Development of a Child-Rearing Support Program Implemented by Public Health Nurses in Japan: Aiming to Reduce Mothers’ Irritation

Abstract

Child abuse in Japan has been increasing annually, with 225,509 consultation cases handled by child guidance centers in 2023—an all-time high. One contributing factor is maternal cognitive distortions, such as perfectionism and victimized cognition, which can increase mothers’ stress and irritability in parenting. This pilot study developed a short-term intervention program led by public health nurses, aiming to reduce mothers’ irritability by addressing these cognitive distortions through cognitive behavioral therapy (CBT) principles. Fourteen mothers of children aged 1 to 6 participated in three online sessions (each 30 - 40 minutes, once a week for three weeks) focusing on externalizing irritating moments, brainstorming coping strategies, and recognizing unhelpful thinking patterns. Participants were assessed before the program, immediately after, and one month later, using measures of irritability, perfectionism, and victimized cognition. Results indicated a statistically significant reduction in mothers’ irritability, which persisted one month after the intervention. While there was a modest trend toward improvement in perfectionism, no significant change was observed in victimized cognition. These findings suggest that a brief, CBT-based program implemented by public health nurses can be valuable in reducing maternal irritability in a preventive context. However, as the study lacked a control group and used a single-group design, further research with randomized controlled trials (RCTs) or quasi-experimental designs is needed to rigorously verify the program’s effectiveness and long-term sustainability.