This article examines how a therapeutic perspective on victim participation has been conceptualized and implemented in criminal trials in Japan after procedural reforms in 2000 and 2008. Findings are discussed with reference to therapeutic jurisprudence studies on victim participation and relevant literature on Japanese criminal justice. Analysis of policy documents, survey data, interviews, and minutes of Ministry of Justice "expert meetings" reveals how the therapeutic needs of victims and the therapeutic effects of victim participation in court proceedings have been understood and conceptualized based on generalized common-sense assumptions of legal practitioners. In court, participants' reference to victims' wellbeing and recovery puts pressure on judges to impose harsher punishment than usual, while reinforcing the position of prosecutors. The adopted therapeutic perspective, combined with traditionally expected displays of remorse, furthermore has the effect of limiting the defence's ability to argue facts and circumstances favourable to the defendant.