Table 4 Exemplar of therapy protocol development: stage two (the rest phase)

Stage two: development of the draft protocol

We developed each of the four phases of Morita therapy into separate sections following our decision, on the basis of our qualitative findings, to structure the therapy according to this model

To produce the rest phase section, we amalgamated the Morita therapy literature on engaging in rest to provide an overview and general guidance for preparing patients for rest (personal communications: Minami, M), specific instructions for developing an appropriate schedule and environment for rest ([5, 7, 27, 28, 30]; personal communications: Minami, M) and guidance on the indicators of progress during rest (personal communications: Minami, M)

In incorporating our qualitative findings, we included potential patients’ feedback on their fears of and barriers to rest

To guide therapists in addressing such issues, we provided guidance on stressing the importance of and rationale for rest, drawing on physical health and natural metaphors in explaining rest, and exploring and tackling feelings of guilt around taking rest, as suggested valuable from our qualitative themes

In order to address the misinterpretations of the meaning and nature of rest encountered in our interviews, we provided warning points for these potential misinterpretations as well as clear guidance on managing patients’ expectations of the purpose and likely experience of rest

We included specific instructions for the conditions for taking rest to further assuage doubts around the meaning of rest in Morita therapy