Introduction: The estimated number of socially withdrawn individuals (Hikikomori) in Japan is 1.46 million, making it a significant social issue. However, few studies have examined occupational therapy (OT) interventions for Hikikomori.
Objective: To analyze OT progress for a boy with hikikomori and his mother and identify factors contributing to his return to school.
Ethical Considerations: Written consent was obtained from his mother.
Method: A community-based OT intervention was implemented over 2.5 years. Support included coaching his mother via a chat app (twice monthly), face-to-face meetings (once every two months), and cooking activities tailored to his interest (every 1–2 months; 90 minutes). The Canadian Occupational Performance Measure (COPM) set the goal of “attending school.” The Goal Attainment Scale（GAS）measured progress in going out (-2: never; +2: attending school daily) and cooking (-2: making ginger ale; +2: preparing spicy curry for his family).
Results: After 2.5 years, he attended school. COPM scores improved (performance: pre 1 → post 9; satisfaction: pre 1 → post 7), as did GAS scores (going out: pre -1 → post +2; cooking: pre -2 → post +2). His mother reported that her own emotions had stabilized.
Discussion: Factors supporting school reintegration included counseling and support for parents, structured activities based on the child’s interests, and emotional stability in the mother, which enhanced the child’s sense of security.