# Bridging the service gap in cognitive behavioral therapy from a user perspective: Findings from a web‐based survey in Japan

## TL;DR

A survey in Japan found that most people are unaware of cognitive behavioral therapy (CBT), with strong preference for in-person sessions and limited knowledge linked to past mental health service use and mindfulness exposure.

## Contribution

The study provides novel insights into CBT awareness and delivery preferences in Japan from a user perspective.

## Key findings

- Only 13.1% of respondents were aware of or had experience with CBT.
- Face-to-face CBT with physicians was preferred by 59.3% of respondents.
- Mindfulness awareness, CPP recognition, and past mental health service use were strong predictors of CBT literacy.

## Abstract

The primary aim was to quantify public awareness, experience, and delivery‑format preferences regarding cognitive behavioral therapy (CBT) in Japan. The secondary aim was to identify user‑related factors associated with CBT literacy (awareness or experience), including information‐seeking behavior and prior service use.

A cross‑sectional web survey of 518 Japanese residents aged 15–79 years was conducted in August 2024. Awareness and experience of CBT, preferred delivery formats, mental‑health service use, mindfulness recognition, and Certified Public Psychologist (CPP) awareness were assessed. A binary logistic regression examined factors linked to CBT awareness/experience.

Only 13.1% of respondents reported awareness of or experience with CBT, while 62.2% had never heard of it. Face‐to‐face CBT with physicians was preferred by 59.3%, compared with 8.9% favoring application‑based delivery. Awareness of mindfulness (odds ratio [OR] = 13.68, 95% confidence interval [CI] 6.83–27.40), CPP awareness (OR = 5.48, 2.48–12.10), and past mental‑health service use (OR = 3.17, 1.52–6.58) were independently associated with CBT literacy; age, gender, and self‑rated mental health were not significantly associated factors.

Public awareness of CBT in Japan remains limited despite more than a decade of insurance coverage. Engagement with mental‐health services, exposure to mindfulness concepts, and familiarity with CPPs appear to be associated with greater CBT literacy. Most users prefer face‐to‐face delivery, suggesting eed to expand trained providers while gradually integrating digital options.

A nationwide web survey of 518 Japanese residents quantified public awareness, experience, and preferred delivery formats of cognitive behavioral therapy (CBT). Of the respondents, 87% had little or no knowledge of CBT, while 59% preferred physician‐led face‐to‐face delivery. Past mental‐health service use (OR = 3.17), mindfulness exposure (OR = 13.68), and Certified Public Psychologist recognition (OR  = 5.48) independently predicted CBT literacy.