Expanding beyond individualism: Engaging critical perspectives on occupation.

BACKGROUND: Perspectives that individualize occupation are poorly aligned with socially responsive and transformative occupation-focused research, education, and practice. Their predominant use in occupational therapy risks the perpetuation, rather than resolution, of occupational inequities. AIM: In this paper, we problematize taken-for-granted individualistic analyses of occupation and illustrate how critical theoretical perspectives can reveal the ways in which structural factors beyond an individual's immediate control and environment shape occupational possibilities and occupational engagement. METHOD: Using a critically reflexive approach, we draw on three distinct qualitative research studies to examine the potential of critical theorizing for expanding beyond a reliance on individualistic analyses and practices. RESULTS: Our studies highlight the importance of addressing the socio-historical and political contexts of occupation and demonstrate the contribution of critical perspectives to socially responsive occupational therapy. CONCLUSION AND SIGNIFICANCE: In expanding beyond individualistic analyses of occupation, critical perspectives advance research and practices towards addressing socio-political mediators of occupational engagement and equity.

Engaging Indigenous families in a community-based Indigenous early childhood programme in British Columbia, Canada: A cultural safety perspective.

This article is part of a larger study that explored how an Indigenous early intervention programme in British Columbia (BC), Canada, known as the 'Aboriginal Infant Development Program' (AIDP), influenced family and children's health and well-being and was responsive to child health inequities. Postcolonial feminist and Indigenous feminist perspectives provided a critical analytical lens to this qualitative inquiry. The study was undertaken with AIDPs based in diverse community organisations located in off-reserve urban municipalities throughout the province of BC. From September 2013 to March 2014, in-depth, semi-structured interviews were undertaken with: Indigenous primary caregivers (n = 10), Indigenous Elders (n = 4), AIDP workers (n = 18) and administrative leaders (n = 3). The purpose of this article is to examine and analyse the findings that focus on how AIDP workers supported family and children's health and well-being by transforming their routine policies and practices in ways that fostered caregivers' active engagement in their programmes. Findings centre on three main themes: (i) overcoming mistrust; (ii) 'being willing to move a step forward' and (iii) resisting what's taken-for-granted. These inter-related themes are examined and discussed in relation to the concept of cultural safety. The findings have international relevancy for social and healthcare community-based programmes that are questioning how to engage with parents who may be hard to reach as a result of multi-faceted social and structural factors.

Sharpening our critical edge: Occupational therapy in the context of marginalized populations.

BACKGROUND: An emerging and important area of occupational therapy practice involves engaging with various individuals and population groups who live in marginalizing conditions that result in health inequities. PURPOSE: This paper calls for more critical and intersectional analyses of occupational therapy in the context of marginalized populations. KEY ISSUES: Intersectionality has the potential to reveal important and complex interactions among social systems that create and sustain marginalization and to inform more nuanced, contextualized, and socially responsive forms of occupational therapy. Central to this process is the co-construction of knowledge with people who experience marginalization. Engaging in this work requires occupational therapists to undertake ongoing critical reflexivity to attend to our sociohistorical positioning of power and privilege in relation to marginalized populations. IMPLICATION: Complicating our discourse on marginalized populations is imperative to enacting our critical potential in working toward social justice and health equity.

A critical reflection on the concept of cultural safety.

BACKGROUND: Cultural safety broadens and transforms the discourse on culture and health inequities as experienced by diverse populations. PURPOSE: To critically analyze cultural safety in terms of its clarity, simplicity, generality, accessibility, and importance. KEY ISSUES: Whilst the clarity and generality of cultural safety remain contentious, there is emerging evidence of its capacity to promote a more critical discourse on culture, health, and health care inequities and how they are shaped by historical, political, and socioeconomic circumstances. IMPLICATIONS: Cultural safety promotes a more critical and inclusive perspective of culture. As an analytical lens in occupational therapy practice and research, it has the potential to reveal and generate broader understandings of occupation and health from individuals or groups in society who are traditionally silenced or marginalized. In relation to Aboriginal peoples, it clearly situates health and health inequities within the context of their colonial, socioeconomic, and political past and present.