Japanese Occupational Therapy Terms: A Japanese–English Glossary

The profession and its licenses

sagyō ryōhō 作業療法occupational therapy

JAOT’s official English definition calls it “occupation-focused therapy, guidance and support provided in fields such as medical care, public health, welfare, education and employment, with the aim of promoting human health and well-being.”

More: the word itself, kanji by kanji →

sagyō ryōhō shi 作業療法士occupational therapist (OT)

A single national license issued under the Physical Therapists and Occupational Therapists Act (1965) after passing the national examination. There is one tier and one nationwide license.

Watch out: No state-by-state licensure, no OTR/L-style registration, and no licensed assistant grade equivalent to the American COTA.

More: how you get this license →

rigaku ryōhō shi 理学療法士physical therapist (physiotherapist)

The other license created by the same 1965 act. The conventional division: PT centers on basic movement and physical function, OT on daily activities, mental health, and participation.

Watch out: Japan’s own English is “physical therapist” — the national body is the Japanese Physical Therapy Association — so use that as the credential name even when writing for readers who say physiotherapist.

seishin hoken fukushishi 精神保健福祉士mental health social worker (MHSW)

The national qualification handling discharge logistics, benefits, and community services in mental health settings — the OT’s closest collaborator on a Japanese psychiatric ward.

Watch out: The profession’s own English is Mental Health Social Worker; the older abbreviation PSW is still heard in clinics but has been retired by the national association.

More: a day in a psychiatric setting →

gengo chōkakushi 言語聴覚士speech-language-hearing therapist (ST)

The third rehabilitation license, created in 1997 and covering speech, language, hearing, and swallowing. Together with PT and OT it makes up the trio a Japanese rehabilitation team is built around.

kaigo shien senmon-in / kea manejā 介護支援専門員（ケアマネジャー）care manager

The certified professional who writes the care plan determining which long-term care services — including rehabilitation — a person receives. An OT working in long-term care works inside someone else’s plan. The certification is issued by prefectures and renewed every five years, unlike the national licenses above.

One word, four quantities — and the point beside it

If you read only one entry on this page, read this one. Japanese uses 単位 (tan’i) for four unrelated quantities that all appear in writing about OT, and English renders all four as “unit.” A reader who carries the wrong sense across a paragraph will misread the system badly, so each entry below names its qualifier. The section closes with 点 (point), the medical fee schedule’s own currency, because the contrast between a point and a long-term care unit is the clearest way to see how differently Japan prices health care and long-term care.

tan’i 単位（履修）unit — curriculum unit (academic credit)

The unit of coursework. Japan’s OT curriculum requires a minimum of 101 units, of which 22 are clinical practicum. One unit represents 15 or more hours of lectures or seminars, or 30 or more hours of laboratory, practical, and clinical work — the same accounting an English speaker would call a credit.

Watch out: If you are converting a foreign transcript, this is the sense that matters, and “credit” is its closest English equivalent. Every other entry in this section is a billing quantity.

More: the 101-unit curriculum →

tan’i 単位（疾患別リハビリテーション）unit — 20 minutes of individual therapy

Under the medical fee schedule, disease-specific rehabilitation is billed in units of 20 minutes or more of one-to-one therapy. A therapist’s day is standardized at 18 units with a ceiling of 24. Charting, planning, and walking a patient back to the ward do not count.

Watch out: A time unit — the sense behind the everyday phrase “I did 18 units today.” Do not carry it into the two entries below.

More: how the unit shapes the workday →

tan’i 単位（精神科作業療法）unit — a group of roughly 25 patients

In psychiatric occupational therapy — a separate fee item — one unit is a group of roughly 25 patients rather than a block of time. The standard is two units, or 50 patients, per therapist per day.

Watch out: A headcount, not a duration. “Two units” here means about 50 people, not 40 minutes — the sharpest trap on this page.

tan’i 単位（介護報酬）unit — the long-term care price unit

The currency of the long-term care fee schedule: every service is priced in units rather than yen. One unit is worth between 10.00 and 11.40 yen, set by two variables — the region class of the provider’s location and the labor-cost band of the service type.

Watch out: Never convert a long-term care figure with a single yen amount: the same service is worth measurably more in central Tokyo than in a rural municipality. (Value set by MHLW notification; region classes and labor-cost bands are published with each fee revision.)

ten 点point — the medical price unit

The currency of the medical fee schedule, and the cleanest contrast with the long-term care unit above: a point is a flat 10 yen everywhere in Japan. A unit of cerebrovascular rehabilitation earns 245 points at a facility meeting the highest of the three staffing standards — the same 245 whether it is delivered in Tokyo or in a fishing town in Hokkaido.

