Beyond Good Intentions: Moving to Indigenous Cultural Safety

Transcription

1 Beyond Good Intentions: Moving to Indigenous Cultural Safety Cheryl Ward MSW RSW EdD (abd) Provincial Lead Journey to Safety: Creating a Place of Belonging February 19, 2015 Ottawa, Ontario

2 All meetings are transformations, what brings you here? Kwakwaka'wakw

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5 Indigenous Cultural Competency Training Program Online 8-10 hours Interactive Facilitated Self-paced Interdisciplinary learning pods Group discussions and facilitated journal process

6 The Reality The difference in health outcomes between First Nations [Indigenous people] and other British Columbians is unacceptable & unsustainable. Transformative Change Accord First Nations Health Plan, 2005

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11 Pathway to Cultural Destructiveness Stereotype (beliefs) Prejudice (attitudes) Discrimination (behaviours) they are all drunks! another one of those kids looking for free stuff. those people are just drug seeking. Patronizing Anger Resentment Disgust Resentment Etc. Avoiding Withholding services Putting beliefs into ACTION

12 Narratives Pathology Denial Cultural Differences

13 Pathology Drunks Not fully human Defective genes

14 Denial Discovery Conquered people Past is in the past

15 Cultural Differences Families too large just how they are.. they don t care about themselves

16 Primary Narratives: Cultural Differences Denial Pathology

17 If it is not one thing it is another 9

18 Predictable Process Learning Integration Unlearning Groan Zone Praxis

19 Facilitation Primary Narratives Reconciling Implications for Practice

20 Participant Profile Spectrum Highly Defended Hostile Engaged Empathic Truth tellers Next Steps: ACTION 20 % 20 % 5-10% 5-10% 20 % 20 %

21 Sites of Resistance Not so much., ummm ok. sort of.

22 Racism But my people experienced oppression too! There are always a few bad apples but

23 Colour Blindness I work hard to treat everyone exactly the same. If people just worked harder

24 Cultural Safety Continuum What s the problem? Our program treats everyone exactly the same! Never mind him, he is probably just drunk! Cultural Destructiveness I can t believe how often I refer patients to the Sacred Space Cultural Blindness Cultural Competence Cultural Safety Cultural Incapacity Cultural Pre- Competence It has taken a lot of work, but the numbers of Aboriginal patients has increased dramatically! I think is essential to have Aboriginal perspectives here. Training shouldn t just be about Aboriginal people. Other people have experienced oppression too. Adapted from Terry Cross, 1988 Used with permission

25 Cultural Safety Continuum Cultural Safety Cultural Competence Cultural Blindness Cultural Pre- Competence Cultural Destructiveness Cultural Incapacity Adapted from Terry Cross, 1988 Used with permission

26 Organizations: Indigenous Cultural Safety Anti-Racism Response Training Interventions Organization Wide Training Plan Evaluation Phase I Foundational Training Pre & Post Testing Strategies for Backlash Resistance to Training Phase II Nation Specific Training Phase III Communities of Practice Issues Integration Clinical Interventions Complaints Internal Interventions Hot Spots Community Profiles Partnerships Accountability Loop ICC Program 2014

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28 "If You Think Truth is Hard, Reconciliation is Harder Justice Murray Sinclair, 2014 Questions?

29 Sources Browne, A.J., Fiske, J., & Thomas, G. (2000). First Nations women s encounters with mainstream health care services and systems. Vancouver: British Columbia Centre of Excellence for Women s Health. Browne, A.J., Johnson, J.L., Bottorff, J.L., Grewal, S., & Hilton, A.B. (2002). Recognizing discrimination in nursing practice. Canadian Nurse, 98(5), Browne, A.J., & Fiske, J. (2001). First Nations women s encounters with mainstream health care services. Western Journal of Nursing Research, 23(2), Cross, T. (1988). Cultural Competency Proficiency Scale. Henry, F. & Tator, C., (2010). The Colour of Democracy: Racism in Canadian Society. Toronto: Nelson Education. Indigenous Cultural Competency Training Program (ICC), Provincial Health Services Authority, Vancouver, BC. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. (2003). Institute of Medicine of the National Academies. Jackson, L. (2011). The Psychology of Prejudice: From Attitudes to Social Action. Washington: American Psychological Association. Lopes, T. & Thomas, B. (2006). Dancing on Live Embers: Challenging Racism in Organizations. Toronto: Between the Lines. Martis, T. FRAMEWORK FOR ACTION: Cultural Proficiency & Diversity. Winnipeg Regional Health Authority. McGibbon, E. & Etowa, J. (2009). Anti-Racist Health Care Practice. Toronto: Canadian Scholars Press Inc. Mezirow, J. & Taylor, E. (2009). Transformative Learning in Practice. San Francisco: Jossey-Bass. Okun, T. (2010). The Emperor Has No Clothes: Teaching About Race and Racism to People Who Don t Want to Know. North Carolina: Information Age Publishing. Papadopoulos, I. (2008). Transcultural Health and Social Care: Development of Culturally Competent Practitioners. Toronto: Elsevier. Ring, J. et al (2008). Curriculum for Culturally Responsive Health Care. Oxon: Radcliff Publishing Ltd. Srivastava. R. (2007). Guide to Clinical Cultural Competence.(Toronto: Elsevier Canada. Sue, D. (2010). Microaggressions and Marginality. New Jersey: John Wiley & Sons. Prepared by Ward, C. (2015)PHSA ICC Program icc@phsa.ca