The standard sets clear expectations for how therapists are to provide culturally safe and anti-racist care for Indigenous clients.
The practice standard was created as a response to the evidence and recommendations in In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in BC Health Care, a report by Dr. Mary Ellen Turpel-Lafond. The November 2020 report provided evidence of Indigenous-specific racism, resulting in decreased access to health care and poor health outcomes, such as lower life expectancy, higher mortality, and increased presence of chronic health conditions.
In Plain Sight was guided by Sulksun (Shane Pointe), a proud member of the Coast Salish Nation, Musqueam Indian Band, and Knowledge Keeper to all, and Joe Gallagher (k’wunəmɛn), Tla’amin Nation, Principal at Qoqoq Consulting Ltd.
It comprises of six core concepts, within which there are principles to which therapists are held accountable.
The six core concepts are:
1.Self-reflective practice (It starts with me)
Cultural humility begins with self-examination of values, assumptions, beliefs, and privileges, how they are embedded in knowledge and practice, and consider how it impacts relationships with Indigenous Peoples.
Cultural humility promotes relationships based on respect, open and effective dialogue, and mutual decision-making.
- Reflect on, identify, and do not act on stereotypes or assumptions.
- Reflect on how their privileges, biases, values, beliefs, behaviours, and positions of power impact the therapeutic relationship.
- Evaluate and seek feedback on their behaviour towards Indigenous Peoples.
2.Building knowledge through education
Health professionals continually seek to improve their ability to provide culturally safe care for Indigenous clients.
Health professionals learn about:
- Determinants of health, cultural safety, cultural sensitivity, and anti-racism.
- Negative impact of Indigenous-specific racism on Indigenous clients accessing the health care system, and its disproportionate impact on women, girls, and two-spirit, queer, and trans-Indigenous peoples.
- Historical and current impacts of colonialism and impacts on health care experiences.
- The Indigenous communities located in the areas where they work (languages, histories, heritage, cultural practices, and systems of knowledge).
3.Anti-racist practice (taking action)
Health professionals take active steps to identify, address, prevent and eliminate Indigenous-specific racism.
- Help colleagues identify and eliminate racist attitudes, language, or behaviours.
- Support clients, colleagues, and others who experience racism.
- Report acts of racism to leadership or the regulatory college.
4.Creating safe health care experiences
Health professionals facilitate safe health care experiences where Indigenous clients’ physical, mental/emotional, spiritual, and cultural needs can be met.
- Treat clients with respect and empathy:
- Acknowledge clients’ cultural identity.
- Listen to and seek to understand their lived experiences.
- Treat clients and their families with compassion.
- Be open to learning from the client and others.
- Care for a client holistically.
- Acknowledge and incorporate in the plan of care cultural rights, values, and practices.
- Facilitate the involvement of the client’s family and others (community and Elders, Indigenous cultural navigators, and interpreters) as needed and requested.
Health professionals work collaboratively with Indigenous clients to meet the client’s health and wellness goals.
- Respectfully learn why the client has sought health care.
- Engage with the clients and their identified supports to identify, understand and address their health and wellness goals.
- Actively support the client’s right to decide on their course of care.
- Communicate effectively by:
- Providing space and time to share their needs and goals.
- Providing clear information about their health care options available.
- Ensuring information is communicated in a way that the client can understand.
6.Strengths-based and trauma-informed practice (looking below the surface):
Health professionals are knowledgeable about different types of trauma, and their impact on Indigenous clients (including intergenerational and historical trauma which impact many Indigenous People during health care experiences. They focus on the resilience and strength the client brings to the health care encounter.
- Work with the client to incorporate personal strengths to meet goals.
- Recognize the potential for trauma (personal or intergenerational) and adapt the approach to be mindful of this, including seeking permission before engaging in assessment and treatment.
- Recognize that colonialism and trauma may affect how clients view, access, and interact with the health care system.
- Recognize that Indigenous women, girls, two-spirit, queer, and trans-Indigenous Peoples are disproportionately impacted by Indigenous-specific racism and consider the potential impact of gender-specific trauma on the client.
What is OT Works! already doing to address the practice standard?
OT Works! is committed to providing culturally safe and anti-racist care for Indigenous clients:
- We are continuously reflective of our practice through our processes, including mentorship, Quality Assurance, and annual feedback.
- We focus on holistic care and client strengths at all times.
- We consistently provide client-centred care.
- We are good listeners.
- We continuously deepen our understand of, and provide, trauma-informed care.
- We acknowledge the Indigenous lands we work on.
- We research and share information with the team about the Indigenous people on whose lands we work.
OT Works! Is taking further, specific and active steps towards an inclusive, respectful and safe space for our Indigenous clients.
Here’s what we will do moving forward:
- Identify unrecognized bias in tools and practices at OT Works! and in the systems we work.
- Reflect on our privilege, position of power, and how it impacts our Indigenous clients.
- Seek specific education on Indigenous cultural practices and impacts of colonialism and intergenerational trauma.
- Ensure the space, time and necessary guidance for specific reflections about our Indigenous learning and care.
OT Works! will continue to build on our strengths as a team of caring, respectful, knowledgeable Occupational Therapists and continue to improve care in BC for Indigenous people.
If you or someone you know is looking for support of an Occupational Therapist, contact us today.
Phone: 604.696.1066 ext. 1000.
Picture in this post – Title: Land Acknowledgment – Artist: Sage Paul, W̱JOȽEȽP (Tsartlip Nation)