1 jocelyn campbell, o.t. feb. 27, 2014 post professional ......feb. 27, 2014 lunch & learn 10...

Jocelyn Campbell, O.T. Post Professional Masters of Occupational Therapy (Thesis Stream)

Feb. 27, 2014 Lunch & Learn

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“Culture permeates every clinical encounter in occupational therapy.” (Muňoz, 2007, p. 256)

Culturally responsive caring



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“Who am I in the research?”

…”anyone with an inclusive and secure identity can make a positive and creative difference in his or her own realm of life.” Kim, Y.Y., (2009) Ch. 2: The Identity Factor in Intercultural Competence, p. 61, in Deardorff, D. K., The Sage Handbook of Intercultural Competence.



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Outline

1. Context – Cambodia

2. My Study – in a nutshell

3. Selective Sample of Data

4. What I learned about: a) them, b) me c) research

5. Now what? – questions for you



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Questions: for you

- Muňoz, (2007) proposes that “culture permeates every clinical encounter” is this true for you in your practice? Examples? - How would you rate your “Culture-Meter” on a scale of 1 – 10, meaning how great is your awareness/sensitivity to nuances of culture in your practice? For example: what do you do to recognize cultural differences? (think about culture as including rural versus urban, catholic versus protestant, rich versus poor, young versus old, nationality, ethnicity) - Do you have unanswered questions about culture in clinical practice that might make for interesting occupational therapy research?



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The Cambodian Context



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Food – “have you eaten rice today?”



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Cambodian (Cham): Being in becoming Family focused Spirituality Relationality Ancestors/elders Certificates/stamps Indirectness/shyness Accept fate/will of Allah Person-person, heirarchy Tradition/conformity Interdependence, filial duty Collectivism/community Saving Face Both-And Circular

Canadian: Doing Individualism Materialism Competition Youth Competence Directness/openness Mastery/winning Person-Object Innovation/novelty Independence Separateness/autonomy Control/authority Either/or Linear

Ethnocentric continuum Ethnorelative

WORLDVIEW

Adapted from Gallardo, et al, 2012 and Sue, et al, 1996.



10 Czymoniewicz-Klippel, M.T. (2011), Kindle Locations 16500-16503

“Most reported spending either a half or full day, depending on their school's requirements, tending to lessons. For some, this involved bicycling for 30 minutes into town, whereas others walked only a short distance to the village-based school. Outside school hours, trying-to-be-good girls chiefly occupied themselves with domestic duties, such as cooking rice, pumping water, and/ or washing clothes. If/ when necessary, they assisted their parents with business-related tasks. “



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My study in a nutshell: Meta Question (Wonder) - How can I work authentically with…. what stories do village girls tell about daily life… what story does RA/FVE tell about working on the study… what story does the researcher tell… How can these inform … Methodology - combined Narrative Inquiry/Autoethnography Preparation – permission for access, locate RA and FVE, consent/assent – approval of Dalhousie REB (ethics) Method(s)– Caterpillar story prompt – audio-record 1+ story session per girl – co-create illustrated story on i-Pad (App – Stories about Me), give – review content for accuracy with girls, transcribe, analyze Sample – 10 girls living in a certain village, between age 6 and 18 who have parent consent and who assent, located from information meeting and with FVE assistance (volunteers) – RA/FVE/researcher Field Texts Interrim Texts Research Texts



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My study in a nutshell (cont’d):

Ethics in Narrative Inquiry:

"Those of us who study lives are aware that we influence the lives we examine-perhaps very little, perhaps a great deal." (Josselson, 1996, p. 80) “the narrative researcher is in a dual role – in an intimate relationship with the participant (normally initiated by the researcher) and in a professionally responsible role in the scholarly community. Interpersonal ethics demand responsibility to the dignity, privacy, and well-being of those who are studied, and these often conflict with the scholarly obligation to accuracy, authenticity, and interpretation.” (Josselson, 2007, p. 538)



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1. Red Sari (age 18)

2. Orange Rose (age 12)

3. Light Green Sunflower (age 12)

4. Light Pink Apple (age 10)

5. Yellow Butterfly (age 10)

6. Turquoise Tenflower (age 11)

7. Dark Green Rabbit (age 14)

8. Dark Pink Morningstar (age 9)

9. Dark Red Moon (age 6)

10. Purple Star (age 11)



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My name is *Manco, I am 55 years old. I live in a fishing village. Now I am the elder in my village so I know all the things that people who live in the village do. I know who is rich who is poor who is kind and who is mean.