Watch out: Point and unit sit side by side in one sentence — a rehabilitation unit is priced at so many points — so keep the two words apart in English.

The two insurance systems

Most of what a Japanese OT does is paid for by one of two public systems, and nearly every institutional term below belongs to one or the other. A smaller share of the profession works under a third framework, the disability-services system, which funds settings such as child development support and after-school day services.

iryō hoken 医療保険public medical insurance

Japan’s compulsory health insurance, covering the whole population and paying hospitals and clinics through a single national fee schedule revised every two years.

Watch out: Say “public” or “statutory” on first mention: to American readers, bare “medical insurance” suggests a private supplemental policy.

kaigo hoken 介護保険long-term care insurance (LTCI)

The second public system, established in 2000 and run by municipalities, covering people 65 and over — and people 40 to 64 with specified conditions — once they are certified as needing care. It funds the day rehabilitation, home-visit rehabilitation, and facility care where a growing share of OTs now work, on its own fee schedule revised every three years.

Watch out: Not “nursing care insurance” — nursing means something else in English.

More: working inside long-term care →

shinryō hōshū 診療報酬the medical fee schedule

The national price list for every insured medical service, expressed in points and identical at every institution in the country. The ministry’s own English calls it the “points table for medical fees.”

Watch out: Not “reimbursement” — it is the price list itself, not the process of paying claims.

shikkanbetsu rihabiritēshon 疾患別リハビリテーションdisease-specific rehabilitation

The five fee categories that cover most medical-insurance rehabilitation — cerebrovascular, musculoskeletal, cardiovascular, disuse syndrome, and respiratory — each billed in 20-minute units and each carrying, in principle, a standard day limit counted from onset or surgery, with defined exceptions where continued improvement is medically expected.

More: the five categories and their limits →

seishinka sagyō ryōhō 精神科作業療法psychiatric occupational therapy (as a fee item)

A fee item in a different part of the schedule from disease-specific rehabilitation, built around groups: 220 points per patient per day, a standard of two hours of OT per patient per day, and roughly 25 patients counted as one unit.

Watch out: Because it sits outside the disease-specific categories, none of the 20-minute unit arithmetic applies to it.

rōken (roken) 老健（介護老人保健施設）geriatric health services facility

A long-term care facility whose legal purpose is maintaining and restoring function so residents can return to living at home. The home-return mission is written into its legal basis, which changes the OT’s job: you are always working toward an exit.

tsūsho rihabiritēshon (tsusho rehabilitation) 通所リハビリテーションday rehabilitation (day care)

A long-term care service that brings community-dwelling older adults in for rehabilitation and returns them home the same day. Provided at facilities such as rōken, hospitals, and clinics, and limited by law to people whose attending physician has confirmed the need.

hōmon rihabiritēshon 訪問リハビリテーションhome-visit rehabilitation

Rehabilitation delivered in the person’s own home under long-term care insurance, limited by law to people whose attending physician has confirmed the need.

kasan 加算add-on fee

An extra payment layered on top of a base fee when a provider meets defined conditions — extra staffing, a specified process, a documented outcome. Much of Japanese health and care policy is steered by creating, repricing, and retiring add-ons rather than by changing base fees.

Watch out: Add-ons are where policy intent shows: if the ministry wants a practice adopted, it usually attaches an add-on to it.

kaifukuki rihabiritēshon byōtō (kaifukuki) 回復期リハビリテーション病棟convalescent rehabilitation ward

A hospital ward type dedicated to intensive inpatient rehabilitation after stroke, major injury, or surgery, with admission limited to defined conditions and defined maximum stays. It has no direct equivalent in most English-speaking systems, where comparable care is split between inpatient rehab facilities and community services.

Becoming an OT

juken shikaku nintei 受験資格認定recognition of eligibility to sit the national exam

The health ministry’s paper screening of a foreign-trained applicant’s education against what a Japanese graduate would have completed. Granted, it lets you apply to take the national exam.

Watch out: Not a license conversion and not recognition of your foreign license. It opens the door to the exam — which is held once a year, in Japanese — and nothing more.

More: the whole path, step by step →

yōsei shisetsu 養成施設training facility

A non-school institution, designated by the prefectural governor, whose graduates may sit the national exam. The parallel route is a school designated by the Ministry of Education (MEXT).

Watch out: Programs are never “designated by MHLW.” The health ministry administers the exam and issues the license but designates no programs — a distinction English sources get wrong routinely.

More: the two routes in full →

senmon gakkō 専門学校specialized training college

A post-secondary vocational institution awarding a diploma rather than an academic degree. Many OT programs sit here, in both three-year and four-year forms, and their graduates take exactly the same national exam.

