Bridging the service gap in cognitive behavioral therapy from a user perspective: Findings from a web-based survey in Japan.

Aim: The primary aim was to quantify public awareness, experience, and delivery‑format preferences regarding cognitive behavioral therapy (CBT) in Japan. The secondary aim was to identify user‑related factors associated with CBT literacy (awareness or experience), including information-seeking behavior and prior service use. Methods: A cross‑sectional web survey of 518 Japanese residents aged 15-79 years was conducted in August 2024. Awareness and experience of CBT, preferred delivery formats, mental‑health service use, mindfulness recognition, and Certified Public Psychologist (CPP) awareness were assessed. A binary logistic regression examined factors linked to CBT awareness/experience. Results: Only 13.1% of respondents reported awareness of or experience with CBT, while 62.2% had never heard of it. Face-to-face CBT with physicians was preferred by 59.3%, compared with 8.9% favoring application‑based delivery. Awareness of mindfulness (odds ratio [OR] = 13.68, 95% confidence interval [CI] 6.83-27.40), CPP awareness (OR = 5.48, 2.48-12.10), and past mental‑health service use (OR = 3.17, 1.52-6.58) were independently associated with CBT literacy; age, gender, and self‑rated mental health were not significantly associated factors. Conclusion: Public awareness of CBT in Japan remains limited despite more than a decade of insurance coverage. Engagement with mental-health services, exposure to mindfulness concepts, and familiarity with CPPs appear to be associated with greater CBT literacy. Most users prefer face-to-face delivery, suggesting eed to expand trained providers while gradually integrating digital options.