MGCIS Integrated Design

ICMZ is a complementary healing layer that is coded in parallel alongside each country's diagnostic and billing systems without changing them. This document fills gaps in the earlier five-stage document design, and sets out an evidence-building pathway aimed at registration as a WHO related classification, together with a sharing and feedback system through which user countries pool data to improve healing outcomes jointly.

Vision: A Universal Healing System for All Humanity

MGCIS is not a system of any single country or culture. It aims to be a universal healing system through which every person can name their own suffering and find a path to recovery. Universality is built in three layers.

Universal structure, local expression, shared verification. Every person heals through the stories of their own culture, and every healing becomes wisdom for all of humanity.

"Narro ergo fluo atque sum nos" — I narrate, therefore I flow, and indeed I am we. Every design in this document is an effort to extend the "I am we" of this motto to all of humanity.

0. Identity and Strengths of ICMZ: A Myth-Based Narrative Clinical Healing System

ICMZ is a third category, neither narrative medicine nor a diagnostic classification. It is a myth-based narrative clinical healing system that names suffering through mythic archetypes and sets out a healing pathway through a seven-stage cycle.

In all submissions and papers, ICMZ is not introduced as "a branch of narrative medicine" or "a new diagnostic system"; it is defined by the fourth column of this table. Narrative medicine is respected as an adjacent field and cited separately in the references.

ICMZ Design Responses to the Limitations of Existing Systems

The strength of ICMZ lies in directly addressing 22 limitations already identified in existing U.S. and WHO systems. Strengths are measured, not asserted. Each response has a verification indicator, and these indicators become the outcome indicators of the trials in Section 6 and the sharing network in Section 7.

Additional limitations (12–22): meaning of recovery, relationships, groups, and practice

These 22 indicators are grouped as the ICMZ Outcome Set. To insurers, WHO, and investors, the message is not "ICMZ is better" but "this limitation of existing systems is being measured with this indicator." Measured strengths cannot be refuted.

ICMZ Integrated Operating Flow

The six stages from screening to recommendation update form a single cycle; each stage is described in detail in Section 5 (screening), Section 2 (parallel coding and narrative music), Section 0 (outcome indicators), and Section 7 (sharing and updating).

1. Basic Principle: Parallel Coding, Not Replacement

Because a system that conflicts with the existing systems of the United States and WHO member states would be rejected, ICMZ does not change a single character of existing diagnostic and billing codes; it records the healing pathway alongside them in parallel.

ICMZ does not replace DSM-5-TR or ICD. It leaves each country's existing diagnostic and billing systems unchanged and adds a parallel healing pathway built on myth narrative and narrative music to improve therapeutic outcomes.

Parallel coding has four meanings.

• Billing stays the same: Diagnoses are billed with each country's billing codes, and treatment is billed under existing counseling and psychotherapy fee schedules.
• ICMZ goes in the record: ICMZ concepts and Kyklos stages are entered in the treatment-technique field and progress notes. This is the same place where a CBT counselor writes "CBT applied."
• Licensed clinicians bill: Only clinicians licensed in each country file insurance claims. ICMZ documents support that record.
• Effectiveness is shown by data: Progress data from cases coded in parallel accumulate to form the evidence for international approval.

2. Three-Layer Parallel Coding Structure

A single session record lists the diagnosis, intervention and outcome layers side by side, and in each layer the field used for billing is kept separate from the ICMZ parallel-coding field.

The most important design point for international approval is that the three layers correspond respectively to WHO's three reference classifications (ICD, ICHI and ICF).

Integration of Narrative Healing and Narrative-Music Healing

As a principle, ICMZ interventions apply narrative and music together in a single context. Mythoiasis narrative music, matched to the myth concept and Kyklos stage addressed in the session, carries the same story forward in sound.

