nature. No strenuous physical work is allowed, such as climbing stairs and sweeping. In the third stage, patients are allowed to engage in moderate physical work, but not social interaction. This stage lasts from three to seven days. For people with physical injuries, it is the phase where they move from passive treatment given to them by others (such as chiropractic, massage and pain medicine) to treating themselves through physical therapy. This third stage can become a part of daily life for some patients. The patient is encouraged to spend time in creating art, such as by writing, painting, or wood carving. The purpose of this stage is to instill confidence, empowerment, and patience through work. The fourth stage is the stage where patients are reintroduced into society. It can last from one to two weeks. The patient integrates meditation and physical activity. The patient may return to the previous stages and their teacher to find coping skills that will allow them to further recover. Methods (Western) Shoma Morita's work was first published in Japan in 1928. Morita Therapy Methods (MTM) adapted the therapy to modern western culture. For example, the original Morita treatment process has the patient spend their first week of treatment isolated in a room without any outside stimulation, which has been modified in MTM. The shinkeishitsu concept has also been broadened to consider not just anxiety, but life situations in which modern westerners may find themselves, involving stress, pain and the aftermath of trauma. MTM is also designed to help patients deal with shyness. As with Morita therapy proper, MTM is roughly divided into four basic areas of treatment. Research A Cochrane review conducted in 2015 assessed the effectiveness of Morita therapy for anxiety disorder in adults. The review states there is very low evidence available and it is not possible to draw a conclusion based on the included studies. See also David K. Reynolds Naikan Quiet sitting References Further reading Morita, Shoma (1998) (Kondo, Akihisa, trans., LeVine, Peg, ed.) Morita Therapy and the True Nature of Anxiety-Based Disorders. State University of New York Press. Chang, SC. (1974). Morita Therapy. American Journal of Psychotherapy, 28: 208-221. Chang, SC. (2010). Psychotherapy and culture. Morita therapy: An illustration. World Cultural Psychiatry Research Review. December, 135-145. Deng Yuntian, Out of the quagmire of obsessive compulsive disorder 走出強迫症的泥潭. A detailed book about Morita Therapy. Fujita, Chihiro. (1986). Morita Therapy: A