Cultural competence

Under the Health Practitioners Competence Assurance Act 2003 (HPCAA), the OTBNZ is responsible for setting standards of clinical competence, cultural competence, and ethical conduct. The OTBNZ has set seven competencies for registration, which are explained in the OTBNZ document Competencies for Registration as an Occupational Therapist.  Competence 3 relates to cultural competence. However, components of culturally safe practice are embedded in other competence areas (for example Competency 4 – Communication).

Culturally safe practice includes consideration not just of ethnicity, but also dimensions such as gender, spirituality, sexual orientation, ability, life stage, language, socio-economics and the experience of trauma (all of which influence people’s values, beliefs, experiences, and activities).

Cultural competence consists of both culture-specific skills and knowledge, and more generic attitudes, beliefs, values, experience, and approaches to perceived difference; awareness of the potential impact of these on practice; and skills which equip a practitioner to work effectively with people who may come from different cultural contexts.

A significant aspect of the unique sociocultural context in Aotearoa/New Zealand is our bicultural heritage. Much of the focus for social policy and healthcare has been the bicultural relationship between Maori as indigenous people and Pakeha, based on what many consider to be the nation’s founding document, te Tiriti o Waitangi/the Treaty of Waitangi.

To practise effectively as an occupational therapist in Aotearoa/New Zealand requires not only a capacity and preparedness to work with people whose life experiences and culture may be different from your own, but also to integrate the principles of te Tiriti o Waitangi/the Treaty of Waitangi into practice.

When considering cultural competence, practitioners should include evaluation of their own attitudes and beliefs; knowledge of other cultural worldviews and practices; and the range of culturally appropriate strategies at their disposal, including the all-important interpersonal ones, in relation to all the dimensions of culture noted above.