Occupational multi-level responsiveness: Describing the skills used by occupational therapists working with children seeking asylum in Australia

Abstract

Background Children seeking asylum face occupational deprivation and human rights violations. No research has investigated how occupational therapists work with child asylum seekers. The World Federation of Occupational Therapists promotes the Canadian Model of Client-Centred Enablement (CMCE) for occupational therapists working to promote human rights. Aims/objectives This research investigates use of CMCE skills to investigate skills occupational therapists use when working with child asylum seekers in Australian immigration detention. Material and methods Interpretive description guided this investigation and purposive sampling was used to recruit 10 occupational therapists. Semi-structured interviews were conducted and thematically analysed. Results Occupational multi-level responsiveness, an overarching practice skill, involved keying into individual, family and socio-political levels to respond to occupational injustices. A wide array of practice skills extending beyond the CMCE framework were used in a nuanced and interwoven manner spanning multiple levels. Conclusions Occupational multi-level responsiveness described occupational therapists working across macro-, meso- and micro-levels. Significance Understanding and enacting occupational multi-level responsiveness may support occupational therapists to plan and implement effective strategies when tackling occupational injustices. The skills identified may be applicable to other complex socio-political fields of practice. More research is needed. Further research should also investigate the occupational experiences of children seeking asylum. KEY POINTS Occupational therapists working with child asylum seekers in Australia take a multi-level approach, responding to individuals, families and socio-political structures. A three pronged approach to implementation of the occupational therapy practice process could support multi-level responsiveness to enhance practice that addresses occupational injustices. CMCE skills are not exhaustive and therapists discussed using other skills beyond those listed in the CMCE. Additional skills reflected humility and efforts towards more equal relationships between therapists and clients.