1. Pairing: A piece of music is assigned to each concept and stage. For example, Katabasis (descent) is paired with a slow piece that helps endure the descent, Catharsis (purification) with a releasing piece, and Palingenesis (rebirth) with a piece about rising again.
2. Within the session: The sequence is myth narrative presentation → narrative-music listening → sharing responses → re-storying.
3. Between sessions: The client listens to the same piece as self-care and records responses in the Pharmakon journal.
4. Recording: The track number, stage, listening context (in or out of session) and pre- and post-listening emotional self-ratings are recorded together in the intervention layer.
5. Safety: The exclusion criteria (Section 5) apply equally to music. Pieces that may trigger traumatic memories are checked in advance, and the client can stop at any time.
6. Billing: Music is recorded as a technique within an existing psychotherapy session. Billing music therapy separately requires a music therapist qualified in that country.

Information on which pieces drew good responses at which stages and in which cultural spheres is also gathered through the sharing and feedback cycle in Section 7, and music recommendations are updated accordingly.

Grade-Based Assignment of Narrative and Music Prescriptions

Once a client's grade is determined, the system assigns candidate narratives to read and narrative music to listen to, and these are delivered to the client after clinician approval. The higher the grade, the greater the share of short, more distant narratives, stabilization-focused music, and clinician accompaniment.

Grade determination: The Pyros four grades (Grade 1 mild to Grade 4 very severe, each with a, b, c and a direction of worsening, improving or plateau) are used, but the grade is always set by the clinician together with standard scales. For example, PHQ-9 has established bands of 5–9 mild, 10–14 moderate, 15–19 moderately severe and 20–27 severe, which serve as reference points for the grade. Because the Pyros grade is still being validated, it is not used on its own.

Prescription table by grade (initial standard, to be adjusted with data):

Conditions subject to exclusion (Section 5) receive no assignment regardless of grade.

Assignment procedure:

1. Screening passed: Proceed only if scope screening and crisis screening have been passed.
2. Grade determination: Grades 1–4 are set using standard scales + HAG + clinician judgment.
3. Concept and stage decision: The mapping engine proposes one primary and two secondary concepts and the current Kyklos stage.
4. Culture and preferences: The cultural sphere, language (of eight) and reading/listening preferences chosen by the client are applied.
5. Candidate selection: Three narratives and three pieces of music with matching concept × stage × cultural sphere × grade tags are selected from the content library.
6. Safety filter: Content whose trigger tags overlap with the client's trauma type is excluded. For example, a survivor of sexual violence is not initially assigned a direct version of the Medusa narrative.
7. Clinician approval: The counselor selects from or replaces the candidates. Only Grade 1 self-care is delivered automatically, with later review by a facilitator.
8. Delivery: "My myth of the week" and "My music of the week" are provided via app, website or print.
9. Response recording: Before and after reading or listening, the client rates their state of mind from 0 to 10 and writes a one-line reflection in the Pharmakon journal.
10. Re-evaluation: Prescriptions are adjusted every two weeks, and the grade is reassessed with standard scales every four weeks.

Automatic adjustment rules based on response:

Content library tags: All narratives, poems and music carry the following tags so that the assignment engine can select them.

All assigned content and responses are gathered through the sharing and feedback cycle in Section 7 to learn which narratives and pieces were effective at which grades and in which cultural spheres. The amounts and frequencies in the prescription table are initial standards and will be revised annually using these data.

Record example (United States, post-traumatic stress, hypothetical case):

[Billing field — submitted to the insurer]
Diagnosis: F43.10 (ICD-10-CM)
Procedure: 90837 Psychotherapy, 60 minutes (CPT)

[Clinical record field — kept in the counseling record]
Treatment technique: Integrative narrative therapy, with ICMZ framework parallel coding
ICMZ concepts: Medousastrophe (primary), Callisto Dilemma (secondary)
Kyklos: transitioning from Katabasis → Anagnorisis
Outcome: PCL-5 58 → 41 (entered measured values)

The existing INS-ICMZ codes are not placed on claims; they are used only as internal reference numbers within the clinical record field above.

3. National Billing Code Conversion Table

For parallel coding to work, the ICD-11 codes in the 330 mappings must be converted once more into the codes each country actually uses for billing. ICD-11 came into effect in January 2022, but as of May 2024, 14 countries were actually reporting in ICD-11, and more countries are in transition.

