CULTURALLY COMPETENT PRACTITIONERS

Defining cultural competency can be difficult, as to be competent implies a degree of knowledge surrounding the group, For most individuals cultural competency is life-time learning and comes with practice and wisdom (Jungerson 2002).

Occupational therapists try to attend to emotional, cognitive, physical and social dimensions, in the context of the persons wider lifestyle. In practice this means we need to negotiate therepeautic interventions in individualised ways: one persons treatment cannot be the same as anothers. It also means that we need to stop stereotyping our patients and clients (Finlay, 2004)

For one we are all familiar with models of practice, so why not list a few that have a specific focus on different cultures.

The Kawa Model  (Iwama, 2006)

The Kawa model is a japenese derived occupational therapy model, that uses the metaphor of the river to address the different sections of life. It was orginally designed for the Japenese culture to meet their own cultural values, the model is very adaptable so can be used with a  variety of cultures.

 Within this model the Ot has the role of being alongside the river to assist clients with breaking down barriers that are hindering the participation in meaningful occupation. The river represents the clients life, rocks are considered problems, driftword is assets and liabilities, water includes purity, spirit, cleansing and renewal, the river walls and bottom represent the social and physical environment and the spaces in between these represent where the client still has life flow which is an important means for intervention.

There are six steps to the application of this model:

step one: appreciating the client in context

step two: clarifying the context

step three: Prioritizing issues according to clients perspective

Step four:Assessing focal points of occupational therapy intervention

Step five: Intervention

Step Six: Evaluation

This video below shows an example of the Kawa Model being put into place

https://www.youtube.com/watch?v=ZxTVH049MNU

Te Whare Tapa Wha (Ministry of Health, 2016)

Te Whare Tapa Wha is a Maori derived model that can be applied to any health issue, whether it involves physical or psychological well-being. The Maori philosophy towards health is underpinned by four dimensions representing the beliefs of life.

Te taha hinengaro: Psychological health

Te taha whanau: Family health

Te taha tinana: Physical health

Te taha wairua: spiritual health

The wharenui (meeting house) is the symbol used to illustrate these areas of well-being. Just as each corner of the house must be balanced and strong to hold its structure. In order for good health each section must be balanced.

Figure 1. Durrie, M. (1998). Maori health: te whare tapu wha model. Auckland, New Zealand: 

            Oxford University Press.

Although both of these models were designed for specific cultures they have the adaptibilty to be utilised with a variety of different cultures. I do not identify as Maori but I feel that "Te Whare Tapa Wha" would be an approprite model to use with myself as physical health, psychological health, family health and spiritual health are the four most important aspects in my life. Each model can give OT’s the tools to focus on culture at a deeper level.

Below Figure 2 and 3 show a few interesting generalised facts surrounding handshakes and eye contact in different countries. It is important as a therapist to be aware of these factors as they could potentially determine rapport with clients.

We need to understand that everyone is different and has different values and beliefs. It is better to ask someone about their culture in a polite way rather than pretend that we know everything about the individual (Meyers, 2010).

Figure 2: Handshakes around the world. (n.d).

Retrieved from https://nz.pinterest.com

/pin/290341507210024461/

Figure 3: Body language around the world. (n.d).Retrieved from https://nz.pinterest.com/pin/290341507210024461/

References

Finlay, L. (2004). The Practice of Psychosocial Occupational 

            Therapy. Cheltenham,United Kingdom: Nelson Thornes Ltd

Iwama, M. (2006). The Kawa Model: Culturally Relevant  

            Occupational Therapy. London, United Kingdom: Churchill  

            Livingstone Elsevier

Jungerson, K. (2002). Cultural safety: Kawa Whakaruruhau: An 

            occupational therapy perspective. New Zealand Journal of 

            Occupational Therapy.

KawaOT. (2010) KAWA RIVER. Retrieved from 

             https://www.youtube.com/watch?v=ZxTVH049MNU

Meyers, S. (2010). Community Practice in Occupational Therapy: 

              A guide to serving the community. Mississauga, Ontario, 

             Canada: Jones and Bartlett Publishers

Ministry of Health. (2015). Maori health models- Te Whare Tapa 

            Wha. Retrieved from 

             http://www.health.govt.nz/our-work/populations/maori-    

            health/maori-health-models/maori-health-models-te-whare-   

            tapa-wha

List of Illustrations

Figure 1. Durrie, M. (1998). Maori health: te whare tapu wha   
            model. Auckland, New Zealand: 

            Oxford University Press.

Figure 2: Handshakes around the world. (n.d). Retrieved from 

            https://nz.pinterest.com/pin/290341507210024480/

Figure 3: Body language around the world. (n.d). Retrieved from 

            https://nz.pinterest.com/pin/290341507210024461/