Government agencies in Japan are often faced with public oppositions to their infrastructure building proposals. Can consensus building processes, as practiced in the US, be used to resolve such disputes in Japan? Scholars and practitioners in the field of negotiation and dispute resolution, as well as policy transfer theorists, have raised concerns about cross-border transfers by referring to a variety of contextual differences between the importing and exporting countries. Without process adaptation and organizational change, consensus building processes are unlikely to be helpful in resolving infrastructure disputes in Japan, considering the breadth and depth of the contextual differences between the US and Japan. Through in-depth interviews with 40 Japanese practitioners and a close observation of a consensus building pilot test for road intersection improvements in Tokushima, Japan, the author exemplifies two streams of transformation in such transfer. This book is not only for scholars and practitioners of urban planning and dispute resolution working internationally but also for those in the field of anthropology, organizational theory, and Japanese studies.