Conversion is based on official correspondence tables (WHO's ICD-10↔ICD-11 mapping tables, the US GEMs, etc.), and results are shown in documents only after review by local coding experts in each country. Conversion to the Korean KCD is kept for internal reference only, maintaining the existing principle of not submitting to domestic institutions.

4. Redesign of the Five-Stage Documents

The stages and page counts remain unchanged, and the 64-page Stage 5 document is changed from "insurance evidence material" to a **"Clinical Documentation Support document for parallel coding (Clinical Documentation Support)"**.

Table of contents of the 64-page document (64 pages in total):

Number sourcing rules (rules to be built into the generator):

• All numbers in the document are taken only from entered data. If none exists, the field is left as "Not entered".
• What the AI does not generate: statistical significance, effect sizes, cost-effectiveness amounts, comparative figures against other treatments, and unverified literature citations.
• The former "cost-effectiveness analysis" and "clinical evidence report" sections are deleted, and the current level of evidence is stated factually in "ICMZ Methodology" in the appendix (pilot data collection in progress).
• Every page carries a footer notice stating that "diagnosis and billing decisions are the responsibility of the licensed clinician".

5. Safety, Ethics, Fairness and Privacy

Because international organizations and insurers check safety before effectiveness, five items are fixed in writing.

• Licensure principle: Only licensed clinicians in each country make diagnosis, billing and crisis decisions. Mythozoesis counselor certification is an additional competency and does not replace licensure.
• Crisis protocol: The system serves only an auxiliary role in alerting the counselor to crisis signals. It does not determine "no crisis", and the counselor checks directly in every case. An input field for a validated suicide-risk screening tool (e.g. C-SSRS) is provided.
• Consent: Separate consent is obtained for the nature of the narrative intervention, whether records are used for research, and the right to withdraw. Consent to research use is separated from consent to treatment.
• Privacy: US HIPAA, EU GDPR and Japan's APPI serve as the standards. Research data are collected only after pseudonymization, and myth concept codes must not become a means of re-identifying individuals.
• Cultural appropriateness: If a client does not want a particular myth or religious narrative, it can be replaced with a concept from another cultural sphere, or parallel coding can be turned off. The 10-cultural-sphere system is a strength in this respect.

Scope of Application and Advance Notice

Conditions that ICMZ cannot address are screened before counseling begins, and the client is informed in advance. For these conditions psychiatric treatment takes priority, and myth and symbolic narratives may instead reinforce symptoms.

Advance notice (included in the consent form):

Mythozoesis (ICMZ) is a complementary approach that adds myth-based narrative and narrative-music healing to existing care. It is not used for psychotic disorders such as schizophrenia, manic episodes, acute suicidal crisis, severe cognitive impairment, or acute intoxication or withdrawal; in these cases psychiatric treatment comes first. If such a condition is identified during sessions, ICMZ sessions stop and the client is referred to specialist care.

Screening is the first field of the Stage 1 briefing document; if a condition applies, no further documents are generated and only referral guidance is output.

Objective Fairness Across Ethnicities, Cultures, Regions and Histories

Because MGCIS is intended for people worldwide, it is designed with a structure that shows in numbers, rather than merely declares, that no ethnicity, culture, region or history is placed above others or pathologized.

Six principles:

1. Equality of the 10 cultural spheres: No cultural sphere serves as the standard or the center of the archetypes. Ancient Greek naming is a shared scholarly nomenclature, like Latin scientific names in biology, and every concept carries names in eight languages together with corresponding stories from each cultural sphere.
2. The client chooses: Cultural spheres are not assigned automatically by ethnicity or nationality. Giving Korean myths to someone of Korean descent or African myths to someone of African descent is a stereotype; the client's choices and responses decide.
3. Name phenomena, not groups: Concepts are named after mythological figures and phenomena of suffering, not after ethnic, national or religious groups. No ethnicity becomes the name of a concept.
4. History from multiple perspectives: Content dealing with war, colonialism and conflict, such as Kratopatheia and Historiopaideia, uses sources from both sides and addresses the psychological phenomena of power rather than blaming individuals.
5. Respect for living faiths: Content dealing with gods and saints who are still worshipped today (e.g. Hindu and Shinto deities) is reviewed in consultation with the relevant tradition, and clients may choose to exclude it.
6. Acknowledging the limits of grouping: Where a single cultural sphere contains many peoples, such as "Africa" or "the Americas", it will be divided into sub-spheres as usage data accumulate.

