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Abstract

Objective

Morita therapy is a Japanese psychotherapy that is founded on acceptance-based principles and has been used to treat anxiety disorders. In this systematic review and meta-analysis, we evaluated the efficacy and safety of Morita therapy, used either as monotherapy or in combination with standard treatments, in adults with anxiety disorders.

Methods

We comprehensively searched 13 electronic databases on May 29, 2025 to identify randomized controlled trials involving adults diagnosed with generalized anxiety disorder, social anxiety disorder, specific phobia, or panic disorder.

Results

Fourteen trials involving 824 participants were included in the systematic review, of which 13 trials involving 746 participants were included in the meta-analysis. Compared to pharmacotherapy alone, Morita therapy plus pharmacotherapy significantly improved anxiety symptoms (SMD: −0.73, 95% CI: −1.43 to −0.02). Similarly, Morita therapy plus treatment as usual outperformed treatment as usual alone in reducing anxiety (SMD: −2.28, 95% CI: −3.88 to −0.67).

Conclusion

Morita therapy may be an effective treatment option for anxiety disorders, either when combined with other interventions or used as a standalone treatment. However, as the certainty of evidence was assessed as low according to the GRADE approach, further high-quality, rigorously designed trials across diverse populations are required to confirm these findings.

Keywords

anxiety disorders behavioral therapy Morita therapy psychotherapy systematic review

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References

Szuhany

Simon

. Anxiety disorders: a review. JAMA 2022; 328(24): 2431–2445. https://doi.org/10.1001/jama.2022.22744

Javaid

Hashim

, et al. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Current Psych 2023; 30(44): 44. https://doi.org/10.1186/s43045-023-00315-3

Sugg

HVR

Frost

Richards

. Personalising psychotherapies for depression using a novel mixed methods approach: an example from Morita therapy. Trials 2020; 21(1): 41. https://doi.org/10.1186/s13063-019-3788-3

Lin

Hsu

Lin

, et al. Neurobiological mechanisms of dialectical behavior therapy and Morita therapy, two psychotherapies inspired by Zen. J Neural Transm 2023; 130(8): 1077–1088. https://doi.org/10.1007/s00702-023-02644-3

Guidelines for practising outpatient Morita therapy: paired Japanese-English translation edition. Report, International Committee for Morita Therapy, 2021.

Nakamura

Niimura

Kitanishi

. A century of Morita therapy: what has and has not changed. Asia Pac Psychiatry 2023; 15(1): e12511. https://doi.org/10.1111/appy.12511

, et al. Morita therapy for anxiety disorders in adults. Cochrane Database Syst Rev 2015; 2015(2): CD008619. https://doi.org/10.1002/14651858.CD008619.pub2

Dai

. Analysis of the therapeutic effect of Morita therapy on anxiety disorder of art creators. CNS Spectr 2023; 28(S1): S21. https://doi.org/10.1017/S1092852923000895

Zhou

. Recovery effect of Morita therapy on anxiety disorders. Int Med China 2008; 3(6): 878–880. https://doi.org/10.16121/j.cnki.cn45-1347/r.2008.06.094

10.

. 30 clinical curative effect of Morita therapy combined with anxiolytics in treating generalized anxiety in 30 cases. Internal Medicine of China 2008; 3(6): 880–881. https://doi.org/10.16121/j.cnki.cn45-1347/r.2008.06.095

11.

Liang

Wan

. Modified Morita therapy in the rehabilitation of patients with anxiety disorders. La Med Clinical 2012; 9(15): 1867–1868. https://doi.org/10.3969/j.issn.1672-9455.2012.15.022

12.

Tong

Deng

Zhang

, et al. Observation of the efficacy of paroxetine combined with morita therapy for patients with panic disorders. Chinese J Clin Rat Drug Use 2016; 9(35): 33–34. https://doi.org/10.15887/j.cnki.13-1389/r.2016.35.022

13.

Zhang

Dai

Guo

, et al. Clinical efficacy Study of modified morita therapy for anxiety disorders. Neural Inj Func Recons 2019; 14(8): 418–420. https://doi.org/10.16780/j.cnki.sjssgncj.2019.08.014

14.

Yang

. Study on the curative effect of outpatient family sickbed Morita therapy on anxiety disorder. Master’s thesis. North China University of Science and Technology, 2021. https://doi.org/10.27108/d.cnki.ghelu.2021.000758

15.

Huang

. Analysis of the role of Morita therapy in improving pathological symptoms in anxiety patients. Card Dis Elec J Integ Trad Chinese Western Med 2020; 8(21): 110. https://doi.org/10.16282/j.cnki.cn11-9336/r.2020.21.090

16.

Liao

Deng

Chen

. Application of anxiety diary combined with Morita therapy in elderly patients with anxiety disorders. Nurs Prac Res 2020; 17(16): 151–153. https://doi.org/10.3969/j.issn.1672-9676.2020.16.057

17.

Xin

Lin

Chu

. Effect of Morita therapy on rehabilitation and nursing satisfaction of patients with first-episode anxiety disorder. Psych Monthly 2023; 18(17): 155–157. https://doi.org/10.19738/j.cnki.psy.2023.17.046

18.

Zhang

Tian

. A comparative study on Morita therapy for treating social phobia. J Psych 2001; 14(1): 36–37. https://doi.org/10.3969/j.issn.1009-7201.2001.01.012

19.

Zhang

Zhu

. Effect of Morita therapy on social phobia. Chinese J Behav Med Sc 2003; 12(6): 652. https://doi.org/10.3760/cma.j.issn.1674-6554.2003.06.025

20.

Nie

. Effect of Morita therapy on social phobia. China Health care nutrition. Clinical J 2008; 17(8): 61–63.

21.

Zhang

. Effect of Morita therapy-based group counseling on interview anxiety disorders in college students. Chin Ment Health J 2010; 24(5): 375–379. https://doi.org/10.3969/j.issn.1000-6729.2010.05.015

22.

Sugg

HVR

Frost

Richards

. Morita therapy for depression (Morita trial): an embedded qualitative study of acceptability. BMJ Open 2019; 9(5): e023873. https://doi.org/10.1136/bmjopen-2018-023873

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Effects of Morita therapy for anxiety disorders: A systematic review and meta-analysis

Abstract

Objective

Methods

Results

Conclusion

Keywords

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References

Supplementary Material