Zen School of Shiatsu

Case-study Rules & Guidelines

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The purpose of a Case-Study is for you to demonstrate your understanding of the application of theory to Shiatsu practice. Please make your work clear, interesting and easy to read.

A Case-Study should tell the story of a Participant’s progression through a series of treatments, highlighting your observations and responses to diagnosis and the Participant’s reactions to treatment, and your recommendations.

Please apply the following Rules and Guidelines:


Not less than 900 words, not more than 1100 per study

Write your Name at the top but refer to your Participant only by an Initial

Describe at least 7 but not more than 9 treatments in each study

Your 6-9 case studies must include a variety of Participants by age, gender, and conditions


First Impression What was the very first thing that struck you about your participant?

Build, movement, complexion, voice, energy, most prominent feature, obvious imbalances? Element?

Presenting Symptoms Why have they come for treatment?

Medical Specific conditions, operations, injuries, treatments, current medication, other therapies. Family medical history/tendencies?

Personal Gender, age, occupation

Relationships: with partners/children/parents/siblings/colleagues

Lifestyle, exercise, relaxation/recreation, habits, addictions

Sleeping pattern, diet, digestion, prescriptive/recreational drug use

Menstruation, general energy, sexual energy

Outlook on life. What makes them happy/upset

Self-perception - how does he/she see her/him-self?


What is the ‘personal environment’ that has allowed conditions to take root, develop and flourish?

What seems to be the energy-pattern?

Why? - explain your reasoning.

Compare with first impression? This is the core section.

Treatment Plan

What are your Treatment Aims based on your Diagnosis?

How do you plan to achieve those aims?

Treatments Given List as 1 to 7, 8 or 9

Date__________ Kyo Jitsu Energy-Pattern
Back _________ _________ _________
Yu-pt _________ _________ _________
Hara 1 _________ _________ _________
Meridians treated: tonified/sedated? any difference from 1st Hara diagnosis?
Points treated and why?
(2nd) Hara post-diagnosis: _________ _________ _________
Recommendations/suggestions: exercise, diet, meditation, lifestyle,self-perception
Reactions to previous treatment/recommendations/suggestions

[NOTE: Hara Diagnosis indicates the predominant imbalance at the time of treatment (1st Hara) and any resultant changes (Hara post-diagnosis) Energy Patterns show the state of ongoing change: trends linking 5-Elements and Hara, common factors, insights into the core issue leading to possibilities of restoring harmony: by treatment, recommendation, or both.]

Treatment Analysis - What is the story?’ Sometimes there will be issues common to both Masunaga and 5-Elements below. You can often avoid repetition with: see above/below - as above, so below?)

A: Masunaga-Zen

From the evidence of the Kyo/Jitsu pattern, what is the main issue? (e.g. "eating pattern, shown in the predominance of Spleen kyo . . . . compromised by excessive decision-making at work: GB Jitsu.’)

Were the presenting symptoms directly or indirectly related to the main issues?

If not where did they come from?

How were they relieved or why were they not relieved?

Did the condition change during the period of treatment? To what?

Were there any discrepancies in the pattern of kyo/jitsu: e.g. ‘Lung kyo/jitsu in the 5th and 6th treatments due to a cold . . .’

B: 5 Elements

What is the main issue? e.g. ‘Earth imbalance, indicated by an abnormally yellowish hue and a craving for sweets... (distinguish between ‘abnormal’ signs of imbalance, these being indicators of the element of your participant’s current CONDITION, and the ‘normal’ indicators of their CONSTITUTION or naturally predominant element.)

Comment only on those elements involved in the primary imbalance (and a secondary one if significant) rather than all the elements.

C: Overall

Is there a predominant energy pattern?

Does the final analysis correspond to your original diagnoses?

Was the original treatment plan followed? If not, what was it that took the treatment series in a different direction?

What trend do the Energy Patterns indicate?

Is there something left over that the Participant may have to address or which may appear in subsequent treatments?


How did the Participant respond to the treatment process overall? Did they follow recommendations? Would you make any further recommendations?

What is likely to happen with this person in the future?

* Helpful Hints on the writing-up process: you have a limited number of words, so:

  • FIRST write down everything that comes in to your head
  • SECOND take your scalpel and edit, edit, edit
  • SLICE AWAY repetitive phrases, long-winded descriptions, listings of superfluous element, lists of things which aren't symptoms, waffle and verbosity eating up your word-credit

  • THIRD show your case-study to a friend - they don’t have to be a shiatsu-person - and ask them what words they would cut
  • FOURTH final surgery