Culture and diversity among occupational therapists in Ireland: when the therapist is the 'diverse' one

Introduction: Literature in occupational therapy, although paying increased attention to cultural differences and diversity, has largely ignored the situation of therapists who are themselves members of social and cultural minority groups. 'Difference' is assumed to be exclusively an attribute of the client. Method: This qualitative study explored the professional experiences of 12 occupational therapists in Ireland who self-identified as disabled or ethnic minority group members. Findings: Participants reported challenges with colleagues and managers, which revolved primarily around cultural differences in the norms and expectations guiding social interactions, communications and practice styles. Overt discrimination was reported only by disabled therapists. With clients, again there were clashes of cultural values, but participants also experienced overt and covert prejudice and intolerance. This was particularly difficult to respond to in the context of client-centred practice. Conclusion: Cultural competence, as the prevailing approach to diversity, emphasises suspending one's own values to facilitate those of clients. This demand may be inappropriate for minority therapists who may face prejudice and discrimination. In contrast, cultural humility and critical reflexivity emphasise negotiating values in the context of social power relations, an approach that may better position occupational therapy to benefit from a diverse workforce.