How to Treat Failure to Launch

A CBT and Family Systems Perspective

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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.

Plus, at course end you can complete a feedback form and short quiz and receive a certificate for 8 hours of CE credits (approved by the Canadian Psychological Association; see their statement below).


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.


"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)."

A Note Regarding CPA Approval: The Canadian Psychological Association's approval of an individual, group, or organization as a CE Sponsor or Provider is restricted to the activities described in the approved application or annual report form. The CPA’s approval does not extend to any other CE activity the Sponsor or Provider might offer. In granting its approval, the CPA assumes no legal or financial obligations to Sponsors, Providers, or to those individuals who might participate in a Sponsor or Provider’s CE activities or programs. Further, responsibility for the content, provision, and delivery of any CE activity approved by the CPA remains that of the CE Sponsor or Provider. The CPA disclaims all legal liability associated with the content, provision, and delivery of the approved CE activity. This program adheres to the ethical standards of the Canadian Code of Ethics for Psychologists.

Your Instructor

Dr Randy Paterson
Dr Randy Paterson

Randy Paterson is the Director of Changeways Clinic and author of The Assertiveness Workbook, How to be Miserable: 40 Strategies You Already Use, Private Practice Made Simple, and Your Depression Map. He is also the lead author of the Changeways Core Program, one of the world's most widely used group therapy treatment protocols for depression, and coauthor of The Antidepressant Skills Workbook. He has presented over 300 workshops on psychotherapy for professional mental health providers across Canada and internationally.

Course Curriculum

  Preventing Delays on the Launchpad
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days after you enroll

Frequently Asked Questions

When does the course start and finish?
The course starts now and never ends! It is a completely self-paced online course - you decide when you start and when you finish.
How long do I have access to the course?
How does lifetime access sound? After enrolling, you have unlimited access to this course for as long as you like - across any and all devices you own.
What if I am unhappy with the course?
We would never want you to be unhappy! If you are unsatisfied with your purchase, contact us in the first 30 days and we will give you a full refund.

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