Shiatsu in Sweden

1. LEGAL FRAMEWORK FOR SHIATSU

  

  • 1.1 Is Shiatsu explicitly defined or recognised in national law?

No. Shiatsu is not a specifically regulated or defined profession in Swedish legislation.

  • 1.2 How is Shiatsu classified legally?

Shiatsu is practised in Sweden mainly as body therapy/wellness and not as a regulated healthcare profession.

  • 1.3 Who may practise Shiatsu?

There is no state licence or protected professional title for Shiatsu. In principle, a person may therefore offer Shiatsu, but members of Kroppsterapeuternas Yrkesförbund must meet the association’s education and membership requirements.

  • 1.4 What activities may Shiatsu practitioners perform?

They may offer Shiatsu within the framework of wellness and body therapy, for example treatments involving pressure, touch, stretching and other techniques included in Shiatsu.

  • 1.5 What activities are they prohibited from performing?

A Shiatsu therapist may not perform activities that, under Swedish law, are reserved for healthcare professionals. There are also specific restrictions on the treatment of certain diseases and conditions, as well as the treatment of children under 8 years of age.

  • 1.6 Are there statutory minimum requirements?

No, there are no specific statutory education requirements for calling oneself a Shiatsu therapist. Kroppsterapeuternas Yrkesförbund, however, has its own education requirements for membership.

  • 1.7 Is registration, authorisation or a licence required?

No specific state Shiatsu licence or authorisation is required.

  • 1.8 Which authority is responsible?

There is no specific authority that regulates Shiatsu as a profession. Depending on the activity, the municipality’s environmental and health protection authority, the Swedish Tax Agency and other authorities may be relevant.

  • 1.9 Is the professional title protected?

No, the title Shiatsu therapist is not a protected professional title.

  • 1.10 Are there restrictions regarding advertising or claims of healing?

Yes. Marketing must comply with Swedish marketing legislation and must not be misleading. A wellness practitioner should also not present their activity as licensed healthcare or promise a medical cure/healing.

  

2. ADMINISTRATIVE REQUIREMENTS FOR THE PRACTICE OF SHIATSU

  

  • 2.1 Must a trade, liberal profession or other form of self-employment be registered in order to practise Shiatsu?

A person who practises Shiatsu professionally as self-employed normally needs to register their business activity and handle tax and VAT in accordance with Swedish rules.

  • 2.2 Under which official activity or economic classification is Shiatsu listed, for example NACE, ATECO, NAF, WZ or an equivalent national code?

In Sweden, SNI (Swedish Standard Industrial Classification) is used, which is the official classification of business activities. For Shiatsu, SNI 2025 specifies code 86.999 – Other human health activities n.e.c.

  • 2.3 What tax rules apply to Shiatsu?

Standard Swedish rules for business activities apply.

  • 2.4 Are Shiatsu services subject to VAT or exempt from VAT under certain conditions?

Yes, Shiatsu as a wellness/body therapy service is subject to 25 percent VAT.

  • 2.5 Does a tax exemption depend on professional qualification, official recognition or the therapeutic purpose of the service?

Yes, the rules on VAT-exempt healthcare are linked to the specific Swedish rules for healthcare and who provides the care. The fact that a treatment has a therapeutic purpose does not in itself make Shiatsu exempt from VAT.

  • 2.6 Is professional liability insurance legally required or practically necessary?

There is no general statutory requirement for specific liability insurance for Shiatsu therapists. Members of Kroppsterapeuternas Yrkesförbund, however, are covered by the association’s treatment injury and liability insurance.

  • 2.7 Are there special requirements regarding practice premises, hygiene, documentation or data protection?

Yes. The activity needs to comply with applicable Swedish rules concerning, among other things, hygiene and data protection. Kroppsterapeuternas Yrkesförbund also has professional ethical guidelines that members must follow.

  • 2.8 Are there special rules for the treatment of minors or other vulnerable persons?

Yes. Swedish legislation imposes restrictions on non-licensed practitioners, including with regard to the treatment of children under 8 years of age.

  

3. PROFESSIONAL ASSOCIATIONS AND PROFESSIONAL STANDARDS

 

  • 3.1 Which national Shiatsu professional associations or relevant umbrella organisations exist?

Kroppsterapeuternas Yrkesförbund is a Swedish trade and professional association within the wellness sector and organises, among others, Shiatsu therapists.

  • 3.2 Which training and practice standards must practitioners meet in order to be recognised, accredited or certified by the relevant professional association?

To become a member as a Shiatsu therapist, the person must have completed an education that corresponds to Kroppsterapeuternas Yrkesförbund’s requirements for the professional category. The association quality-assures education programmes and also carries out individual assessments of education programmes.

  • 3.3 How many training hours, practice hours, supervision hours and final examinations are required?

In accordance with the ESF minimum requirements 2011, Kroppsterapeuternas Yrkesförbund’s requirement is 490 hours of teacher-led instruction including 100 customer treatments documented in writing, as well as basic medical education.

  • 3.4 Is the training recognised and regulated by state institutions, for example within the NQF?

Shiatsu is not a state-regulated profession in Sweden. However, the sector has the possibility to apply for a SeQF level (equivalent to EQF), which is not currently relevant due to a lack of resources.

