Meaning and inclusion: Revisiting culture in occupational therapy

Culture represents one of the most important issues facing occupational therapy today. If we regard culture broadly as shared spheres of experience and the means through which meaning is ascribed to objects and phenomena around us, we have much to contemplate and reflect upon regarding the fundamental structure and meanings of this wonderful profession. And, as we continue to construct and celebrate meaning in occupational therapy, perhaps we should broach the issue of inclusion, to examine how culturally relevant occupational therapy really is for both its colleagues and its clients. Ever since occupational therapists the world-over participated in a renaissance of ‘occupation’ (Whiteford, Townsend & Hocking, 2000), meanings ascribed to the experience of human agency have become an essential nexus for our contemplations about human occupation and occupational therapy. The shared spheres of experience and construction of meaning in interpreting human action, as represented in our literature, have been predominantly situated in Western experience. Our professional discourse appears to have so far excluded what should be deemed equally valid, alternative contributions representing ‘other’ spheres of experience and meaning around matters of occupation and occupational therapy. Culture, in both common social and occupational therapy contexts, remains a slippery construct, taking on a variety of definitions and meanings depending on how it has been socially situated and by whom. At times, culture is treated synonymously with race and ethnicity; a restrictive, static and often stereotypic embodiment of individual identity and being. Similarly, in its application to collectives, culture can represent larger modal behaviour patterns and social tendencies of groups of people who are often reduced to simple, categorical depictions of ‘the other’. In certain social contexts, there are class and raceological (Gilroy, 1993) implications to this common take on matters of culture. Since the enlightenment, when the great thinkers of Europe embarked on their search for a universal truth, culture has been regarded synonymously with civilisation, referring to a class or level of intellectual and aesthetic attainment enabling one to rationally determine what is good, true and beautiful in our surrounding world. In order for such standards of truth to be sustained and perpetuated, there is a necessary framework erected and maintained by the reference culture to re-define and reify what is true, worth knowing and worth doing. If these ‘truths’ are not critically examined and reconsidered in occupational therapy, inclusive of alternative frameworks and worldviews, such constructions of culture may lead to us to regard ‘other’ peoples in a similar vein to how Euro-centric social scientists from a past era regarded and constructed the other as lesser (Lidchi, 1997) forms of people; lacking in refinement, intellectually moribund and desperately in need of cultivation and proper rearing. This enterprise of ‘cultivating’ the other is not unlike the occupation and colonisation of other peoples in other lands, articulated and enacted surely with the noblest of intentions. Much of the current discourse on culture in occupational therapy has centred on competency and sensitivity of practitioners toward clients and the cultural features and practices they are seen to embody, more than the cultural construction of occupational therapy itself and the implications this holds when contemplating issues of meaning and inclusion in our clients’ lives. From the vantage of the ‘other’, some glaring questions require our attention. With whose cultural norms do we view our clients — especially those clients who fall outside our conceptions of the normal? Do our current epistemologies, ideologies, theories and practices in occupational therapy truly abide within the lived realities of those we serve? To what extent do occupational therapists situated outside the mainstream social spheres of experience participate in our knowledge production and discourse? These are all formidable concerns for those who consume and contribute to the product contained in the pages of our professional journals. In our zeal to assist and perhaps to cultivate the ‘other’, we may have unwittingly assumed that our particular view of truth and reality; what is considered to be good true and beautiful was universally adequate. This, despite such profound differences between our and their explanations of reality, truth, and what is worth knowing and what is worth doing. To help grow our profession toward greater cultural relevance and inclusive directions, we may need to re-examine our frameworks of inclusion — for what we consider to be good, true, beautiful, and worth knowing in this profession. The other side of the equation entails encouraging those who have been previously excluded from contributing to our professional discourse, to view the Australian Occupational Therapy Journal as a welcoming and safe forum to share their diverse views of occupation and occupational therapy. Our maturity as a profession and ability to effect people's lives in powerfully positive ways hinges on a greater inclusion of diverse spheres of experience and meaning.

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