Fiorenzo Ranieri
The journal Psicologia Clinica dello Sviluppo (Il Mulino) published the article “Indirect Psychotherapy With Parents of Adolescents and Young Adults With Hikikomori” in its first issue of 2026 (available in Early Access at the following link: [link]). The pre-print version submitted for peer review is reproduced below.
Abstract:
This article presents a psychodynamic approach to working with families of adolescents and young adults experiencing hikikomori, a specific form of extreme social withdrawal. Young individuals with hikikomori present sensitive challenges for mental health professionals, particularly when they refuse direct contact with clinicians. In such cases, therapeutic work with the parents often becomes the only feasible intervention. The method of indirect psychotherapy is a parent-focused intervention that respects the adolescent’s refusal of treatment while aiming to redefine relational dynamics within the family system. This process seeks to establish an alliance with the parents and gradually engage them in confronting the often idealized yet emotionally neglected internal object of the “child.” When effective, this approach can catalyze meaningful changes in the family and, indirectly, in the adolescent. The article concludes with the presentation of several clinical vignettes.
Keywords: indirect psychotherapy, parent-focused intervention, hikikomori, psychodynamic therapy, psychic retreats Continue reading Indirect Psychotherapy With Parents of Adolescents and Young Adults With Hikikomori