Engaging with poverty: A New Zealand occupational therapy perspective
27 November 2019
Cathcart, H. (2019). Engaging with poverty: A New Zealand occupational therapy perspective. (A thesis submitted in partial fulfilment of the degree of Master of Occupational Therapy at Otago Polytechnic, Dunedin, New Zealand.) [PDF 4MB]
Poverty is a significant global issue that is internationally recognised as a violation of human rights, and the United Nations is committed to the eradication of extreme poverty. Although New Zealand does not experience the extreme deprivation seen in developing nations, poverty is an area of growing concern in New Zealand society. Because of the widespread nature of poverty in New Zealand, it is important for occupational therapists to be aware of the impact of poverty on their clients, and on therapeutic interventions.
The aim of this research was to explore how occupational therapists engage with issues of poverty in their practice. Using an interpretive descriptive methodology, interviews were carried out with nine occupational therapists from a range of practice areas across New Zealand. Participants were asked to reflect on what they have seen in relation to poverty in their practice, the impact of poverty on their client’s occupational participation and engagement with therapy, how therapists are able to respond to poverty within their roles, and specific challenges they face when engaging with clients who are impacted by poverty.
The participants in this research demonstrated that they engage with poverty in a holistic way. Poverty was identified as a multifaceted issue that encompasses a range of personal and social factors, not simply limited to inadequate finances or physical resources. Poverty impacts clients of occupational therapy, carers and support staff that work alongside occupational therapy clients, community organisations and charities that support vulnerable members of society, and even the very services that employ occupational therapists.
When faced with poverty in practice, occupational therapists engage with their hearts, heads, and hands. That is, they take the time to understand and empathise with their client's situations; they grapple with issues of poverty, specifically as these issues relate to ethics, justice and human rights; and finally, they act in practical ways to address issues of poverty. The strategies used to address poverty for their clients were the same tools and strategies used by occupational therapists every day in both the presence and the absence of poverty – referrals, documentation, clinical reasoning, peer support and supervision, advocacy, and occupational engagement. Participants also reflected on the way in which personal experiences and professional values shape the way they engage with issues of poverty and deprivation.
While this study has demonstrated the ways in which occupational therapists in New Zealand already engage with poverty in their practice, there was also a sense from most of the participants that occupational therapy is not yet doing enough to engage with and address the ways in which poverty violates human and occupational rights. This research wishes first to celebrate the tireless work that occupational therapists in New Zealand are doing to engage with and address poverty in their practice, and then to stimulate discussion about poverty in occupational therapy practice, both about the successes and the challenges of engaging with this widespread injustice. Recommendations from this research include strengthing occupational therapy discourse about poverty, challenging the way in which occupational therapy and occupational science think about and conceptualise poverty, expanding occupational therapy practice to address poverty more effectively, and evaluating the responsiveness of occupational therapy to issues of poverty. It is hoped that these recommendations will inspire and equip occupational therapists to take further action to engage with and address poverty for individuals, families and whanau, communities, and New Zealand society as a whole.
Heidi Cathcart's thesis was supervised by Mary Butler.
This thesis is available under a Creative Commons licence Attribution-NonCommercial-NoDerivatives 4.0 International