What Does the Literature Say? What Are Our Guidelines?

We've seen anecdotal evidence of the need for improvement in the ways that practitioners demonstrate cross-cultural awareness, and practice intercultural communication, but what does the formal evidence say on the matter, and what do our organisations say?  There is not a large body of evidence from New Zealand, but plenty has been written in other countries. Below is a screenshot of the Occupational Therapy Board of New Zealand's position on Cultural Competence:

(Occupational Therapy Board of New Zealand, 2010)

As you can see, culture is more than ethnicity, something that is reflected in the literature throughout the health field, and that has appeared time and again in the readings I have found.  Despite the positive intentions of our Board, and others around the world, Kirsh, Trentham, and Cole (2006) found that:

That this research was conducted in Canada, the home of one of the best-known OT frameworks, speaks volumes.  Kirsh et al (2006) found five main themes in their research of subjects who identified as minorities, either ethnically and/or in terms of religion or sexuality.  I have summarised them below in a Powerpoint.

Within the field of occupational therapy itself, there have been voices that have made suggestions in line with these findings, a primary voice being Michael Iwama.  His Kawa model is well-known in the field, and is based upon the organic and tangible model of a river, rather than the more abstract models that are also in use.  Of differences in cultural views of occupation, he (2006, p. 18) has written:

Whilst new and alternate theoretical materials are a challenge for myself as a student, I can certainly see where our field's most popular models may not directly translate, particularly when utilised with people from collectivist cultures.

References

Occupational Therapy Board of New Zealand.  (2010). Cultural competence. Retrieved from http://www.otboard.org.nz/Competence/CulturalCompetence.aspx

Iwama, M. (2006). The kawa model: Culturally relevant occupational therapy. London, UK: Churchill Livingstone.

Kirsh, B., Trentham, B., & Cole, S. (2006). Diversity in occupational therapy: Experiences of consumers who identify themselves as minority group members. Australian Journal of Occupational TherapyI, 53, (pp. 302-313).