Individual Counseling

Tokyo Mental Health is here to support you and provide you with the help you need.

Are you worried about your mental health? Maybe you are concerned about a close friend or family member? It can be really challenging to feel like you are struggling on your own, not able to understand your situation or find a way to move forward. At Tokyo Mental Health we aim to support you and help you to achieve your goals for your wellbeing.

Our team of internationally trained psychotherapists, psychologists and counselors are here to help you. Our providers are professionally trained in a variety of therapeutic approaches and have varied areas of interest and expertise, which we believe is important in order to meet the needs of our varied client-base. Here are some of the areas in which we can help you:

We aim to take an interdisciplinary approach at TMH – this means we strive to provide you with the services that best meet your needs – this could include referring you for a psychological evaluation or to see our psychiatrist, Dr Andrew Kissane, at the American Clinic Tokyo. We understand that everyone is different and sometimes it is necessary to approach your care from different perspectives.

Why not contact TMH today and take the first step to start your mental health journey with us?

Table of Contents

 Do I need therapy? When should I see a counselor?

Knowing when counseling might be for you

You may feel that your mental health is not where you’d like it to be, and/or know that something is wrong, but not sure whether psychotherapy may be for you. You may also have sought mental health treatment in the past, and feel that you may be relapsing or just getting back into “old habits.”

It is, however, important to access the right care at the right time as research has shown that accessing care early can increase the likelihood of a positive treatment outcome.

If you are unsure whether you are experiencing mental health problems, checking for the signs below can be a good indicator of when you should seek help from a mental health professional.

Potential warning signs of a problem with your mental health

The signs below can have a variety of causes and any one sign can be caused by things other than mental health problems. If you are not sure if it is related to mental or physical health, we would recommend seeing a physician. However, these signs below are common symptoms that clients report having and are indicators that their mental wellbeing may not be where they’d like it to be.

  • Not being able to cope on your own
  • Not feeling in control of your own situation
  • Increased distress and anxiety, such as excessive worrying or fear
  • Increased depressive symptoms and negative thoughts, such as feeling excessively sad or low
  • Tearfulness or crying more than usual
  • Inability to cope with day-to-day activities
  • Increased thoughts of self-harm and suicide
  • Feeling confused or unable to concentrate
  • Feeling excessive or prolonged anger/irritability
  • Avoiding social situations (such as seeing friends or family)
  • Changes in sleep cycle or habits
  • Changes in eating habits or appetite
  • Changes in sex drive
  • Experiencing somatic symptoms with no identifiable physical causes, such as headaches, stomach pain, or chronic pain
  • Difficulty perceiving reality, such as experiences of depersonalization, derealization, and hallucinations

If you are unsure whether counseling might be for you, please do not hesitate to contact us online or at [email protected]. We will be happy to assist you by answering your questions.

 What is individual counseling?

Definition of 'counseling'

The American Counseling Association defines counseling as:

“…a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health.”

Counseling (or counselling in the UK) is certainly a broad field with many methods, styles, aims and approaches.

Tokyo Mental Health offers supportive counseling for children, adolescents and adults, for a broad range of problems including depression, anxiety disorders, stress, psychosis, and more. We also offer couples and family counseling for those in need of support and guidance in their relationships.

 Is there a difference between counseling and psychotherapy?

The term counseling was first coined (in the mental health context)  by Carl Rogers to describe the work that he was doing in the 1940s and 50s. At that time, there were legal restrictions on calling your work psychotherapy unless you had a medical qualification whereas Rogers was a psychologist. Things are a little bit different now as the field of counseling and psychotherapy has expanded over time. There still remain some subtle nuances that differ between these two terms. 

Counseling today is a broad term used to cover a range of talk therapies. Psychotherapy can also encompass a variety of interventions. Sometimes the terms counseling and psychotherapy are used interchangeably. On other occasions the term used can depend on whether the healthcare professional trained in a program that refers to its registered practitioners as ‘counselors’ (e.g. licensed mental health counselors in US) or a program that uses the word ‘therapist’ (e.g. Marriage and Family Therapy training programs in the US).

Some healthcare professionals have clearer definitions of what they mean by terms such as counseling or psychotherapy although often these differences are less important than the difference in therapeutic approach, or differences between counselor/therapist as individuals when it comes to the impact or effectiveness of talking therapies. Differences of therapeutic approach may also determine frequency of appointment, length of treatment, therapist’s directiveness and structure of sessions.

If you are unsure about what approach is best for you please take a look at our resources page regarding interventions for more information.

 What is counseling like at TMH?

