Cultural competency and the reproduction of White supremacy in occupational therapy education

Abstract

Background: In this two-part paper, critical race theory is used as an analytic tool to examine how anti-Blackness, anti-Indigenous colonial relations and Orientalism have and continue to influence the ways in which occupational therapy is taught and practised in Canada. Purpose: The purpose of this paper is to incite reflection on the ongoing oppressive narratives that pervade occupational therapy education and support culturally unsafe practices. Methods: Through the lenses of liberal multiculturalism, liberal recognition politics and neoliberal capitalism, the author demonstrates how notions of ‘cultural competency’ are the logical product of an institutionalised racism that functions as a tool for the reproduction of White supremacy and racism in healthcare and healthcare education. Conclusions: Findings challenge the ongoing use of cultural competency frameworks in healthcare systems and education and propose a radical shift towards critical and structural frameworks.

From racialized think-pieces toward anti-racist praxis in our science, education, and practice

“…Both our personal and research experiences compelled us to further integrate analysis of historical, social, and structural perspectives of racism into our research, teaching, and practice related to occupation. Yet, we found little literature (e.g., Grenier, 2020;Restall et al, 2016) acknowledging and addressing the historical, social, and structural emergence of occupational therapy and occupational science through racism, particularly in the United States, and even less that conceptualized the construction of racism through an occupationbased lens.…”

“…Failure to make this distinction further legitimizes racist labeling in occupational science scholarship. Academics have offered "excluded identities" and "minoritized" or "racialized" groups as alternatives among others (Grenier, 2020;Walden et al, 2018). .…”

“…The process of evaluating and understanding occupation as something people want or are obligated to do and its impact on health and survival is as old as the occupational therapy profession (Johnson & Dickie, 2019). However, from 1917 to 1991, occupational therapists more often conceptualized occupation through its utility in practice rather than as a sociological phenomenon in and of itself (Hammell, 2009a), and as a consequence, neglected examination of the racialized context through which it developed (Grenier, 2020). This orientation fostered a knowledge base rooted in Whiteness-a privileged exclusionary category generally based on having White skin and the accumulation of social, economic, and political power (Christian, 2018)-and was consistently only interested in the benefits of occupation.…”

“…In current occupational science literature, scholars attend to labels of race to ensure representation, but simultaneously often over-intellectualize the role of race in occupation. Thus, they neglect the systems and structures that produced those labels-and racialized occupational experiences-in the first place (Grenier, 2020). This not only restricts occupational science scholarship from contributing to active anti-racist deconstruction of oppressive systems to bring about a more just and equitable social order, it deprives occupational therapy educators of opportunity to teach future practitioners to be actively anti-racist in their practice and conceptualization of occupation.…”

Commentary on racism in occupational science

“…This year I was delighted to see an occupational therapy paper entitled, "Cultural competency and the reproduction of White supremacy in occupational therapy education" (Grenier, 2020) naming White supremacy, and racism as a system of power, as central to the profession of occupational therapy. As Sara Ahmed (2012) has written in another professional context, institutionalized Whiteness establishes a culture in which racism is subsumed into normalized practices.…”