The Treaty-in-action: In research, relationships and (w)riting

Marrin Haggie

Ema Tokolahi

Biographies

Marrin Haggie is of Waikato, Ngāti Mahuta, Ngāti Patupo, Ngāti Tuwharetoa, Te Atihaunui-a-papa-rangi, Ngāti Apa, Te Arawa and Ngā Puhi descent and a Sport and Exercise lecturer at the Waikato Institute of Technology. As a lecturer and researcher in Exercise Physiology and Strength & Conditioning, his area of practice also extends to Māori and Indigenous health. Marrin’s doctoral thesis included the formation and creation of a Waikato-specific Māori health model. Marrin utilized the principles of Rangahau Kaupapa Māori to create the bespoke health model for his people of the Waikato iwi, and to introduce the concept of Tupuna Guided Living.

Ema Tokolahi is an occupational therapy lecturer at Otago Polytechnic and a post-doctoral research fellow at Wintec. Originally from the United Kingdom, she immigrated to New Zealand in 2005 and felt an instant connection with the place and the people – she is striving to grow and develop her understanding of Te Ao Māori and how to serve as an authentic Treaty partner in her practice, teaching and research. Ema has previously worked in mental health services for children, adolescents and adults.  Ema received her doctoral degree from Auckland University of Technology in 2017 after evaluating the impact of a preventative occupational therapy intervention on children’s wellbeing in the school environment.  She has since been involved in research exploring: role emerging placements; interprofessional workforce development; feasibility of an interprofessional student-assisted health service in partnership with iwi/community organisations; and expansion of student health placements through a Pasifika cultural organisation.

Abstract

In this kōrero we will reflect on our relationship as Treaty partners in conducting a research study. We will illustrate how relationships were fundamental to the successful design of the study and analysis of the data, and how this was achieved using an approach that was inclusive of, and elevated, a Māori world view in the context of a Western academic institution. The study explored the feasibility of an interprofessional student-assisted health service in partnership with community/iwi organizations. Data were collected using whakawhiti kōrero and analysed using the Qualitative Analysis Guide of Leuven (QUAGOL) – a guide for facilitating the process of analysis. While this is not intended to be an Indigenous methodology, we found it to be respectful of Te Ao Māori and inclusive of perspectives from both sides of the Treaty partnership. We will present the values we believe were upheld through the research process, such as kanohi-ki-te-kanohi and whakamana tangata, with examples of how this looked in our everyday mahi. We will discuss how relationships between researchers ourselves, and the relationships between us and the key stakeholders of the project were dynamic and organic in nature, representing fundamental values in this kaupapa. We will also illustrate the barriers faced and how we navigated through the challenges presented to ensure the mana of all involved was maintained and uplifted.

Rōpū Tāne / Male OT SIG – Group discussion

Dan Johnson

Calling all interested parties to engage in a fun, friendly and frank discussion regarding all things male-related in the world of Occupational Therapy. The intention is a relaxed, unscripted discussion, to allow reflection, camaraderie, and sharing of experiences within our profession. Anyone is welcome to attend the session, for as long as you can make yourself available. We are taking the opportunity presented to us through the use of our digital event to try different forms of engagement, and would love you to join this more socially-focused session.

Recognising moral injury in health care workers in the age of Covid-19

Dan Johnson

Biography:

Dan is a well-travelled UK trained Occupational Therapist, who has been living and working in Aotearoa for nine years. Dan’s Occupational Therapy experiences include living and working in the UK, Vietnam, Romania, Colombia and New Zealand. Dan’s clinical work experiences stretch across a wide spectrum and includes prominent work in the fields of Mental Health, Emergency Acute admission, working with Military and ex-service personnel, PTSI, and cross-cultural practice. Dan also has an extensive publication history including publications in the UK, NZ, WFOT and through blogging media.

Dan’s teaching and lecturing credits include guest lecturing at both Undergraduate and Masters level including University lectures in the UK, Japan, Chile, Argentina and Colombia. Dan has presented at WFOT 2010 & 2014 Congresses in Chile & Japan respectively.

Closer to home Dan has been a keen presenter here in New Zealand with a wide variety of presentations at National events on a variety of topics including ‘The Occupation of Parenting’, ‘The Occupation of Dating’, ‘Entrepreneurialship in Occupational Therapy’, Cross Cultural Practice & Vocational Rehabilitation.

Dan is currently on the OT Council as the Tangata Tiriti, WFOT Delegate, and outside of OT is a keen footballer, coach for Special Olympics Basketball Wellington, husband to Vibi, and father to Santiago and Isaac.

Abstract

Facing trauma in health care settings is not a new phenomenon, however the recognition of the impact of moral dilemmas and moral injuries is scarce by comparison. Global issues of displacement and pandemic induced practice have brought the application of ethical and moral issues in practice into sharper focus.

Whilst Moral Injury is not recognised by the International Classification of Disorders manual, growing evidence is leading to the recognition of how a moral injury can impact on a person’s occupational engagement. The additional sense of shame and guilt that follows a moral injury can compound these effects. Interestingly spirituality and cultural practice have been identified as potential treatment mediums and follow the process of consideration of how culturally derived values are being breached for any given individual. This presentation will:
– introduce the concept of Moral Injury,
– compare and contrast the difference between Moral Injury and PTSD
– highlight findings from current evidence
– Consider how Occupational Therapists can engage in developing interventions, including as part of a Te Tiriti partnership process.

Becoming political actors: Occupational therapists shaping the profession’s future

Yasmin Orton

Clare Hocking

Deborah Payne

Biographies

Yasmin Orton is currently a Doctoral Candidate at AUT. She has practiced as an OT in UK, USA and Aotearoa NZ. Positions over time included both clinical and leadership roles. She recently submitted her Doctorate of Health Science thesis focussed on clinical governance in the DHBs and how it has influenced occupational therapy practice. Writing and researching this thesis enabled Yasmin, a naturalised NZ citizen, to gain further insight and understanding of te Tiriti o Waitangi; how it is the foundation of healthcare delivery in Aotearoa, and why occupational therapists should incorporate Bicultural responsiveness and equitable delivery of healthcare for Māori into practice by engaging in political activism.

Clare Hocking is a Professor of Occupational Science and Therapy at Auckland University of Technology. Of English heritage, Clare’s leadership with Kaiwhakaora ngangahau in Aotearoa now focuses on holding fast to an occupational perspective, advancing the profession’s role in promoting inclusion, and serving as a Treaty partner to strengthen responsiveness to te Tiriti in educational and practice settings.

Deborah Payne is an Associate Professor of Nursing at Auckland University of Technology. Her BA and MA majored in Social Anthropology which gave her an awareness of the diversity of cultures, te Tiriti o Waitangi and the effects of ethnocentrism and colonisation. Deborah was a founding member of the Nursing School’s Bicultural Action Group, and a member of the Kawa Whakaruruhau Komiti.

Abstract

Introduction: Occupational therapy is responsive to ideas circulating in our socio-political context. In historical sequence, we might point to client-centredness, reflective practice, and te Tiriti o Waitangi responsiveness, which arose outside the profession but are now deeply embedded in practice. Incorporating new ideas keeps the profession current but can also create “pinch points” where valued practices must give way to new norms and expectations. Heeding Foucault’s warning that “not everything is bad, but everything is dangerous”, this interactive webinar focuses on clinical governance, a framework adopted from Britain that devolves accountability for safeguarding and continuously improving the quality of health care from managers to all health professionals.

Objectives:

1.       Explore how clinical governance might bring new and old practices into conflict

2.       Through discussion amongst the facilitators and participants, identify opportunities to promote positive changes, such as implementation of Te Tiriti o Waitangi articles, or resist erosion of the things occupational therapists value.

Approach: We begin with a brief overview of some key clinical governance discourses – that is, ideas that shape how we think about things – pointing to what each makes possible or limits everyday practice. Examples include the increasing emphasis given to safety, efficiency, fiscal prudence, and individualistic beliefs about self-responsibility. Emphasis is given to how these ideologies are embedded in a Western worldview. Thus informed, participants are invited to identify pinch points in their own practice, where the drive to eliminate risk, standardize healthcare delivery, and reduce costs might rub up against competing discourses, such as occupation-focused practice, prioritization of equitable health outcomes for Māori, and te Tiriti responsiveness.

Practice Implications: Implementation of clinical governance is steadily changing healthcare priorities, the way DHBs function, and how clients are perceived. Occupational therapists can choose to ‘go with the flow’ or actively engage in shaping the possibilities open to the profession and the people it serves.