Methods in counseling

Every counselor is different and will use an approach or integrate a variety of approaches  into their practice and this can affect the structure of sessions, what is expected from the client in and outside of sessions, as well as how your counselor will guide you. Some counselors take a more hands-on approach and other counselors will let the client take the lead. Some counselors will give ‘homework’ tasks between sessions, whereas other counselors may not explicitly give any ‘work’ outside of sessions. However, most counselors will expect that clients practice or reflect on some of the tools/skills/techniques they discuss in session outside of the therapy room.

There are different ways of conceptualizing the differences between therapy modalities:

a. Structured by the therapist vs Structure comes from the client

‘Structured’ means that the therapist generally guides what might happen during the session and might focus on one specific topic for a number of sessions. They might ask clients to do activities during sessions or outside of session, or they may have a set number of sessions in which several processes need to happen, such as psychoeducation or planning behavioral interventions. In contrast, coming from the client means the client would be expected to bring topics to the session to explore. Topics may differ each session or topics may cover a broader theme related to therapeutic goals. This does not mean that the therapist may not guide you or provide a focus for sessions but that they would expect the client to lead most of the time.

A good example of a modality that is often highly structured with the structure being imposed by the model would be Cognitive Behavioral Therapy (CBT). CBT is well-suited to short-term work and CBT therapists tend to set the number of sessions and the agenda for each session explicitly in collaboration with the client. There is much research evidence on which the therapist would base their recommendations for the session agenda, but nonetheless, the recommendations would come from the therapist. Other examples of highly structured therapies would be MBCT and DBT. In contrast, in psychodynamic therapy, the psychoanalyst would allow the client to talk freely without imposing a particular structure. This kind of approach lends itself well to a more long-term therapy. A middle ground between these would be Solution-Focused Therapy. There is a set structure to the session, trying to find solutions to your concerns, but this may take some time and will require exploration with your therapist so they will expect you to lead at times during sessions.

b. Doing Exercises vs Encouraging Reflective Thinking

While a lot of therapies aim for the client to come to a better understanding of themselves and therapists aim to help clients achieve their therapeutic goals, each modality has a different path towards this same destination. Some therapeutic modalities put an emphasis on doing. This means that the therapist may ask clients to do exercises in or outside of the session. This might then be the focus of content; following up with how the ‘homework’ is going outside of the sessions, which will inform the ‘work’ inside sessions. Other therapeutic modalities do not have explicit ‘work’ that they expect clients to do. Much of the ‘work’ in these modalities is done inside the session but there is not usually a use of exercises. While these modalities may not put an emphasis on exercises, the therapist will usually expect clients to continue to reflect before and after sessions. Some other modalities might fall somewhere in the middle where they might expect you to do some reflective homework outside of sessions, such as keeping a journal or thought diary.

A good example of a modality that relies on activities would be Mindfulness Based Cognitive Therapy (a 3rd-wave CBT approach) which relies on teaching clients how to practice mindfulness and asking clients to continue these mindfulness exercises outside of sessions. In contrast, Narrative Therapy does not use activities but rather aims to encourage reflection upon experience in and outside of the therapy room. There may be some times when a therapist might ask you to write your narrative down but for the most part they would expect you to reflect on your narrative in and outside the sessions, adding and changing it as you go. A middle ground between these might be Emotion-Focused Therapy (EFT). While there is more of an emphasis on reflection and exploration in and outside of sessions, sometimes your therapist might do some activities with you in the session to help you understand more about your emotional experience. Your EFT therapist may also ask you to do some activities outside of the session related to emotion regulation, communicating with others etc.

c. Acquiring skills/tools vs Acquiring insight

A therapist’s ultimate goal is for clients to leave feeling that they have gained something from therapy and hope to help their clients reach their goals. In order to do this, some therapeutic modalities focus on giving clients tools or teaching them skills they can apply outside of the therapy room. These modalities are based on the idea that giving clients tools means they can apply them to their life outside of therapy. So, once therapy terminates, clients can refer back to the skills they picked up. Meanwhile, other modalities do not provide clients with tools or skills they need to practice at home. These modalities rely on the therapist’s skills in providing insight to the client’s experience. The therapist hopes that the client themself will start to become more insightful about their own experiences. In this way, clients do gain a skill of sorts – of self-awareness – but it is not explicitly taught. There are some modalities that fall somewhere in the middle with the aim of inquiring insight but giving clients tools to assist in practicing self-awareness.

