Comparison of Current Schizophrenia Therapy in the United States and Japan
Sayuri Yamaguchi
The University of Arizona
http://juns.nursing.arizona.edu/yamaguchi.htm
(PWS stands for people with schizophrenia)
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Family and Folk Therapy in Okinawa, Japan
In the Okinawa prefecture of Japan, the family is actually considered to
be the first source of mutual help and support for the PWS. The ties
within the Okinawan family are strong, and easily run through three
generations. The problem of one family member is usually regarded as
being a problem of the whole family, and all the family members unite to
deal with any given situation. This cultural characteristic of Okinawans
offers many advantages. The strong family and social ties provide the
security, care, and emotional and material support that are very much
needed by the discharged chronically ill PWS (Matayoshi, 1996).
In Okinawa there is a unique "ethno-medicine" family therapy, which is
practiced by a therapist/healer known as a "Yuta." The Yuta's role is
primarily an advisor who closely relates to the patient's daily life,
providing spiritual counsel concerning health problems and general
counsel for mental health matters (Naka, Takaishi, Ishizu, and Sasaki,
1983). One example is that the Yuta uses the examination of a patient's
family tree to identify a mental illness in the patient's ancestors, so
as to make the PWS aware of this connection. By doing so, the family
member and the client see schizophrenia as an inherited family problem,
rather than as an individual's behavioral problem (Matayoshi, 1996).
This therapy is effective because it takes into full consideration the
cultural, societal, and personal needs of the PWS. The Yuta's
credentials are totally reliant on reputation rather than education, a
factor that seems to reduce patient/therapist boundaries; the PWS
therefore feels more relaxed and less distanced from the advice that
they are receiving. A conceptual model of current comparison therapy for
a PWS in the U.S.A. and Japan is presented (Figure 1). Cultural
diversity in the U.S.A. and Japan are shown, as well as differences and
similarities in patient management.
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