  • 3.5 Does the association distinguish between different membership, recognition or certification levels?

Yes, they differ between different associations, with Kroppsterapeuternas Yrkesförbund being the leading association for quality assurance of Shiatsu therapists in Sweden.

  • 3.6 What requirements apply to the individual levels?

For Kroppsterapeuternas Yrkesförbund, see section 3.3.

  • 3.7 Is regular continuing professional development required in order to maintain recognition or certification?

Kroppsterapeuternas Yrkesförbund encourages skills development through, among other things, scholarships, networking meetings and continuously through our other communication channels. However, continuing professional development is not a requirement.

  • 3.8 Is there a complaints or disciplinary procedure?

Yes. Kroppsterapeuternas Yrkesförbund has ethical guidelines and an Ethics Council that handles cases for the safety of both members and clients.

  • 3.9 Does the association maintain a publicly accessible practitioner register?

Yes. Kroppsterapeuternas Yrkesförbund has a public “Find a member” function where the public can find affiliated therapists.

  • 3.10 Is membership of the association voluntary?

Yes.

  • 3.11 Is membership required for certification, use of a protected association title or inclusion in the public register?

Membership is required to use the membership benefits and quality assurance associated with Kroppsterapeuternas Yrkesförbund and to be listed as a member in the association’s register. However, the professional title Shiatsu therapist itself is not protected by the state.

  • 3.12 What legal or practical significance does association certification have in the country concerned?

The certification shows that the practitioner meets Kroppsterapeuternas Yrkesförbund’s requirements and at the same time helps to bring together and make visible a quality-assured sector. This strengthens the association’s credibility and influence, including in advocacy issues.

  

4. RACTICAL SETTINGS FOR SHIATSU PRACTICE

  

  • 4.1 In which settings is Shiatsu commonly offered, for example in private practice, health centres, clinics, care facilities, companies or wellness establishments?

Mainly in private practice, workplaces and in other wellness contexts.

  • 4.2 Is a medical referral, prescription or collaboration with a healthcare professional required for certain applications?

No.

  • 4.3 May Shiatsu be offered as a complement to medical treatment?

Yes, as complementary wellness/body therapy, but the Shiatsu therapist must remain within their area of competence and not replace medical care or treatment when such care is needed.

  • 4.4 Are there special rules for collaboration with doctors, physiotherapists or other healthcare professionals?

If a doctor works entirely in private practice, outside the publicly funded healthcare system, there is greater freedom to collaborate with shiatsu practitioners. However, established healthcare and alternative treatments must be kept clearly separate. A doctor must not present, or give the impression, that shiatsu is a scientifically proven medical treatment.

  • 4.5 Are foreign Shiatsu training programmes or certificates recognised?

Since the profession is not state-regulated, there is no general state process for recognising foreign Shiatsu education programmes. Kroppsterapeuternas Yrkesförbund can, however, assess foreign education programmes individually against the association’s membership requirements.

  • 4.6 What additional requirements apply to practitioners who completed their training in another country?

The applicant needs to be able to provide documentation of the content and scope of the education, for example diplomas, curricula and information on theory, practical teacher-led hours and practice. If necessary, supplementary documentation and practical examinations may be requested.

  

5. ACCESS AND REIMBURSEMENT

  

  • 5.1 Are Shiatsu services reimbursed by statutory health insurance?

No, normally not.

  • 5.2 Are Shiatsu services reimbursed by private health insurance or supplementary insurance?

It may depend on the individual insurance company and the insurance terms, but there is no general right to reimbursement.

  • 5.3 What conditions apply to reimbursement?

This is determined by the respective insurer.

  • 5.4 Must the treatment be prescribed or recommended by a doctor?
  • Not to receive Shiatsu as a private wellness service.
  • 5.5 Must the practitioner hold a particular state authorisation, professional qualification or association certification?

There is no state Shiatsu authorisation. Private actors may, however, impose their own requirements regarding education, quality assurance or membership in a professional organisation.

  • 5.6 Are there limits on the number of sessions, the amount reimbursed or the recognised indications?

Not through any general public reimbursement system for Shiatsu. Any limitations are determined by the respective private insurance or other financing arrangement.

  • 5.7 Is billing carried out directly with the insurer or through subsequent reimbursement to the client?

There is no general system because Shiatsu is normally not financed by public health insurance.

  • 5.8 Are there other forms of financial support, for example employer programmes, workplace health promotion, voucher systems, municipal programmes or tax deductibility?

Yes – the Swedish wellness allowance is very relevant here. Employers may offer a tax-free wellness allowance to their employees. Shiatsu may, depending on how the service is designed and marketed, be covered by the rules for the wellness allowance as a treatment for relaxation or to counteract soreness and stiffness. For treatments without an exercise component, the limit is SEK 1,000 including VAT per treatment session for the treatment to be considered of minor value.

Shiatsu therapists can also join various wellness portals, where additional requirements regarding education or verification may be imposed.

  • 5.9 Is Shiatsu offered or funded in public institutions or pilot projects?

As far as we are aware, there is no general public Swedish system in which Shiatsu is financed as a form of treatment. Individual projects or local initiatives may occur.