Experiencing cultural differences of occupational therapy across the globe

CSU and Yamagata students near a river canal

Story by Rachel Sipes

Since 2002 students and faculty from the Department of Occupational Therapy at Colorado State University have had the opportunity to travel annually to Yamagata, Japan and learn about the Japanese culture.

This past August, Assistant Professor Lisa Fyffe, her daughter Sela, eight master’s degree students, Michael Mitter, Gina Larson, Cassandra Stevenson, Kristina Ihrig, Tara Saideman, Emily Predny, Rachel Sipes and Brooke Gratza and one Ph.D. student, Susan Mingils, traveled to Yamagata for one week. During the week CSU students and faculty were warmly welcomed and hosted by occupational therapy faculty, students and staff at the Yamagata Prefectural University of Health Sciences nestled in the northern mountains of Japan.

The occupational therapy programs have many similarities, such as studying occupations from children to older adults, but through these exchanges faculty and students have learned about the differences in the profession as it is influenced by each countries’ health care system, values and perspectives.

Mental health in Japan

CSU-OT students toured a local mental health facility where treatments are focused on work reintegration, socialization, daily life activities and family connections. During this visit students learned about different mental health services by contrasting how the needs of those affected by mental health are treated in the United States versus Japan.

“I was surprised that the field of occupational therapy in Japan is much more centered around mental health and incorporates more use of handicrafts,” shared Mitter regarding the mental health facility visit. “My overwhelmingly positive impression of occupational therapy in Japan is that the collective nature of this society more intentionally strives to ensure that all members can participate in a way that keeps them connected to the social and physical environment in which they reside.”

Another difference students noted was the amount of time people with mental health challenges tend to stay in the hospital. On average, patients in Japan stay between 45 and 325 days and focus on return to independent living  which is very different than in the United States where patients in mental health hospitals tend to stay approximately one week with a focus on medication adherence.

Fyffe commented, “For me, the biggest surprise was that Japan does not have the substance abuse and prescription drug epidemic that we have in the United States. Through my first care-giving job working as a mentor in an adolescent drug and alcohol rehabilitation center I saw firsthand how generational poverty and drug addiction destroys the lives of those affected. This essentially does not exist in Japan.”

“As an island country illegal drugs do not enter Japan as easily, so illegal drug use is not as common. Also, Japan has a much different cultural view of pain management than we do in the United States, and opioids are not prescribed as routinely as they are here. Rather, persons with pain are instructed in lifestyle changes and non-pharmaceutical methods for managing pain,” shared Fyffe.

Art therapy

A piece of watermelon and created artAnother local visit included a tour and information session of a tiered living retirement center for older adults in the Yamagata community. Larson shared about this experience, “A very positive aspect of the older adult home was the wide continuum of care options all in one facility and the integration of those different care levels to make it a unified, supportive culture between all patients.” Older adults from the community have the option to use the rehabilitation center, participate in day programs or make their home in the retirement facility.

During this visit students were able to learn about the challenges facing Japan such as the low birth rate and high life expectancy which influences care for the elderly. After learning about the residential, rehabilitation and day programs offered, students and residents spent time together painting and eating watermelon during the art therapy program of the day.

Students departed with several Japanese elders bidding goodbye, smiling and waving American and Japanese flags in the air. One student shared, “The smiles and kindness of the residents at the nursing facility will always be in my heart. I will never forget their waves and smiles as we drove away after spending time with them that day.”

Experiencing life in Japan

Traditional tea ceremony“Traveling to Japan and spending the week at Yamagata University was truly life changing. I have been fortunate in my lifetime to travel to many different countries, but what made Japan so unique was that we were fully included in their daily life,” shared Fyffe.

Not only did students learn about health care and occupational therapy in Japan but students were able to gain a greater understanding of Japanese culture as a whole. Students experienced Japanese homestays; cooking and eating sushi, ramen and a dish called okonomiyaki; singing karaoke and even participating in a matcha green tea ceremony.

CSU visitors also had the incredible opportunity to attend the annual Hanagasa festival with dancing, music and parades of people in kimonos as well as walking 1000 steps up to the local Risshakuji Temple. Through all these events, the CSU-OT visitors experienced the beauty, values and culture of Japan.

Heartwarming hospitality

CSU and Yamagata students at festivalAfter spending a week in Yamagata learning and experiencing so many new things, students and faculty were changed and given a whole new perspective of the world. The week was packed full of events and opportunities, but at the end of every day, the CSU students were overwhelmed and energized by the kindness and hospitality of the Japanese hosts.

Fyffe commented, “I was raised in the South and thought I knew about hospitality and kindness—but the Japanese take this to an entirely different level! There is no detail too small and everyone does the most minute jobs with pride and attention to detail. It is very humbling and inspiring to see.”

This relationship will continue as the Yamagata guests visit CSU-OT in March 2020. This is an especially important year because the department will renew its commitment to the partnership for another five years which will allow for continued exchanges between CSU-OT and the YPUHS faculty and students. The department looks forward to this visit and is so grateful for the opportunity to continue to connect and learn from our Japanese friends.

The Department of Occupational Therapy is part of CSU’s College of Health and Human Sciences.

CSU and Yamagata students at welcome ceremony with traditional Japanese hats