Culture: An Important Aspect of Client-Therapist Relationships

    When people typically think of culture, they think of race, ethnicity, and where a person comes from. What most people do not understand is that culture includes many more aspects of an individual including class, gender, sexual orientation, and ability (Hammell, 2013). Each of these aspects of one’s culture can impact their daily occupations and routines. For example, one aspect of my culture is being a female. As a female, I have certain occupations and routines that I partake in. My mom, as a female also, when pregnant with me had many occupations and routines she had to do all because she was a female. She had to go to more doctor's appointments. Simply going to the doctor’s office involves multiple occupations. 

    Class, as a part of an individual's culture, is also important. I am considered to be upper-middle class. Being in the upper-middle class, I am fortunate enough to have my own car. This allows for transportation for me to be easy. Some clients are not in as high of a class as me. When it comes to transportation, they may have to take the city bus or even walk. This is important to recognise when treating a client because you, as an occupational therapist, want to make your clients life easier. It would be unreasonable to require a client who does not have easy transportation to come to therapy four times a week, when it could be shortened into two times a week. 

    OTPF-4 discusses the OT process which includes evaluation, intervention, and outcomes (Lancaster, 2023). Culture plays a role in all three of these processes. It is important to always be aware of the culture of your client in order to give your client optimum care.  

    OT practitioners should always take note of their clients' culture. The information they obtain, regarding culture, from their client can be used to facilitate treatment goals and interventions. By knowing one's culture, it allows for you and your clients goals to be realistic. Some clients' culture may include the value of providing for their families. Knowing this, one of the goals that can be set for the client can be aimed towards this value. By having goals aimed towards a client's value, they will be more inclined to strive to reach them. Knowing a client's culture can also help with treatment. A client will be more likely to want to engage in interventions if they are activities that they value or enjoy doing. 

    When I was working at OrthoSouth, one of our clients was strongly in touch with Indian culture. She explained to us how part of being an Indian mother meant she must provide nutritious meals to her family and many of her meals included roti, a type of bread. She was in the clinic for a wrist injury and one of the activities we did to help strengthen her wrist was kneading dough. The OT I was working with took a part of the clients culture and implemented it into our clients' treatment. After her treatment was finished she explained to us how much she enjoyed kneading the dough because it was something she did on a day to day basis. This scenario made me realize how important it is to understand a client's culture. I am not a part of Indian culture. I am a part of American culture and our values differ. I do not have to cook a meal for my family every night. Although our values differ, by understanding the client's culture, I will be able to improve their experience and treatment. 

    The term “cultural humility" is the preferred term when speaking on our cultural knowledge that we as occupational therapists hold. It is preferred over the term “cultural competence" because cultural competence implies that one can be fully competent in another's culture. This is not true. Someone can never fully understand the depths of one's culture because each person's culture is unique to themselves. Cultures are also always changing and adapting so it is ignorant to think that you can fully be competent. Cultural humility readdresses the power imbalances and facilitates more inclusivity in the environment (Hammell, 2013). Cultural humility means self evaluating and realizing that cultural differences are present within client-therapist relationships (Hammell, 2013). 

Hammell, K. W. (2013). Occupation, well-being, and culture: Theory and cultural humility. Sage Journals. Retrieved March 1, 2023, from https://journals.sagepub.com/doi/10.1177/0008417413500465