Why consider Culture in Therapy?

I believe that culture plays a huge role in our profession as occupational therapists. It affects our goal setting, our treatment planning and therefore, our intervention implemented. Cultural knowledge provides context of the client’s values, skills and beliefs which are essential in building a trusting, therapeutic relationship with the client and encouraging engagement in future therapy.       

As an occupational therapist you should enquire intensely about the client’s context as your therapeutic value depends on it. For example, if I rushed into therapy teaching my client to shower independently, without understanding his socio-economic status and context, he may actually need to wash himself in his village river or using a bucket when he goes home. This would not only be disrespectful towards the client, causing a less therapeutic relationship, but it would also have been a pointless intervention session as the client will not use what he was taught in the session post-discharge. 

I also believe therapists should consider the formal assessments they perform on clients according to the region in which the assessments were created in, as they are standardized based on that region’s culture. Otherwise, interpretation of test results would be unsuitable.

Another example, is of the country of Singapore where it’s first OT’s studied in London (A western country). These OT’s had to drastically change their mindsets towards their country’s culture and context, when returning to provide intervention for patients. 

As a result of protest action on campus the university cancelled our prac day on Monday. With permission, I still performed a brief session with my client and his therapist as I had prepared a passive exercises programme for him to take home before discharge. Through my other pamphlets I had created for Mr Udairaj I learnt the importance of simplifying documents with well researched methods for patients to easily use. I also learnt the need to use laymen’s terms and not OT terms in a programme as the patient would not understand. Despite my effort and it not being implemented for the client, as a result of my inexperience and many corrections  which needed to be made, I learnt greatly from creating the pamphlets through my supervisor’s corrections. 

Today (Wed, 13/03) I performed my Midterms Demo. Through this demo, I learned to stretch my client out of his barriers in order to reach my aims with more confidence. For example, I had placed the bowl of yoghurt on my patient’s right side as I knew it would require less effort to place yoghurt onto the spoon. However, my supervisor advised me that I should have possibly placed the bowl on his left side, requiring extension in this direction and requiring a greater effort on his part for the elbow flexion movement. Despite the difficulty he may have faced, this structuring would have been more therapeutic in reaching my aim of improving his JROM in elbow flexion. My supervisor also discussed with me my warm up with the client. I learnt a lot from this discussion as it made me realise how a warm up can influence an activity. For example, I used JROM as a warm up of the client’s biceps needed to flex his elbow for feeding. If I had used an activity which strengthened the client’s biceps muscle through weightbearing and resisting the muscle it could have positively influenced his improvement in Active JROM elbow flexion. 

I believe cultural knowledge, understanding and skills are vital in becoming a culturally competent occupational therapist, as this is essential to being a competent healthcare provider.

In my experience as a therapist last year I have learned from my mistakes, such as providing a client with a knife and fork when he never eats with this utensil, but rather a spoon. I have learnt to evaluate my sessions before implementing them, according to the client’s context and their cultural behaviours. 

I would like to end off with this inspiring quote that shows the importance of diversity, which makes each individual unique. 

REFERENCES:

Stanley, P. (1995). Culture and its Influence on Occupational Therapy Intervention. https://journals.sagepub.com/doi/

Yang, SY. (2006). Cultural Influences on Occupational Therapy. https://onlinelibrary.wiley.com/doi/pdf/10.1002/oti.217.

Leendertz, AE. (2013). Cultural competency: perceptions of South African trained occupational therapists. http://wiredspace.wits.ac.za/handle/10539/12524.

Images collected by Burten, S. Diversity. (2019). https://za.pinterest.com/real19/diversity/.