Throughout this book, we have explored the ways in which we bring theory to our practice as social workers. This process is a complex and continuing one. As theoretical understandings change and develop over time, and as service systems change, we develop our understandings, practice wisdom and insights. Social work as a profession has been strong in emphasising both the need for more formalised reflective practice and the opportunities that social work supervision presents to consider how practice can be improved through processes of critical reflection. In this chapter, we look at the skills involved in critical reflection and how social work as a profession benefits from engaging in reflective and reflexive, theoretically informed practice. So, we explore the elements of successful supervisory relationships, as well as some ways of thinking about supervision within the client, worker, agency and community system. Then we return to the importance of the cultural lens in supervision – ensuring culturally responsive supervisory practices as one vital way of supporting optimal practice.

The issue of end-of-life decision-making has become increasingly important in the super-ageing society that is Japan. Until now, however, there are little regulation and no legislation on end-of-life medical issues, such as forgoing life-sustaining treatment (LST) or advance directives. In 2007, the Ministry of Health, Labour and Welfare developed the first guideline on the decision-making process for terminal medical treatments. This guideline includes two key elements: (1) respecting patient self-determination and (2) broadening decision-making on the course of care to involve the healthcare team. However, it leaves many terms undefined and the position of liability is vague, leading to much uncertainty in healthcare practice. Revisions to the guideline in 2018 have emphasised advance care planning, but the completion rate for advance directives has, however, remained low, and this may be explained by practical and sociocultural factors. In light of this situation, we argue that we need further research and discussion to seek the best end-of-life decision-making framework that is most suitable for Japanese culture.

According to behavioral theory, positive and negative reinforcement, along with stimuli associated with positive or negative incentives, control SUD as well as benign drug use. Cognitive theory adds the influence of the social context and human cognition. Positive reinforcement, often experienced as pleasure, is most effective immediately after a given behavior – such as addictive drug use. Negative reinforcement (relief of an aversive state) also has powerful behavioral control. Addictive drugs temporarily relieve many unpleasant conditions, including the shame and guilt of addiction. Any aversive (punishing) consequences usually appear much later, decreasing their power to suppress behavior. When drugs are easily available and intoxication is tolerated in a society, heavy use is more prevalent, abuse is enabled, and addiction develops in those with fewer risk factors. Eventually, after losses resulting from heavy drug use, further use may be the only available coping tactic and source of reward. Continued drug use brings additional harm, but now has even greater control over behavior because it is the sole source of even temporary relief.

In cases of international or cross-cultural research we need to take extra care at every stage of the process, and this chapter looks at various aspects of this. Research involving unfamiliar environmental and cultural differences may complicate the understanding of the research problem, and researchers often fail to anticipate the impact of local cultures on the question asked. Consideration also needs to be given to the scope and limits of the problem. In some cultures, a broader scope is necessary to cover the necessary variables. Comparability of data is the main issue in international/cross-cultural research, and it is not possible to use data gathered in one market for another market. This is due not just to the availability and reliability of data but also to the manner in which data are collected and analysed.

In cases of international or cross-cultural research we need to take extra care at every stage of the process, and this chapter looks at various aspects of this. Research involving unfamiliar environmental and cultural differences may complicate the understanding of the research problem, and researchers often fail to anticipate the impact of local cultures on the question asked. Consideration also needs to be given to the scope and limits of the problem. In some cultures, a broader scope is necessary to cover the necessary variables. Comparability of data is the main issue in international/cross-cultural research, and it is not possible to use data gathered in one market for another market. This is due not just to the availability and reliability of data but also to the manner in which data are collected and analysed.