Measurable fairness audit (published annually):

Data sovereignty of Indigenous and minority cultures: Stories and data of the Ainu, Ryukyu, Indigenous peoples of the Americas and others follow the CARE Principles for Indigenous Data Governance (Collective benefit, Authority to control, Responsibility, Ethics). The Institute works in partnership with the communities concerned, and the means of returning part of the benefit derived from their stories to the community is set out by agreement.

Equity of access:

• The glossary and basic materials are free; support programs for textbooks are maintained.
• Paid services apply tiered pricing by country according to World Bank income classifications.
• Support for low-spec devices, slow networks and offline use; accessibility features for people with disabilities (screen readers, captions) provided by default.
• After the eight languages, languages are added in order of user numbers (e.g. Arabic, Hindi, Portuguese, Swahili).

International Fairness Committee: Members are drawn evenly from WHO's six regions (Africa, the Americas, South-East Asia, Europe, Eastern Mediterranean and Western Pacific), and the chair rotates among regions. The committee reviews the audit above, operates a public channel for objections, and issues an annual fairness report together with the outcomes report.

6. Evidence-Building Plan

International approval requires two kinds of evidence: that "the classification is applied consistently" and that "parallel coding produces better outcomes." Work on the first can begin now.

1. Classification reliability study (possible now): Two or more clinicians independently assign ICMZ concepts to the same set of hypothetical cases, and agreement (kappa coefficient) is measured. No patients are needed, and the study demonstrates the "mutually exclusive categories" that WHO-FIC requires.
2. Reanalysis of existing cases (possible now): Applying ICMZ to published DSM and ICD cases can serve as evidence of "classification fit." However, it is not evidence of treatment effect, and papers and investment documents will state this distinction clearly.
3. Clinical trial registration: Before recruiting participants, the plan is first registered with ClinicalTrials.gov or a registry linked to WHO ICTRP. The registration date becomes the official record of priority.
4. Pilot (overseas partner institution): After ethics committee (IRB) approval, licensed clinicians code ICMZ in parallel with existing treatment and measure validated scales before and after. The aim is to confirm feasibility, safety and client acceptability; no claims of effect are made.
5. Randomized controlled trial: "Existing treatment + ICMZ parallel coding" is compared with "existing treatment alone." As an add-on design fully consistent with the parallel-coding principle, it is also favorable for ethics review. Outcome measures are specified in advance from the ICMZ Outcome Set in Section 0 (scale change, dropout rate, stigma, cultural fit, etc.).
6. Publications: Results are published in peer-reviewed English-language journals in the order reliability study → pilot → RCT. An application for US CPT Category III also requires these papers or an IRB-approved protocol.

First Pilot Design (Draft)

The aim is not to prove effect but to show that the approach is feasible and safe; these results will form the design basis for a randomized controlled trial.

Use and Ongoing Expansion of the 330 Clinical Mappings

The 330 mappings submitted to WHO (code, concept, clinical description, DSM-5, ICD-11; 19 DSM categories) have a case structure close to actual counseling content, making them the largest asset for building evidence now, without patients. However, because they are expert-constructed cases, they are used not as evidence of healing effect but as evidence of content validity and classification reliability.

Four uses:

Ongoing entry and expansion method:

1. Standardized entry form: All new mappings are entered using the same fields: mapping number, de-identified case summary, core symptom keywords (8 languages), ICMZ 1 primary and 2 secondary concepts, DSM-5-TR, ICD-11, ICD-10-CM, Kyklos stage, differentiation rule (why it is not a similar alternative concept), recommended grade, linked narrative and music, trigger tags, module, cultural region, validation status, and version and author.
2. Codes only from the master registry: Codes are never created ad hoc during mapping. Concepts not in the registry are registered first. Mismatched codes would break the billing chain.
3. Listing after review: The sequence is draft → review by two experts → differentiation rule finalized → incorporation into the engine. Validation status is shown in three levels: draft / expert-reviewed / field-confirmed.
4. Regression testing: Each time a new mapping is added, the system automatically checks that existing standard cases (e.g., a man in his 50s whose son has died → G009 Niobeia Petrification/309.81/6B41) still return the same answer. If an answer changes, it is deployed only after review confirms the change was intended.
5. Fill gaps first: Of the current 330, Kyklos stages are concentrated in Katabasis (about 150), while Acme has only about 10. Gaps by stage, by module (30) and by cultural region (10) are tabulated and filled first.
6. Real counseling mappings flagged separately: Once the pilot begins, mappings of real cases obtained with consent are accumulated separately as "field cases." The rate of agreement between the engine's suggestion and the clinician's final choice becomes the engine's accuracy, and discordant cases become material for refining differentiation rules.

Expansion target (proposed): Adding 30 cases per month to reach about 700 within one year, with the number of mappings, category coverage, stage balance, content validity and engine–clinician agreement rate published quarterly. These figures serve as direct evidence of "quality and stability," a WHO-FIC registration criterion.

7. International Sharing and Feedback System

This is a federated structure in which each user country keeps its raw data within its borders and shares only pseudonymized, aggregated results. As more countries participate, the narrative recommendations received by clinicians in every country become more accurate.

Feedback cycle (returns to step 1 on completion):

1. Recording: Clinicians in each country create three-layer parallel-coding records using a common data model.
2. In-country storage: Raw data are kept only on servers in that country. This complies with cross-border transfer restrictions such as the EU GDPR.
3. Aggregate sharing: Only pseudonymized aggregate statistics (or federated analysis results) are sent to the ICMZ Learning Network hub. Small cells with fewer than 10 cases are not disclosed.
4. Analysis: The analysis examines which concepts and narratives appeared together with scale improvement in which diagnoses and cultural regions.
5. Feedback: Results are reflected in the "next-session narrative recommendations" on clinicians' screens in each country. Changes to recommendations are reviewed by an expert committee and released with a version number.
6. Expansion: New distress structures discovered in the field are submitted as Layer 2 (open extension layer) proposals and listed after review.

Common data model (all user countries record the same fields):

Governance:

• International Steering Committee: Composed of representative clinicians from user countries and the Institute; reviews recommendation changes and Layer 2 listings.
• National data stewards: The partner institution in each country is responsible for storage, pseudonymization and legal compliance for its own data.
• Data sharing agreement: Participating countries sign the same agreement and share only what has been approved by an ethics committee.
• Annual report: Aggregates by country and cultural region, and the history of recommendation changes, are published each year.

Associations seen in observational data are not causal, so promising concept–narrative combinations are confirmed through the trials in Section 6 before being adopted as standard recommendations. The network itself serves as evidence of "use in multiple countries" and "ongoing maintenance and revision," both WHO-FIC registration criteria.

Client-Participatory Measurement and Sharing

Healing effect, ICMZ's greatest strength, is designed to be measured not by clinicians alone but together with clients, with results shared among clients to help the next person heal. One person's recovery becomes the next person's map.

Measurement points:

Outcome determination (same yardstick for every client):

• Reliable change: Determines whether change exceeds measurement error (Reliable Change Index, RCI).
• Clinically significant change: Examines whether the scale score has moved into the general-population range.
• Four outcomes: recovered · improved · no change · deteriorated. The deterioration rate is always published alongside. Reports that include only favorable results lose credibility.

My Healing Map (client screen): Clients view their own measurement results as follows.

• Where they are now among the 7 Kyklos stages (a single point on the map)
• The trend in scale scores in plain language ("The weight on your mind has lessened since you began")
• A list of the myths and tracks that helped them most

Seeing one's own change is itself a source of continuing motivation and serves as a mechanism to reduce dropout (Limitation 4).

Client-to-client feedback and sharing (all optional):

When a new distress structure appears repeatedly in donated recovery stories, it is submitted as a Layer 2 new-concept proposal. Clients become co-creators of the system.

