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Navigating English-Speaking Therapy Options in Tokyo

Common challenges with finding counseling services in Japan

Seeking counseling or therapy services in Tokyo can present a unique set of challenges. It was when I noticed some of these challenges myself that the idea of Therapy Garden was born. While everyone's experience is different, following are some common challenges faced by clients. Which ones can you relate with? 

Mental health is still an emerging field in Japan

  • Cultural Stigma: Even though mental health awareness is improving globally, in Japan, there's still a significant stigma attached to seeking help for mental health issues. This stigma can deter individuals from seeking help even when they need it.

  • Limited Resources: Compared to some Western countries, Japan has fewer mental health resources, which can sometimes make it harder to find available professionals, particularly specialists in certain areas of mental health.

  • Regulation and Qualifications: Understanding the qualifications and regulatory framework for therapists in Japan might be confusing, especially for expatriates. This can make it hard to distinguish between qualified professionals and those with fewer credentials.

Finding a therapist who understands you can be a challenge

  • Language Barrier: While Tokyo is a cosmopolitan city, not all therapists speak English or other foreign languages. Finding a therapist fluent in a client's native language can be a challenge, especially if it's not Japanese or English.

  • Understanding Cultural Nuances: For expatriates or foreigners living in Tokyo, it may be important to find a therapist who understands the cultural nuances and challenges of living in a foreign country, in addition to providing therapy in their native language.

The available therapists aren't always easy to access

  • Cost: Therapy can be expensive, and not all services might be covered by insurance. This can be a significant barrier for many individuals.

  • Accessibility: While Tokyo's transportation system is world-class, finding a conveniently located therapist can be a challenge, especially for those who live or work outside central Tokyo.

Limited awareness of the counseling services available

  • Limited Awareness: There may be limited awareness or misconceptions about the types and benefits of therapy available, which could deter individuals from seeking help.

  • Different Therapeutic Approaches: The therapeutic modalities predominantly used in Japan might differ from those in Western countries. For example, cognitive-behavioral therapy (CBT), while popular in Western countries, might not be as prevalent in Japan.

Recommended counseling services in Tokyo/Japan

The counseling options listed below are among those that I refer my clients to when we aren't a good fit owing to reasons like budget constraints, or if their presenting issue is outside my area of expertise. I will be continually updating this list, so watch this space for further additions.

If you have budget constraints or need urgent crisis assistance

TELL Japan (often simply referred to as TELL) is a not-for-profit organization that provides mental health support and counseling services to the international and local community in Japan. Established in 1973, TELL has been instrumental in offering various services, which include the Tell Lifeline - a free, anonymous, and confidential telephone and online chat counseling service, operating daily for several hours. This Lifeline provides immediate support to people in emotional distress, facing challenges, or simply in need of someone to talk to. The major benefit is that it's free and available even until 11pm on most days. The disadvantage is that you won't be able to choose who you talk to, and you will most likely not be able to talk to the same support worker if you call/ contact chat the second time, and so there is a lack of continuity. 

If you need medication for mental illness

If you or your loved one is suffering with conditions that get in the way of living life as usual, like major depressive disorder, panic disorder, insomnia for more than 2 weeks, obsessive compulsive disorder, hallucinations/ delusions, eating disorders or severe mood fluctuations (bipolar disorder), it may help to see a psychiatrist - a medical professional who will be able to diagnose a mental illness and prescribe medication if necessary. Mejiro-sola Clinic in Shinjuku, Tokyo is recommended for its bilingual service in English and Japanese. It was founded by Fumitaka Noda M.D., PhD., based on his experience as a psychiatrist and educator in Japan and overseas. The Clinic accepts Japanese Medical Insurance (Kokumin Kenko Hoken or Shakai Hoken) for its medical services, although the psychotherapy service is not covered by insurance, as is generally the case in Japan. 

If you are having problems in your relationship, and you and your partner would like to address them together


Darius P. Skowronski Ph.D. is a fully licensed clinical sexologist who specializes in relationships, gender and sexuality issues, sex education and sexual development, sexual health and satisfaction, sexual disorders, sexual addictive behaviors and sexual abuse. He is also passionate about cross-cultural psychology with a special emphasis on international couples and marriages. His clinic at Aoyama, Tokyo aims at psychological and sexual well-being of individuals, couples and families. 

If you are a parent looking for counseling support for your teenager

Teenagers today must navigate the stressful demands of a complex and competitive digital age, where the allure and pressures of social media can be immense. Natasha Kottegoda-Breden assists young individuals in discovering their genuine self and values, teaching them techniques to manage life's numerous obstacles. This includes coping with fluctuating or low moods, mastering new skills to better challenging relationships, dealing with family trauma and separation, addressing attachment concerns from early years, integrating culturally into a new school or country, or confronting issues of identity and sexuality. Their therapy sessions are precisely tailored to meet the unique needs of each child.

For a counselor specialised in LGBTQIA+ issues 

Sabrina Surovec specializes in LGBTQIA+ issues and historical trauma in their online private practice Rainbow Head Therapy. The foundation of their counseling style rests on a philosophical background of existentialist and intersectional feminist thought. Person-Centered, Solution-Focused Therapy informs their therapeutic practice.  Sabrina is also fandom-friendly, and knowledgeable about issues surrounding online harassment. Holistic wellness is important to them, and they are supportive and knowledgeable concerning issues with sexuality, gender identity, and sex-positive, SSC (safe, sane, consensual kink practices).

For an expat career coach 

Nathan Cornwell Consulting creates workplace success for expats and international teams. They use their expertise in employability and organisational psychology to create personable, evidence-based and results-focused solutions. The unique approach has helped individuals and organisations across the globe to improve their performance. The business was founded by Nathan Cornwell, an organisational psychologist, talent management and employability specialist who has lived and worked abroad for over 10 years including in China, South Korea, Vietnam and the UAE. He leverages his experiences consulting with renowned MNCs such as KPMG, EY and PwC to help make international leadership work.

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If you're new here, I'm Diya John, a counselor and psychotherapist with a Masters in Psychology and a Diploma in Counselling from Australia. I founded Therapy Garden to make evidence-based counseling more accessible to expatriates, immigrants and the international community. I am based in Tokyo, but I work with clients in different parts of the world via online therapy. You can read more about my areas of specialisation and services

or book a free consultation. I would like to continually add to this list of counseling services in Tokyo/Japan to make it as comprehensive as possible. At the same time, I am keen to include only those resources that I have personally vetted. If you have experienced a counselor based in Tokyo/Japan whom you would like to recommend, feel free to let me know.

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