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In the work of an occupational therapist, prejudice is very relevant. Prejudice is a big issue in any health sector professions, as professionals are interacting with a wide range of people every day from minority groups. A study done in 1998 of the rates of prejudice among nursing students showed that most of them had a limited awareness of race issues but still said they would feel comfortable working with individuals of other races, however their attitudes towards sexual minorities were more negative (Eliason, 1998). While this study is rather dated and society as a whole has become a lot more accepting and aware of minorities in recent years, prejudice is still present and as seen in this study can present a huge problem for healthcare workers, as it is crucial for these professionals to be able to give the same high standard of care to all individuals. A more recent study among occupational therapists examining gender prejudicing showed that gendered perceptions shaped interventions. For example, when assessing the client, the therapists focused more on household and family for female clients and more on paid work for male clients (Liedberg, Björk & Hensing, 2010). The occupational therapist based their intervention process on their perceived interests of the client which were based on stereotypes, rather than letting the client shape the intervention. For an occupational therapist, one of the most important things is that the client can trust the therapist and feels valued and listened to. If a therapist has negative preconceptions about the client, is will be more difficult develop an empathetic and trusting relationship with them.
By looking at the theories, we can begin to understand the implications of prejudice in the practise of an occupational therapist. The self-fulfilling theory can be applied to the 2010 study of occupational therapists. The therapists expected the clients to prioritise their gender-stereotyped roles, and so designed an assessment process which focused on these roles. The therapists were prompting behaviours based on their own expectation of the client group. This shows the effect that prejudice has on the work of an occupational therapist.
The social identity theory can also be applied to this scenario, as it is based on the principal that members of a different social group are the same. Particularly when an occupational therapist is working with a client of a different gender, they will be more likely to generalise their behaviours and interests with those that are typical of the client’s social group. However, it could also be considered that in some cases, prejudice could assist and speed up the intervention process. In some cases, it may be more efficient to focus on assessments based on typical gender roles as it is likely that for instance many male clients will prioritise paid work over housework. Still, it is important to remember than people are individuals and therapy must be tailored to the needs and wants of that individual. In the study of prejudice among nursing students, it is noted that healthcare professionals are predominantly white, nursing being one of them. The social identity theory states that individuals will show preference towards individuals of the same social group – in this case, the nurses are more comfortable working with other white heterosexual patients – and individuals will expect a more diverse set of behaviours from their ingroup, whereas they have an expectation of outgroup members to have more similar behaviours. This explains why the nurses were less familiar or comfortable with members of different racial or sexual orientation groups. The unfamiliarity with these group has led the nurses in the study to believe that members of these groups will all display the same traits and will be different to their white skinned heterosexual counterparts.
It is important for an occupational to consider throughout practice whether their prejudicing of clients is affecting their work, particularly with clients coming in with issues that may not be as socially understood or accepted. For instance, if a client has a spinal cord injury as a result of driving under the influence of alcohol, it is important that the therapist focuses on the current function and satisfaction of the client and not let the fact that the client was drink driving affect the intervention negatively.
It is particularly important to avoid prejudice when interacting with clients who have various mental health issues such as depression or schizophrenia. While it is easy to categorize these individuals into a group and provide them with a generalized intervention for their mental illness, it is more important for an occupational therapist to consider the client’s occupational problems in their daily life, which will be different from person to person.
Prejudice has numerous implications for the practice of an occupational therapist. Despite most healthcare professionals consciously adopting a more democratic approach, unconscious prejudices can shape the work they do. Prejudice can affect therapy in several ways, like altering perceptions – their prejudgement of a group can affect their opinion of clients. Prejudice can also cause a therapist to not recognise power dynamics, for instance between a white therapist and a black client, or a male therapist and a female client, or within a group between members. As I mentioned earlier, prejudice can also cause the therapist to generalise the intervention based on their beliefs of the values of the client’s group, which will often be inaccurate and irrelevant.
There are multiple approaches that can be taken to overcome these prejudices. One approach would be to adapt the education of health professionals to provide them with additional tools for counteracting the influence of prejudice. Teaching to promote positive relations and frames of minds may be more effective in preventing prejudice than teaching to suppress stereotypes, as these stereotypes will more than likely remain however it is more important to teach the occupational therapist to focus on more positive aspects instead (Betancourt & Green, 2010). By occupational therapists working to develop new mental habits, they can learn self-regulation of bias, and negative prejudices may be overridden by more democratic motives (Monteith, Arthur & Flynn, 2010). It would be helpful to focus on common group memberships, such as shared interests or hobbies, rather than the different group memberships such as race, gender and sexuality. This would help both reduce prejudice and improve trust between the client and therapist.
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