Creating Culturally Safe Vocational Rehabilitation Services for Indigenous Australians: A Brief Review of the Literature

Abstract

This article reviews the research evidence on vocational rehabilitation services and rehabilitation counselling practice with Indigenous Australians. It applied a context sensitive, cultural safety and reflexivity approach to construct salient themes from the research evidence. Findings suggest Indigenous Australians with disabilities experience significant ‘double-disadvantage’, and that vocational rehabilitation service providers lack the knowledge and skills in culturally safe practice in order to enhance the opportunities for social and economic inclusion of Indigenous Australians. A whole-of-profession approach, incorporating and ensuring Indigenous client equity and cultural safety in vocational rehabilitation, is critically and urgently needed.

Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition

“…Narrow conceptualizations of culture and identity may limit the effectiveness of particular approaches, and a focus on specific cultural information may inadvertently promote stereotyping.[31]Cultural Awarenessa beginning step towards understanding that there is difference. Many people undergo courses designed to sensitise them to formal ritual rather than the emotional, social, economic and political context in which people exist[30][is] concerned with having knowledge about cultural but, more specifically, ethnic diversity.[32]an individual’s awareness of her/his own views such as ethnocentric, biased and prejudiced beliefs towards other cultures (p. e120)[33]essentially the basic acknowledgment of differences between cultures[34]recognizing that there are differences between cultures[35]Cultural Sensitivityalerts students to the legitimacy of difference and begins a process of self-exploration as the powerful bearers of their own life experience and realities and the impact this may have on others.[30]building on the awareness of difference through cultural acceptance, respect and understanding[36]builds on cultural awareness’ acknowledgment of difference with the addition of the requirement of respecting other cultures[34]where students start to analyse their own realities and the impact that this may have on others.[35]Cultural Humilityincorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and non-paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.[37]entails valuing life-long learning and critical self-reflection, along with a respectful and inquisitive approach whereby practitioners are expected to seek knowledge from their clients regarding their cultural and structural influences rather than assuming understanding or expertise about a culture outside of their own[38]defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individual’s cultural background and experience.[39]does not have an endpoint or goal; there is no objective of mastering another culture. Rather it is a continual process of self-reflection and self-critique that overtly addresses power inequities between providers and clients.…”

“…A key difference between the concepts of cultural competency and cultural safety is the notion of ‘power’. There is a large body of work, developed over many years, describing the nuances of the two terms [34, 36, 38, 43, 46, 49, 59, 62–69]. Similar to cultural competency, this concept has varying interpretations within and between countries.…”