This article centres on increasing the conscience on the topics that arise when the occupational therapists take their practice to new or contexts and cultures or practise with persons who come from the same ones. In order that the therapeutic interventions are effective, the therapists must bear in mind the realities and the shared meanings of the persons whom these interventions are directed. The article emphasizes some of the underlying presuppositions to the practice and to the frames of the occupational western therapy and, on the other hand, it shows that they are not necessarily effective in an oriental context. Centring specifically on Japan and on the vision of the world and the Japanese culture, the principal author shows that in order that the occupational therapy is effective and useful it must adapt and change as/like response to the culture in the one that is being practised. To assure that its practice provides with power the persons instead of oppressing them, it invites the occupational therapists to recognize the cultural interpretation of the occupational therapy in itself, as well as to allowing the cultural mediators of the customer groups to dealing and dictating the terms for which it is necessary to introduce the occupational therapy.