Watch out: Course length and institution type are independent: four-year courses exist at vocational colleges too. And not “technical college,” which collides with KOSEN.

rinshō jisshū 臨床実習clinical practicum

Supervised clinical placement, the largest single block of the curriculum at 22 of 101 units. At least two-thirds of practicum time must take place in medical service facilities, and at least one unit must involve day or home-visit rehabilitation.

Watch out: Do not map onto US Level I / Level II Fieldwork. Japan structures placements as observation, assessment, and comprehensive practicum, and sequencing across the years is left to each school.

kokka shiken 国家試験the national examination

The state licensing exam, held each February with results in late March. In 2026, 4,947 of 5,426 candidates passed — 91.2%, and 96.6% among new graduates.

Watch out: Not a “board exam”: there is no professional board, and nothing here corresponds to US specialty board certification.

More: five years of exam results →

jitchi mondai 実地問題practical questions

The case-based section of the national exam: written items presenting a clinical scenario, worth three points each. Candidates must clear a separate minimum on this section, so someone strong on memorized facts but weak on clinical reasoning can fail on it alone.

Watch out: “Practical” is a translation trap — these are written questions. There is no hands-on component for general candidates.

shitei kisoku 指定規則the designation ordinance

The ministerial ordinance setting what a program must provide to be designated: three or more years of study, the 101-unit curriculum, faculty requirements, and class-size limits.

Watch out: An ordinance has legal force — do not call it “guidelines.” The 3,150-hour floor and the practicum structure sit in a separate ministry notice, which is technical advice rather than binding text.

Practice and theory

sagyō 作業occupation (in the OT sense)

The theoretical term at the center of the profession. JAOT’s definition states that 作業 means the daily life activities that hold purpose or value for the person concerned, listing activities of daily living, housework, work, hobbies, play, social interaction, and rest.

Watch out: In everyday Japanese 作業 means manual labor or a task, which is why the profession’s name misleads Japanese readers too.

seikatsu kōi 生活行為daily life activities

The doings that make up a life — bathing, cooking, shopping, hobbies, neighborhood roles — understood as acts a person performs with their own intention. It is the concept at the core of MTDLP.

Watch out: Never translate this as “activities of daily living.” ADL is a subset; the whole point of the term is that it reaches past self-care into hobbies, household roles, and community participation.

seikatsu kōi kōjō manejimento 生活行為向上マネジメント（MTDLP）Management Tool for Daily Life Performance

JAOT’s standardized, occupation-based process framework: identify the daily life activities a person wants or needs to do, set goals jointly, plan, deliver, and hand over — recorded on a defined set of sheets.

More: MTDLP in depth →

kawa moderu 川モデルthe Kawa model

A conceptual framework picturing a life as a river: water as life flow, rocks as problems, riverbanks as environment, driftwood as personal assets and liabilities. Born in Japan in 1999 and now taught across six continents, yet little used in Japanese clinical practice as far as the published literature and my own experience show.

Watch out: Not “the River model” — Kawa is the established English name.

More: the model from inside Japan →

shōrei kentō-kai 症例検討会case conference

A recurring in-house meeting where a clinician presents a case for discussion with colleagues. In Japan it is the entry rung of the research ladder: an internal case may become a prefectural presentation, sometimes a national one.

Watch out: Not grand rounds (typically physician-led and institution-wide) and not peer review (no manuscript is involved).

More: how research reaches the clinic →

After qualifying

shōgai gakushū (shogai gakushu) 生涯学修JAOT’s lifelong learning system

JAOT’s voluntary continuing-education framework, renamed from 生涯教育 (lifelong education) in April 2025 and restructured into three tiers: Registered, Certified, and Specialist Occupational Therapist.

Watch out: The reading is shōgai, not “seigai.”

nintei sagyō ryōhō shi 認定作業療法士Certified Occupational Therapist

A voluntary advanced credential from JAOT, positioned as the generalist tier of the lifelong learning system. As of August 1, 2026, 2,063 therapists held it — against 118,465 people who had qualified as OTs by March 31, 2025 (a cumulative count of everyone who has passed the national exam).

Watch out: A false friend. In English, “certified” sounds entry-level (compare the US COTA); in Japan this is an optional credential held by a small minority. JAOT’s own English pages render it “authorized occupational therapist.”

senmon sagyō ryōhō shi 専門作業療法士Specialist Occupational Therapist

The top tier of the same system, awarded in 12 fields as of August 2026, including dementia, hand therapy, cancer, dysphagia, and driving and community mobility. JAOT’s own English pages render it “specialized occupational therapist.” As of August 1, 2026, 180 of these credentials had been awarded.

Watch out: That 180 is cumulative across the 12 fields — one therapist may hold more than one — so it is not a count of 180 people.

More: continuing education in context →