Japanese Occupational Therapy Cultural Awareness Interventions

Japanese culture has a unique perspective on health and wellness that may influence the practice of occupational therapy in Japan. The healthcare system in Japan may be different from other countries, and foreign patients may need help navigating the system and understanding their rights and options for therapy. Occupational therapists need to be aware of cultural differences and work closely with other healthcare professionals and social workers to help foreign patients access the services and support they need, especially in a field dominated by White female practitioners predominantly from the middle class.

Some of the traditional Japanese beliefs that may influence occupational therapy include:

Emphasis on balance and harmony. Japanese culture places a strong emphasis on balance and harmony in all aspects of life, including physical, mental, and spiritual health. Occupational therapists in Japan may focus on helping individuals achieve a sense of balance and harmony in their daily activities.

Respect for the individual is important. Japanese culture values respect for the individual, and occupational therapists in Japan may take a person-centered approach to therapy, focusing on the unique needs and goals of each individual.

The importance of nature can be used as therapy. Japanese culture has a strong connection to nature and many traditional healing practices use natural elements such as herbs, plants and minerals. Occupational therapists in Japan may incorporate elements of nature into therapy, such as gardening or outdoor activities.

Emphasis on mindfulness and relaxation is another possible intervention. Japan has a long tradition of mindfulness practices such as yoga and meditation. Occupational therapists may incorporate these practices into therapy to help individuals relax and reduce stress.

Emphasis on community for most Japanese addresses the social occupation. Japanese culture places a strong emphasis on community and social connections. Occupational therapists in Japan may work with family members and caregivers to help individuals participate in community activities and build social connections.

Japanese culture also emphasizes the importance of work and productivity, and occupational therapy may focus on helping individuals return to work or improve their ability to perform work-related tasks. Occupational therapists in Japan may also use traditional Japanese healing practices, such as shiatsu massage and aromatherapy, as part of their treatment, as these practices are believed to promote relaxation and healing.

Japan has a long tradition of craftsmanship and attention to detail, and occupational therapists may use traditional Japanese crafts, such as calligraphy or ikebana, as part of therapy to help individuals improve fine motor skills and hand-eye coordination. As a case example, one activity that was meaningful to one of my clients was folding origami. We worked on doing this whole standing to promote fine motor control as well as standing balance, endurance, and postural control. This was highly therapeutic, but remember that each client has different interests.

Another important aspect is that Japan has an aging population, and many older adults may require occupational therapy to help them maintain their independence and ability to perform daily activities. Occupational therapists in Japan may work with older adults to help them adapt to age-related change.

What about other alternative treatments?

OTs should consider the potential integration of traditional Japanese healing practices into occupational therapy. Some traditional Japanese healing practices, such as shiatsu massage, aromatherapy, and acupuncture, may be used as complementary or alternative therapies in occupational therapy. These practices may be used to improve relaxation and reduce stress, as well as to address specific physical or cognitive conditions. However, it’s important for occupational therapists to be familiar with the scientific evidence for the effectiveness of these practices and to use them in a way that is consistent with ethical standards and best practices.

Some traditional Japanese healing practices may not be recognized as mainstream medical treatments and may not be covered by insurance. Occupational therapists may need to work with patients and insurance providers to ensure that the cost of these treatments is covered.

Last, Japanese patients may face a unique set of barriers to health and overall quality of life in America. Some common factors that may influence the health of Japanese Americans include:

Bicultural identity: Many Japanese Americans may have a bicultural identity, which can influence their healthcare beliefs and practices. They may be more likely to use both traditional Japanese and Western medical practices, and may have different attitudes and beliefs about healthcare compared to Japanese people in Japan or Americans.

Language barriers: Japanese Americans may face language barriers, which can make it difficult to access healthcare services and understand medical information. This may be particularly true for older Japanese Americans who may not speak English fluently.

Health disparities: Japanese Americans may experience health disparities compared to other racial/ethnic groups in the United States. For example, they have lower rates of certain types of cancer, but higher rates of certain types of heart disease and stroke.

Access to care: Japanese Americans may face barriers to accessing healthcare services, such as lack of insurance coverage, lack of transportation, and limited access to culturally and linguistically appropriate care.

Socioeconomic status: Japanese Americans may have a wide range of socioeconomic status, and those with lower income may experience more health disparities than those with higher income.

To help guide OT practice and put these beliefs and values together, an Asian theoretical framework can be very beneficial. The Kawa (Japanese for river) model, developed by Japanese and Canadian rehabilitation professionals, presents an important and novel alternative to contemporary ‘Western’ models of rehabilitation. Rather than focussing primarily on the individual client, the Kawa model focusses on ‘contexts’ that shape and influence the realities and challenges of peoples’ day-to-day lives.

The Kawa model is based on the belief that the body, mind and spirit are interconnected, and that maintaining balance and harmony in all aspects of life is essential for good health. The Kawa model stresses the importance of preventative care, and encourages individuals to take an active role in their own health and well-being through healthy lifestyle habits such as regular exercise, a balanced diet, and stress management.

The Kawa model may be used in conjunction with Western medical practices, and may be particularly useful for individuals with chronic health conditions. It may be used in a variety of settings, including hospitals, clinics, and community health centers, and may be provided by a variety of healthcare professionals, such as occupational therapists, physical therapists, and traditional Japanese healers.

It’s worth noting that the Kawa model is not widely known or well-established in Japan, and the availability and accessibility of Kawa model-based care may vary depending on the region and healthcare facility. Still, this model can be very beneficial if applied and considered from a holistic client perspective as it may be much more relevant and metaphorical than Western models.


  1. Odawara, E. (2005). Cultural competency in occupational therapy: Beyond a cross-cultural view of practice. The American Journal of Occupational Therapy, 59(3), 325-334.
  2. Iwama, M. K., Thomson, N. A., Macdonald, R. M., Iwama, M. K., Thomson, N. A., & Macdonald, R. M. (2009). The Kawa model: The power of culturally responsive occupational therapy. Disability and rehabilitation, 31(14), 1125-1135.