Occupational Therapists' Experiences of Assessments With Indigenous Peoples: A Storytelling Approach.
Kaarina Valavaara, Jay MacDonald, Pamela Barnes and 3 others
PMID 40398451WHAT IT FOUND
Occupational therapists described pressure from referrers and funders to complete standardized assessments that clash with culturally safer practice.
What they said helped was human connection first, sharing power, and letting Indigenous service users decide whether and how to take part.
Key findings
01Participants reported pressure from physicians, other referring colleagues and third-party funders (insurance companies, health authorities, government equipment programmes) to complete standardized assessments, which they said got in the way of building relationships and advocating for other assessment approaches.
02Participants said they knew of no, or very few, standardized assessments developed for and with Indigenous Peoples, and said many standardized tools were not created for or considerate of Indigenous ways of knowing and doing.
03Many participants were unsure whether they were getting true informed consent, given that standardized assessments were required to fund services, and recognized that Indigenous service users may not feel able to refuse without negative repercussions such as involvement of child and family services.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Almost all of the participants were settlers, and the perspective the researchers call critically important is missing: Indigenous occupational therapists were not represented, and the authors say that work should be led by Indigenous scholars and clinicians. There was one Indigenous participant. The project did not ask Indigenous service users at all, because the 18-month timeframe did not allow the relationship building and reciprocity the researchers considered necessary to do that ethically. So everything here is what occupational therapists said about their practice, not what service users experienced. These are self-reports from a voluntary survey and discussion groups recruited through professional networks. The paper reports what therapists said they do, with no observation of actual sessions and no outcomes for service users. Confidence ratings were low overall: 30% of respondents said they had received Indigenous cultural safety training and felt sufficiently knowledgeable, and the authors note there was no consensus among participants about what a culturally safer assessment approach actually is. The findings are presented as a fictional conversation between a composite therapist and a knowledge keeper. Individual voices and any disagreement between participants are blended, so you cannot tell how widely a particular view was held.
Declared interests
Funded by the UBC Institute for the Scholarship of Teaching and Learning. Several authors are members of the Canadian Occupational Therapy and Indigenous Health Network, the network from which the project emerged and from which community consultants were drawn.
The easy way to misread this
Do not read this as evidence that any particular assessment approach works or does not work. It reports what 43 occupational therapists, almost all of them settlers, said about their own practice. No Indigenous service users were asked, and no service user outcomes were measured. A composite character speaks for the group, so a strong statement in the findings may come from one person rather than from all of them.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →