1. Reflect on treatment sessions that you have observed with your clinical instructor.

How
have you seen cultural competency in practice? Be specific. Have you seen instances in
this fieldwork or in other experiences where a practitioner did not demonstrate cultural
competence when interacting with a client?
The facility Im working at is located in a relatively rural southern town. It is also located near
a huge retirement community. My supervisor is from New Jersey, and has the stereotypical
New Jersey accent. I think she does a good job relating to her patients, some of which have
lived in the south their entire life and have never traveled outside of the area. I think this is a
good example of different cultures blending together. My therapist has been at this facility for
7 years and knows how to interact and work with these patients, though Im sure some of
the patients may have a harder time relating to the OT because of her accent and fast
talking. However, I have never seen this cultural difference interfere in the delivery of
therapy in any way, though it is something to keep in mind when building a rapport and
working with patients.
I have not personally witnessed a glaring example of a therapist failing to demonstrate
cultural competence. I think this maybe due to the fact I have only shadowed under very
experienced therapists who have been working in the field for a long time. I think the risk of
failing to be culturally competent is higher for people new to the field and working with the
public, as they may have not been as exposed to as many different people/ cultures as
experienced clinicians have been. I think as we enter into the field as new practitioners,
cultural competence will be an aspect of our service delivery that we need to keep at the
front of our mindset.

2. Think about the definitions of occupational apartheid, occupational justice, and

occupational deprivation. Give an example and explanation of each as applied to the
client population that you are working with at your fieldwork site.
Occupational Apartheid: Occurs when individuals or groups of people are deprived of
meaningful activity through some sort of segregation, often due to ethnicity or religion.
I have not seen any clear examples of occupational apartheid. I think the best example of
segregation at the facility is the division between the pts on the sub-acute side and those pts on
the LTC unit. Both groups are welcome to participate in the same services, such as social
gatherings like Bingo, eating in the cafeteria, and ice cream parties. However, these events tend
draw more people from the people the LTC unit, and individuals from the sub-acute unit
typically do not attend.
Occupational Justice: The process of trying to fix, remedy, or call attention to disparities people
face in the pursuit of everyday occupations.

An example of occupational justice is in regards to the smoking policy at my facility. The facility
is made up of a sub-acute rehab wing and also a long-term care unit. The long term care rooms
serve as the persons permanent residence and is viewed as his/her home. A few years ago a
policy was implemented that smoking would no longer be permitted anywhere on facility
grounds. Several residents on the LTC unit had a problem with this, as they believed they should
be able to smoke at their home. As a result, an exception was made, and those individuals
already living at the facility could be grandfathered in, and could continue to smoke, outside on
facility grounds. Currently there is 1 individual who is still alive who was grandfathered in and is
still allowed to smoke on facility grounds. A nurse or staff member must accompany her outside
during her smoke breaks. This causes problems though, because people see this particular lady
outside smoking and do not understand why she is allowed to smoke at the facility and they are
not. The facilitys act to try to remedy the complaints made by LTC patients regarding the
smoking policy, is an example of the facility trying to ensure occupational justice.
Occupational Deprivation: A state in which individuals or groups are prevented from
occupational engagement.
I think lots of people are deprived from participating in occupations that they enjoy because of
health conditions. The extent of this however, is made even larger in a rehab facility. For
example, one of the pts I have been working with has been unable to take a regular shower due to
his hip injury (and the precautions that accompany it), poor trunk stability, and poor endurance.
Because the pt was unable to do a stand pivot transfer for a number of reasons, he was deprived
of the ability to do the routine task of taking a shower. Luckily, after a week of hard work in
therapy, he had the strength and endurance to be able to complete a showering task with the
occupational therapist.

3. Look up at least three member profiles on the WFOT.org website. Go to those member
country websites. What similarities and differences do you see between the member
countries that you chose in terms of how occupational therapy is defined, where
occupational therapy is practiced, and visions for the future of the profession?
Bangladesh (BOTA): According to the vision statement of the National
Organization in Bangladesh, they invision occupational therapy being offered in
public, private, and non-governmental sectors in order to enhance public health.
The goal of improving public health is a goal of both AOTA and BOTA. Another
common goal between BOTA and AOTA is helping to make occupational therapy
a well-known field to the general public. The BOTA is also responsible for
registering all occupational therapists in Bangladesh. This is different than in
America, where another organization (NBCOT) is responsible for registering all
occupational therapists.

New Zealand (NZOTA): NZOTA also looks to ensure occupational justice and
biculturalism in delivering occupational therapy services. The vision of NZOTA
is also similar to AOTA in that their vision also consists of Empowering
individuals organizations, and communities to achieve health and well being
through occupation. The NZOTA is also making a big push for delivering
evidence-based practice. Both organizations define occupations in similar ways as
helping people to participate in the activities of everyday living.
South Africa (OTASA): The OTASA makes a heavy emphasis on making
diversity a strong principle in the delivery of their service and also ensuring that
occupations are at the root of all therapy. The OTASA also takes pride in
delivering scientific and evidence based practice, to the extent that the definition
of occupation, according to OTASA includes scientifically chosen meaningful
activities to assist diverse clients