*pseudonym



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D: I think that uh the ten girl story, before I think that Oh, maybe they have the same story. But now everything change. Yeah I I I understand. Because ah ah we choose one story from one girl, and we will know exactly about their activity and another girl we will focus on to what they wanting and uh focus on what they will do at future uh so ah I think that if we think together, we meet together and we will have a good idea for doing next time. **************** D: because uh the children want to be a teacher, so the main thing their parent. If the parent um can help their daughter or their their children, so their children can be. But if their parent don’t think about this, maybe they have no chance. **************** J: So I pick this story and some people in Canada say me “NO, why you pick this story? This little kid story no, not good for your resesach.” And I say, but I think this good story. So what do you think? D: I think so. Like I told you uh ah this story ah mean ah focus on focus on ah people also. J: mm D: Because uh yeah I think uh same same the processing of caterpillar like the processing of children yeah J: hmm D: yeah and we butterfly mean the future yeah uh mean the future of children you know J: mmhm D: see everything have to change, have to change, everything J: and you too D: mmhm J: You changed too, cause you’d be D: you too, yeah, I will

J: I think, you already did, D: mm



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D: I just know one thing that uh my friend alway uh don’t like Muslim uh they say that uh Muslim is uh du-sty yeah? J: Dirty D: yeah dirty and uh like uh house uh dustys hou or yeah I just heard like that I don’t know anything I just heard like that



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I want to learn English, then I can be a translator in a car factory.

I sell fruit door to door and give the money to my mom.



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I went to work in Malaysia for 3 years, now I am back and I have applied for a job in a factory.

I look after my sister and my niece, someday I will be a teacher.



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I am in first place in my class, we learned about children’s rights. I went to the beach with my class.

I ride my bicycle to school. My house is not so big , not so small. My mom makes fishing nets.



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I like to play on my own and I help my mom selling vegetables.

I am fifth in my class but getting a perfect mark on a test was the best day of my life.



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Now what?



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I learned from them: -Kindness is powerful, humbling and challenging - Thinking that money is the only way to get things is a barrier, the paradox of no working together in a collectivist and relational setting - Rote learning in school has a ripple effect - That it is possible to want something and have absolutely no idea how to get it

I learned about me: -How much I rely on asking direct questions, how hard it is to figure out indirect ways to get at things - In spite of all the tolerant upbringing and all the travel and exposure to difference, I am still ethnocentric and culture blind at times - That the cost of connectedness is a burden of relational responsibility -That I want to live in Cambodia and that I can be a researcher



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Things I learned about doing research in another country - How much listening and repeating and re-confirming meanings is

needed when working with a translator, and there are still errors

- There is an immediate adjustment for the time zone and the temperature, then a slower more subtle ongoing adjustment to living in a completely unknown place, kindness to self is needed.

- That no matter how hard you try to plan and think of everything, there are decisions in the field that must be made, having a well articulated foundation of values to make them from is essential.

- Having assistance from local people makes it possible to do it.



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Questions: for you

- Muňoz, (2007) proposes that “culture permeates every clinical encounter” is this true for you in your practice? Examples? - How would you rate your “Culture-Meter” on a scale of 1 – 10, meaning how great is your awareness/sensitivity to nuances of culture in your practice? For example: what do you do to recognize cultural differences? (think about culture as including rural versus urban, catholic versus protestant, rich versus poor, young versus old, nationality, ethnicity) - Do you have unanswered questions about culture in clinical practice that might make for interesting occupational therapy research?



