Relevant OT/OS Research Updates, April 2019

Once again, we want to highlight the North American Refugee Health conference June 14-16 at the Sheraton Centre Toronto Hotel, Toronto, Canada where one of the network’s co-chairs, Sara Abdo, will be presenting! Register in advance in order to attend.

Many of the network’s members are researchers; either through a faculty or student role.

In our last newsletter we highlighted the recently published study by network member and OT Nadine Blankvoort, who is a PhD Researcher in the area of Refugee Integration programs in the Netherlands.

In this newsletter we would like to highlight a current project being undertaken by Network member Heidi Lauckner (project lead, Dalhousie University), and recent publications by Network member Suzanne Huot (UBC).

Heidi Lauckner’s multi-phase two-year community development project (2019-2020), titled Empowering Newcomers for Recreation Leadership, “will engage newcomers in identifying ways to integrate into, adapt, or initiate recreation programming that is created by and for them. This initiative focuses on leadership development, and provides a sustainable means of introducing newcomers to community recreation by putting newcomers themselves at the centre of program development and facilitation.”

Project methods and approaches will include multi-member stakeholder collaboration, a peer support model, a photo project/exhibit, and train-the-trainers leadership programming. We look forward to hearing more about this very innovative and exciting project as it continues!


Suzanne Huot, an occupational scientist on faculty with UBC’s OT school, has contributed to a number of recently published studies and articles relevant to the occupational engagement of newcomers. Six of these articles are listed below. Thank you so much for your important continued work in this area, Suzanne!

Six Relevant Newcomer-Related Research Publications authored by Suzanne Huot (Occupational Scientist):

 

Abstract excerpt: “Refugee populations are particularly vulnerable to marginalization and have reduced social networks. In the present study we explored whether, how, and why participation in choir singing, as an example of an everyday occupation, could be of significance for refugees in their transition to a new daily life in a Norwegian municipality… Staying occupied and meeting with people were found to be two key strategies to develop a sense of belonging…Their choir participation was thus a part of their experience of searching for identity within their new context.”

Abstract excerpt: “Our study examines the power of language in shaping immigrants’ engagement in occupations during their integration into a host society. Beyond serving as a means of communication, language is understood as a form of capital that is mediated through social power relations. We used a qualitative secondary analysis methodology that adopted an occupation-focused perspective to study 20 transcripts generated through narrative and semi-structured interviews with 10 immigrants in a mid-sized Canadian city. ‘Learning English’ was identified as the overarching theme that connected to the sub-themes of accessing resources during settlement, economic integration, social and cultural integration and isolation, and family. Findings illustrate specific ways that the mediation of engagement in occupations through the host society’s dominant language creates challenges for immigrants’ integration experiences. Ultimately, the dominance of English in Canada poses barriers to engagement in needed and wanted occupations for immigrants who do not possess this valued linguistic capital.”

Abstract excerpt: “The purpose of this paper is to illustrate how the differential value of immigrants’ symbolic capital within the host societies’ fields influenced their engagement in daily occupations and shaped their socio-economic integration. It is argued that the misrecognition of capital contributes to symbolic violence experienced by immigrants who must subsequently engage in a range of occupations in order to regain forms of symbolic capital that are lost and devalued following immigration. A study was conducted with a multinational group of immigrants in London, Ontario, Canada and Auckland, New Zealand, using narrative and visual methods… Results illustrate a reciprocal relationship between occupation and symbolic capital, whereby recognition of the latter facilitated immigrants’ everyday ‘doing’.

Abstract excerpt: “We examined the role of minority community spaces (e.g. schools, places of worship, community centres) for supporting participation in occupations among French-speaking immigrants and refugees in Canada who settled in two Anglophone dominant cities. Fifty six people from diverse countries participated in eight focus groups (four in each city) conducted as part of a larger, four stage comparative case study… We contend that community spaces can provide important opportunities for linguistic minority community members to engage in meaningful occupations, but these must attend to the heterogeneity of the populations they serve.”

Abstract excerpt: The participants’ employment related occupations were characterized by the overarching theme of ‘making difficult decisions’. This main theme was connected to four related sub-themes: 1) mechanisms of exclusion, 2) learning the host country’s culture, 3) the influence of one’s outlook on the decisions made, and 4) accessing support… ‘Making difficult decisions’ was faced by all participants throughout the process of becoming part of the Canadian workforce and, ultimately, society at large.

Abstract excerpt: “International or internal migration as a result of unexpected circumstances, such as that experienced by forced migrants (i.e. refugees, asylum seekers and internally displaced persons), can disrupt established occupations. Occupational therapists have the potential to improve quality of life by re-establishing lost occupations. Research on forced migrants has been increasing within the occupation-based literature and has the potential to inform practice with this population. Our aim was to identify and synthesize current knowledge of the occupational experiences of forced migrants…Based on a total of 320 studies that were identified, 24 met the inclusion criteria. Six themes emerged as a result of the data extraction and synthesis process:occupational deprivation, occupational imbalance, occupational adaptation, occupational change, efforts to maintain and re-establish identity, and outlook for the future.”


OT Now Article – Making the Connection: Why refugee and asylum seekers need occupational therapy services:

In the last month we were contacted by an OT in Quebec, who brought the following OT Now article to our attention: Making the Connection: Why refugee and asylum seekers need occupational therapy services (July/August 2017, open access), by Kara Winlaw, a community OT working in BC at the time of publication. We highly recommend the article!

