Reflecting on our effectiveness: Occupational therapy interventions with Indigenous clients

Background: The health and social inequity experienced by the Indigenous population of Australia has resulted in the establishment of a national priority to close the gap in health outcomes. The occupational therapy profession is being urged to ensure the cultural appropriateness of practice interventions for Indigenous people. Although the importance of practice modification has been recognised by the occupational therapy profession, minimal research has been conducted in relation to older Aboriginal and Torres Strait Islander populations. Method: The aim of this study was to explore occupational therapists' views of their effectiveness when practising with Indigenous clients. The qualitative study utilises in-depth interviews with occupational therapists working in a regional centre of North Queensland to explore their views of effectiveness when modifying interventions for Indigenous clients. Results: Inductive thematic analysis of the descriptive data generated four themes. The first theme provides insights into participants' views of effectiveness when providing interventions to Indigenous clients. The remaining themes identify specific modification as (i) awareness of culture and respect for the individual, (ii) developing different expectations and (iii) ensuring equality of outcomes. Conclusion: The study supports the importance of modifying practice to provide culturally safe occupational therapy to Indigenous clients. The importance of adopting a client-centred approach in modifying interventions is also highlighted. Self-reflection by the therapist regarding their occupational therapy practice with Indigenous clients is strongly suggested. In response, a self-reflection tool has been developed from the findings of the study.