A formulation is an attempt to understand an individual’s predicament. In contrast, a psychiatric diagnosis is a way of categorising difficulties.Making a formulation or diagnosis is not a straightforward task, especially given differences of culture and power.It is helpful to think of both as constructed narratives.

With people seeking asylum, both present specific benefits, disadvantages and challenges.They can powerfully affect the person themselves, determine what help is offered and influence third parties, such as asylum decision-makers. A helpful approach to formulation and diagnosis depends on the therapeutic relationship and the clinician’s skill in working with differences in culture and power. Clinicians need tobear in mind how formulations and diagnoses depend on the quality of assessment and the cultural context in which they are embedded.

Formulations for people seeking asylum need to pay particular attention to culture, family, and physical health, and to the impact of the asylum process, of being a refugee, and of discrimination. Diagnoses should be made only after discussing formulation and considering the potential additional impacts of a diagnosis.

This chapter outlines a brief history of the current educational reforms in Japan. Against this historical contexts, the following issues are discussed: (1) the prioritization of English as the international language; (2) the discourse of Japanese incompetence in English; (3) the setting of English proficiency benchmarks; (4) the early introduction of English and the implications for the role of homeroom teachers; and (5) the power relationship between homeroom teachers and Assistant Language Teachers. The chapter argues that the imposition of policies and standards on teachers and teacher educators will lead to de-professionalization as they are deprived of the opportunities to exercise their own professional judgment. It suggests ways in which de-professionalization of teachers can be avoided and the power imbalance can be redressed between Japanese teachers of English and native English speaking teachers.