It is a great read with a strong call to action for OTs in Canada. Here is an excerpt:

“Many professions and organizations within Canada are dedicated to addressing the challenges faced by refugees and asylum seekers. However, by and large, occupational therapists appear to be missing from this landscape… Our lack of professional input with refugees and asylum seekers is not simply a missed opportunity; it fundamentally represents a failure to uphold our professional values… Now, more than ever, is the time to show support for refugees and asylum seekers by ensuring they have access to the same health care services as the rest of the Canadian population.

By devoting our time to this cause, we would be confronting one of the biggest challenges in the global community while honouring our historical commitment to social justice (Trimboli & Taylor, 2016)”.
~ Kara Winlaw (2017)


Recent Ethnographic Newcomer Research by Grounded Space in Toronto, ON & Surrey, BC – “Emotional Ambivalence” as key finding:

I have been following the work of In With Forward, a “social design organization” for a few years now, and I have been so impressed with the innovative work that they have been doing in Canada since 2014 – primarily operating in Toronto, Ontario and Surrey, British Colombia. Their aim is to change social services through ethnographic research, collaboration and experimentation, in order to make social support systems more like trampolines, and less like safety nets.

In the last couple years IWF received funding to build Grounded Space, “Canada’s first Social Research & Development Collective”, to continue building capacity and developing effective change-making services that meet the needs of Canada’s most marginalized folks.

Bottom-up, ethnographic, grounded theory research is the backbone of most of their work as they build upward toward prototyping solutions and implementing service shifts with community partners.

But what does this have to do with occupation?

Since October 2018, with funding from Immigration, Refugees, and Citizenship Canada, In With Forward in their iteration as Grounded Space, has been “partnering with North York Community House in Toronto and Options Community Services in Surrey to capture the experiences of newcomers and re-imagine parts of their journey.” Their process up to now, which involved ethnographic research with 65 newcomers in Toronto and Surrey, is presented in an engaging and insightful publication called “The Sense Maker” (March 2019); a beautiful example of accessible knowledge translation.

I think there are a lot of insights in their research process that are relevant to occupational engagement and the potential role of an OT in supporting newcomers with navigating “emotional ambivalence” as they transition to their new home (their key finding/theme).

Here’s a brief introduction to their findings and the exploratory questions they present related to the emotional ambivalence of migration (a phenomenon I have personally witnessed repeatedly with many newcomers):

“Eros, who moved to Canada from the Philippines to reunite with his mother, feels both lost and found. Maria and Sal, who came to Canada from Mexico to reunite with their kids, experience both peace and disappointment. Nandeep, who immigrated to Canada from Punjab state, holds both acceptance and sadness.

So often when we talk of migration, we go big picture, describing international currents, economic drivers, and security situations. So often when talk of resettlement, we go practical, focusing on housing, jobs, and English classes. And yet beneath the politics and the pragmatics, emotions percolate.Migration, as Professors Paulo Boccagni and Loretta Baldassar remind us, entails the renegotiation of self and others in new and old places. That re-negotiation process is laden with feelings. And those feelings are experienced internally, within bodies, and externally, within social contexts, through our words, expressions, customs, and interactions. Moving to a new country means constantly moving emotions.

And yet, emotions are too often marginalized throughout the migration process, only to later be cordoned off as mental health issues, requiring specialist mental health supports.

What if we recognized and embraced ambivalent emotions throughout the resettlement process — from pre-arrival, to month 13 (when initial supports come to an end) to year three (when Canadian citizenship becomes a possibility)? What if we understood that anticipation, relief, gratitude, and hope is often mixed with disappointment, worry, sadness, and humiliation?

How might we create new kinds of spaces and supports to move through ambivalence — and not silo emotions to clinical spaces or filter them through Western conceptions of mental health? This is the opportunity space Grounded Space will explore over the next three months.”

Check out their publication “The Sense Maker” (March 2019) for more of their insightful, Canadian-based research!


OOFRAS Announcement – A Documentary Film about OT work with Refugees:

As a final announcement regarding research related initiatives, OOFRAS has shared the following with the co-chairs to forward on:

The World Federation of Occupational Therapists (WFOT) has partnered with Reality Learning to create a documentary film about occupational therapy work with refugees. It will be used in online professional development modules about working with refugees. Please consider donating to support the creation the film and learning modules.”

The Synopsis of the 15-minute educational and awareness-raising film reads as follows: “Theo is a committed, occupational therapist managing human rights for the influx of over 60,000 people displaced from around the world to refugee camps in Greece. Taking personal and professional risks, he works with teenager Sohail and artist Nakam, to unravel the secrets of working and living in ‘limbo’, of building meaningful lives and thriving communities.”

 

Questions for Reflection & Action:

  • What are current OT/OS research gaps in the Canadian newcomer field that need to be addressed?
  • How might occupational therapists/scientists collaborate with a partnership initiative like Grounded Space?
  • How could OTs more effectively support newcomers with navigating emotional ambivalence and difficult emotional experiences, regardless of whether or not they qualify for a mental health diagnosis?
  • How can the Occupational Justice for Newcomers Network collaborate and network effectively with larger international networks like OOFRAS?
  • How can OTs respond to Kara Winlaw’s (2017) call-to-action: “Our lack of professional input with refugees and asylum seekers is not simply a missed opportunity; it fundamentally represents a failure to uphold our professional values… Now, more than ever, is the time to show support for refugees and asylum seekers by ensuring they have access to the same health care services as the rest of the Canadian population. By devoting our time to this cause, we would be confronting one of the biggest challenges in the global community while honouring our historical commitment to social justice (Trimboli & Taylor, 2016)”.

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