One modality that emphasizes teaching skills is Dialectical Behavioral Therapy. The therapist will teach you skills in emotion regulation, distress tolerance, mindfulness and interpersonal effectiveness in order to address your mood concerns and improve your relationships. Conversely, an approach like Person-Centered Therapy (or Client-Centered Therapy) does not explicitly teach any skills to the client. However, the therapist aims to make the client more aware of their experience using active listening and reflection during sessions. The therapist hopes that the client will start to naturally become more aware of their experience and be able to use this insight by themself. A happy medium between these approaches would be Acceptance and Commitment Therapy (“ACT”). In ACT, the therapist will teach clients how to practice mindfulness and give them tools on how to “diffuse” from uncomfortable thoughts.

 How do I book an appointment at TMH?

Please use the contact form on our website to submit your enquiry. One of our team will respond with more information about how to set up an appointment with one of our providers.

How quickly can I be seen for an individual counseling appointment?

TMH has implemented a waiting list for times when we are experiencing a high volume of enquiries. During these times, some types of first appointment may take up to 4 – 6 weeks to schedule. We require clients to complete some outcome measures (Psynary or RCADS) prior to being placed on the waiting list and first appointments. This provides us with more information regarding the nature and severity of your concerns and will be used to track progress going forward. It is also used for clinical governance. If you have any questions about the waiting list process please do not hesitate to ask.

At times when the waiting list is not in place, appointments can generally take 2 weeks to schedule. However, please note if you would like to see a specific provider or have preferences for language/gender of therapist/time of day, this may incur longer waiting times as we will need to match you with an appropriate provider for your needs. We are happy to accomodate preferences so please ensure to let us know in your initial inquiry.

Can I book an appointment for my friend or family member?

If your friend or family member is considered an adult in Japan (over 18 years old) then we would need them to contact us directly to set up their care. They would need to confirm they wish to use our services, including our consent to treatment form which is part of our intake procedure. If they are a minor then we would need a parent or legal guardian to consent to treatment on their behalf.

If you are worried about a family member and you think it might be useful to be seen as a family rather than an individual, please check out our family therapy page for more details. However, please note all participants would need to consent to receiving family therapy via our informed consent form.

 What to expect in your first appointment

While we have a range of psychologists, counselors and therapists here at Tokyo Mental Health who all work differently, you can expect your first appointment to include some of these components:


Your therapist will introduce themselves and where their approach requires, explain about how they work. They will ask your preferred name and, if you would like to, you can let your therapist know your preferred pronouns. Your therapist will give you an opportunity to ask any questions about their qualifications and experience if there is anything you are unsure about.

Before coming to your appointment at Tokyo Mental Health you will sign a consent form outlining company policies regarding our services, confidentiality, cancellations and emergency contact information. In your first appointment your therapist will review some of this information briefly with you.

Session content

After introductions, your therapist will generally cover the following topics:

  1. The presenting issues – what are the problems you are currently facing?
  2. Your current life circumstances – what are the factors that are contributing to your problems from your past and present experiences? (this includes biological, environmental and psychological factors)
  3. Coping strategies – what do you currently do, if anything, to help with your problems? Are there any factors that are maintaining the thoughts, feelings and behaviors that are troubling you?
  4. Relationships – who is currently in your life and what effect do they have on your problems?
  5. Impact on functioning – how do your problems affect areas in your life such as work/school, relationships and hobbies/interests?
  6. Safety/Risk – your therapist will ask you about self-harm and suicidal thoughts and if you present with some risks your therapist will go through a safety plan with you
  7. Goals – what are your goals and expectations for therapy? How can your therapist support you?


Towards the end of the consultation, you and your therapist will decide the next steps to take. Please note that as your counselor comes to understand more about you, in some cases it may be necessary to refer to other providers after an initial consultation so you can get the right sort of help. Your therapist will discuss with you the frequency of sessions and may outline a structure for future appointments – this is dependent on the therapist’s approach. If you are unsure about anything this is a good opportunity to ask your therapist any questions.

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 Can I see a counselor online?

Our online counseling services

We offer online therapy services to make therapy as accessible as possible for those who are not based in or around the Tokyo area or who would feel more comfortable in seeing a therapist online. We also offer telephone counseling services. For more information, please contact us using our online enquiries form, or email us at [email protected].

 Where can I find more information about counseling?

Got questions?

You can read more about counseling for specific disorders on our website under ‘resources’.

You can also visit our page to read more about couples counseling, or family therapy.

If you have any questions, please visit our FAQ page where we answer our frequently asked questions. Got a question that is not there? No problem. Contact us or email us at [email protected]. We are happy to help you.