An occupational therapy approach to the support of a young immigrant female's mental health: A story of bicultural personal growth

Abstract

Young immigrants who suffer from psychosis perceive their illness from the outlook of at least two cultures, which is often a source of confusion and misunderstanding for clients, their families, and clinicians. This article presents a case study with a narrative approach, aiming to illustrate how an occupational therapy intervention can highlight the role of culture and address bicultural identification in a young adult immigrant woman with mental health problems. The results show how a culturally adapted intervention model can be used to help the client go through a transition from an interdependent to a more independent self. During the course of occupational therapy, the client gained greater insight into her problems and could view herself as integrating numerous facets related to two different social and cultural contexts. Moreover, the client achieved better skills in dealing with discrepancies and cultural contradictions and became capable of relying on either or both of the cultures in different situations.

Occupational therapy and culture: a literature review

“…A negotiation process then starts, called acculturation (34). The process may promote or restrict social inclusion in the new culture (34,38,57). .…”

“…This could imply, on a basic level, being aware of tangible markers of culture, such as customs, language, dance, crafts, art, and a system of rules, including values and perceptions (43,52). On a more complex level, cultural awareness, respect for cultural heritage, cultural humility, cultural literacy, cultural knowledge, cultural sensitivity, and cultural and transcultural competence are described as key issues for responsive interventions in terms of culture for OT (34,35,38,39,42,43,(45)(46)(47)52,55,57,66). These interventions must be adjusted to the contexts of practice (40,46).…”

“…According to the articles, the way in which power relationships are established between OTs and clients should be included in the analysis as well as in therapeutic strategies, especially when culture is involved (31,32,38,39,43,44,50,54,56,58,60). If not, clashes or dilemmas with regard to culture can appear in therapeutic relationships (39,55,57,67). .…”

“…These concepts are not meaningful in a universal way but have been used as if they were (49). Given the same influences on rehabilitation theory and OT development, there is an unaddressed need to cover rehabilitation requirements of very diverse clientele in terms of culture worldwide (31,33,34,(37)(38)(39)(40)(41)(42)(43)(44)(45)(47)(48)(49)(50)52,54,55,(57)(58)(59)(60)(61)68). These Western influences could determine a certain dominant culture within the discipline or show a class-specific character in the professional knowledge (48).…”

“…From static to dynamic. The first force expresses how the concept of culture has changed in the past decades, from being static and centred on ethnicity to a dynamic, complex, and multidimensional entity (34,35,39,40,42,49,53,57,69). Despite this, the static or reductionist conceptualization remains in use in the discipline, although with some criticism of this (40).…”