Safeguards:

• People are not ranked or compared with one another. Comparison is only with one's past self.
• All shared posts and donated stories are reviewed before posting; if they contain crisis expressions, they are not posted and the responsible counselor is notified.
• Client stories from protected-tier modules (Section 9) are shared only within that module.
• Participation and donation can be withdrawn at any time; upon withdrawal, the content is removed from the library.
• Recommendation aggregates are not shown if based on fewer than 10 people, so that individuals cannot be identified.

The results of this measurement and sharing are published in an annual outcomes report covering recovery, improvement and deterioration rates, which becomes the actual evidence of ICMZ's healing effect to present to insurers, WHO and investors.

Open Innovation Operations: Rapid Adoption of New Healing Methods

When a new healing method is identified, anyone can propose it; it is piloted quickly according to its risk grade and adopted as standard once its effect is confirmed. "Immediate" applies in two cases: low-risk content is added within a few weeks, and anything found to cause harm is removed within 24 hours.

Entry points for proposals (all through a single public proposal channel):

• New research and clinical trial results (including international academia)
• Field findings from clinicians in user countries
• Patterns seen in clients' recovery stories and content ratings
• Promising combinations emerging from ICMZ Learning Network analysis
• Traditional healing narratives and music from each cultural region (reviewed by cultural-region advisors)
• New technologies (virtual reality, wearables, etc.)

Adoption pathways by risk grade:

Step-by-step flow: Proposal received (public; first response within 2 weeks) → risk-grade classification → pilot adoption → evaluation using the ICMZ Outcome Set (including deterioration rate) → standard adoption and versioned release → ongoing monitoring and withdrawal if needed.

What is open, and to what extent:

Governance: An Open Innovation Committee (clinicians, researchers, people with lived experience, cultural-region advisors and ethics experts) makes decisions, and all proposals, decisions and reasons are kept as a public record. Members' conflicts of interest are disclosed in advance. Adopted methods are reflected in the same version in textbooks and counselor certification courses, so the field always works to the latest standard. Contributors are credited by name, and the Institute manages the system's standards and trademarks.

8. Future-Oriented Design

Over the next 5–10 years, mental health insurance and regulation are expected to move toward "paying for outcomes, connecting digitally, keeping AI under human oversight, and adapting to culture." By building these into the design before the changes arrive, ICMZ will already be a prepared system when they do.

Stepped-Care Model

The same ICMZ concepts and narrative music are provided at different intensities according to the level of distress, and a client is moved up a level when signs of deterioration appear.

Anticipated Risks and Responses

9. MGCIS Integrated Design: One System, Thirty Modules

The 30 platforms are unified into a single system, MGCIS, and the existing platforms become its 30 modules. This translates the book's (Chapters 39–47) "one mirror, thirty rooms" into a system structure, so it does not contradict existing materials.

Confirmed Terms

Four-Layer Structure

1. ICMZ engine: Concepts, screening, documentation, music, measurement and sharing used in common by all modules.
2. 7 domains: Groupings of Chapters 40–46 of the book.
3. 30 modules: Profiles within each domain (target population, additional screening, concept set, music set, outcome indicators, funding channel, referral pathway).
4. 4 funding channels: Insurance billing / public and international budgets / institutional and corporate contracts / self-care and digital.

Even without insurance approval, 20 modules can operate now through public budgets, institutional contracts and self-care, and their usage record becomes the basis for insurance and WHO approval.

7 Domains × 30 Modules (Standard List)

A data grade of "protected" indicates a module whose data is legally stored separately with segregated access rights (see data partitioning below).

Inter-Module Referral Chains (Linkage Effects)

Because a person's record sits within one system, the same myth carries the story forward as the person moves between modules. Client consent is obtained again at each move between modules.

Data Partitioning and Operating Principles

• One logic, partitioned data: The 11 protected-tier modules are kept in a separate repository, accessible only to staff of that module. Only consented items pass to other modules.
• Safety rules live in the engine: Modules cannot switch off exclusion or crisis protocols. Protected modules add to their profiles each country's mandatory reporting obligations (child abuse, etc.) and trauma-informed guidelines.
• A module code is one field in the common data model: Myths and music shown to be effective in one module are recommended to other modules as well.
• Unified certification and training: The 90 qualifications are grouped into a "common qualification + module certification" structure, and the common textbook is the Mytho-Humanities School foundational textbook.

