors.

  • Be aware of strategies and considerations involved in incorporating family members in treatment.

The Materials

Workshop participants receive:

  • Complete presentation slides

  • An extensive reference list for further reading

  • A set of pdf handouts for use with clients and families

Who should attend?

This program is intended for members of registered healthcare professionals with prior experience in providing psychotherapy, and for students in these fields.

  • Psychologists

  • Psychiatrists

  • Clinical counselors

  • Social workers

  • Occupational therapists

  • Psychiatric nurses

  • and other trained psychotherapists.

The response…

  • "Thank you for your work in a relatively new area of practice! I feel this course has provided additional insight into how we can better approach this work as an organization."

  • "The presentation style was clear and entertaining as well as educational. The material was practical and additional handouts useful and appreciated. References as well."

  • "There are excellent points re: cultural/societal expectations that may drive this difficulty that I had not previously considered (e.g., knowing your passion before you find it, needing confidence before attempting a task, lack of realistic goals for adulthood)."