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References Black, R. M., & Wells, S. A. (2007). Culture and occupation: A model of empowerment in occupational therapy. Bethesda, MD: AOTA Press. Bonder, B., Martin, L., & Miracle, A. W. (2002). Culture in clinical care. Thorofare, NJ: Slack. Boyacigiller, N. A., Goodman, R. A., Phillips, M. E., & John E. Anderson Graduate School of Management at UCLA. (2003). Crossing cultures: Insights from master teachers. New York: Routledge Clandinin, D. J. (2007). Handbook of narrative inquiry: mapping a methodology. Thousand Oaks, Calif: Sage Publications. Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and story in qualitative research. San Francisco: Jossey-Bass Publishers Clandinin, D.J. & Rosiek, J. (2007). Mapping a Landscape of Narrative Inquiry: Borderland Spaces and Tensions in Clandinin, D. J., Handbook of narrative inquiry: mapping a methodology. Thousand Oaks, Calif: Sage Publications. .



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Czymoniewicz-Klippel, M.T. (2011) Researching to learn: embracing occupational justice to understand Cambodian children and childhoods. (Kindle Locations 16318-16790). in Kronenberg, F., Pollard, N., & Sakellariou, D. Occupational therapies without borders: Towards an ecology of occupation-based practices. Edinburgh: Churchill Livingstone/Elsevier . (kindle edition). Deardorff, D. K. (2009). The Sage handbook of intercultural competence. Thousand Oaks, Calif: Sage Publications. Denzin, N. K., & Lincoln, Y. S. (2000). Handbook of qualitative research. Thousand Oaks, Calif: Sage Publications. Ellis, C. (2013) Preface: Carrying the Torch for Autoethnography, in Jones, S.H., Adams, T. E., & Ellis, C., Handbook of Autoethnography. Chicago: Left Coast Press. Gallardo, M. E., Yeh, C.J., Trimble, J.E., Parham, T.A., Eds. (2012). Culturally adaptive counseling skills: Demonstrations of evidence-based practices. Thousand Oaks, Calif: Sage Publications.



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Hoppes, S., Ballou, H. T., & Robinson, C. (2007). A Course in Autoethnography: Fostering Reflective Practitioners in Occupational Therapy. Occupational Therapy in Health Care, 21, 133-143. Jones, S.H., Adams, T. E., & Ellis, C. (2013). Handbook of Autoethnography. Chicago: Left Coast Press. Josselson, R. (1996). "Introduction," in R. Josselson (ed.). Ethics and Process in the Narrative Study of Lives . Thousand Oaks, CA: Sage Publications. Josselson, R. (2006). Narrative research and the challenge of accumulating knowledge. Narrative Inquiry, 16, 1. Josselson, R. (2007) “The Ethical Attitude in Narrative Research: Principles and Practicalities,” in Clandinin, D.J. (ed.) Handbook of Narrative Inquiry: Mapping a Methodology. Thousand Oaks, Ca: Sage.



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Kim, Y.Y., (2009). The Identity Factor in Intercultural Competence, in Deardorff, D. K., The Sage Handbook of Intercultural Competence. Thousand Oaks, Calif: Sage Publications. Muňoz, J.P. (2007). Culturally responsive caring in occupational therapy. Occupational Therapy International, 14 (4), 256 – 280. Spitzberg D.H., & Changnon, G. (2009). Ch. 1 Conceptualizing Intercultural Competence, in Deardorff, D.K., Sage Handbook of Intercultural Competence, Thousand Oaks, Calif: Sage Publications. Sue, D.W., Ivey, A.E., Pedersen P.B. (1996). A Theory of Multicultural Counseling & Therapy. Pacific Grove, Ca: Brooks/Cole Publishing Co. Trahar, S. (2011). Learning and teaching narrative inquiry: Travelling in the Borderlands. Amsterdam: John Benjamins. Tylor, E. B. (1970). The origins of culture. Gloucester, Mass: Peter Smith. Wilson, S. (2008). Research is ceremony: Indigenous research methods. Black Point, N.S: Fernwood Pub.

1 jocelyn campbell, o.t. feb. 27, 2014 post professional ......feb. 27, 2014 lunch & learn 10...

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