Launch Sequence

1. MCLIS (clinical): The hub to which all modules refer. Already in operation.
2. MHWIS (health workers): Employers pay, effects are easy to measure with a burnout scale (ProQOL), and risk is low.
3. MGRIS (grief and bereavement): Has the highest fit with myth and directly answers Limitation 12 (medicalization).
4. MOLIS (corporate EAP): Generates both revenue and a usage record without insurance approval.
5. Protected-tier modules are opened one at a time after safety has been confirmed in the four modules above.

10. International Approval Pathway

The realistic route by which WHO formally recognizes an external classification is registration as a "Related Classification" in the WHO Family of International Classifications (WHO-FIC). The nursing classification (ICNP) and the primary care classification (ICPC-2) are included in this capacity, and it fits exactly the parallel coding principle of standing alongside ICD without altering it.

Related Classification registration criteria and ICMZ status:

Registration procedure: The proposing institution submits to the WHO-FIC Family Development Committee (FDC) → committee evaluation → presentation and approval at the WHO-FIC Network annual meeting → recommendation by the WHO-FIC Council → publication by WHO. A World Health Assembly resolution is not required.

Parallel pathways:

• ICD-11 proposal platform: Proposes supplementary information on existing entries rather than new diseases. #357P will be strengthened in this direction.
• ICHI (International Classification of Health Interventions): Includes mental health interventions, and its clinical intervention section is finalized. A mapping table will be prepared showing where "myth-narrative-based psychological intervention" fits among existing intervention entries.
• US CPT Category III: Temporary codes for emerging health services. The service must be "currently performed on humans," and must additionally have one of an IRB-approved protocol or English-language peer-reviewed literature, among others. This is a target after the pilot is completed.

11. Phased Roadmap

About four years to Related Classification registration is proposed, and each phase must meet its passing criteria before moving to the next (durations are estimates).

1. Phase 0 · Document preparation (now to 3 months): Revision of the 64-page generator, US billing code conversion table, parallel coding of validated scales, safety and consent documents, cleanup of the English edition, draft ICMZ FHIR code system.
   • Passing criteria: zero fabricated numbers in generated documents; billing codes reviewed by local coding specialists.
2. Phase 1 · Reliability and collaboration (3–9 months): Classification reliability study, securing one overseas partner clinical institution, clinical trial registration, prior consultation with a WHO-FIC Collaborating Centre, feasibility review of a digital therapeutic app pathway (DiGA, etc.) for the self-care app.
   • Passing criteria: inter-rater agreement (kappa) of 0.6 or higher; IRB approval.
3. Phase 2 · Pilot and first paper (9–24 months): Parallel coding pilot, submission of reliability and pilot papers, strengthening of #357P, ICHI mapping table.
   • Passing criteria: no serious adverse events; pilot completed; at least one paper published or under review.
4. Phase 3 · Application for approval (24–48 months): Randomized controlled trial, launch of the sharing and feedback network among user countries (Section 7), application for WHO-FIC Related Classification registration, application for US CPT Category III.
   • Passing criteria: actual usage records from one or more countries; peer-reviewed papers; documentation of the revision and maintenance system.

Expert Review List

Before actual application, written confirmation will be obtained from experts in each of the areas below. The legal and regulatory content of this document is a design direction based on public sources and is not legal advice.

Sources

• WHO Family of International Classifications (definition, criteria and procedure for Related Classifications)
• WHO — International Classification of Health Interventions (ICHI)
• AMA — Criteria for CPT codes (Category I and III)
• ICD-10 vs ICD-11: US transition status and country adoption figures as of May 2024 (citing WHO, secondary source)
• DiGA Fast Track guide (risk classes I and IIa, provisional listing 12→24 months)
• EU AI Act and AI in medical devices (high-risk criteria and application dates)
• WHO (2025) — Over a billion people living with mental health conditions
• DSM-5 field trial reliability (Scientific American)
• Swift & Greenberg (2012) meta-analysis of premature discontinuation in adult psychotherapy

CPT psychotherapy codes and national diagnostic coding systems are generally known information and must be verified against each country's latest edition before actual application.