Conclusion: Occupational therapists need to become political actors, recognizing the broader impact of choosing to act or not act in response to ongoing health sector reforms and restructures.

Let’s get real: Using these values, attitudes and seven real skills in Kaupapa Māori and other health services

Toni Tinirau

Trish Gledhill

Biographies

Tēnā koutou katoa. Ko Tainui ahau, Ko Whangarei Heads e noho anō ,Ko Trish Gledhill tōku ingoa. Trish is the Programme Lead at Te Pou for Let’s get real, the capability framework for anyone in health working with people and their whānau with mental health and addiction needs.  As a registered Occupational Therapist, Trish has held several practice and leadership roles within education, mental health and addictions, and social service sectors in both Australia and Aotearoa. She is also a founding trustee of Kina Families and Addictions Trust.  She holds a particular interest in trauma – informed and resilience based practices. Throughout her career Trish has maintained a strong interest in service developments that support her passion for the wellbeing of people and whānau, that improve access to services for Māori and our diverse populations within Aotearoa.

He mihi mui ki a koutou! Ko Ngāti Porou raua ko Ngāti Hāmoa te iwi, Ko Toni Tinirau tōku ingoa. Toni is Cholmondeley Children Centre’s Clinical Operations Manager. Cholmondeley is the only tamariki respite service in Aotearoa, who use a trauma-informed therapeutic model of play.  Toni has worked in Whānau Ora contracts for over 11 years and in social services and supports for over 20 years. Her focus has been in hauora Māori and growing strong communities by creating programmes with a preventative lens. Toni has developed and led teams primarily in the mental health and addiction space so frameworks that support services to provide Best, Safe and Accurate supports are important to her.  Toni has a Postgraduate Diploma in Health Sciences, an accredited clinical supervisor and registered addiction practitioner with Drug and Alcohol Practitioners Association Aotearoa New Zealand (dapaanz) and an approved ISSC provider with ACC. Toni is a member of various governance boards and groups within Waitaha.

Abstract

Introduction

Let’s get real describes the values, attitudes skills and knowledge required to work effectively with people and whānau with mental health and addiction needs.

Developed in consultation with Māori, the refreshed version of Let’s get real encompasses a te ao Māori world view along with strong lived experience and whānau perspectives. The Let’s get real is underpinned by values and attitudes that include te ao Māori values which are woven throughout seven Real Skills.  Specific attention is given to knowledge and skills of Working with Māori as one of the seven Real Skills.

Objectives

This presentation has these key objectives:

• to create awareness of the refreshed version of Let’s get real
• to promote the capability of non – Māori to demonstrate responsiveness to Te Tiriti o Waitangi.
• to promote the capability of all workers across the Let’s get real values, attitudes and seven Real Skills.

Approach

The Let’s get real values will be evident in the tikanga employed in the session. For example, by demonstrating strong partnership through co-facilitation and examples of working closely with health providers. Whanaungatanga will be a key element  in connecting with participants with respect for the diverse views shared. A facilitator bringing tangata whenua perspectives will describe how Let’s get real is introduced in a kaupapa Māori organisation. Other stories will be shared about using Let’s get real in mainstream health services and by professional groups to enhance organisational cultures and workforce capability to better meet the needs of people accessing health services.

Practice implications

Funded by Ministry of Health and led by Te Pou, Let’s get real is applicable to all workers across health servicesBy applying the Let’s get real values, attitudes and seven Real Skills occupational therapists can increase their capability in working with people and whānau with mental health and addiction needs in any health setting. Occupational therapists in leadership roles can use Let’s get real to support service development and education programmes to increase responsiveness to Te Tiriti o Waitangi and to improve outcomes for people and whanau accessing services.

Conclusion

This presentation provides an opportunity for occupational therapists working in all areas of health to increase their understanding about how to use Let’s get real to  promote better experiences and services for people and whānau with mental health and addiction needs.

Let’s get real | Mental health and addiction | Te Pou

Innovation in mahi through navigation of Covid-19 and lockdowns

Melanie Smith

Helen Wilkinson

Biographies

Helen

Tēnā kōtou katoa.
Ko Ngāti Pākehā te iwi.
Ko Ōtepoti tōku kāinga.
He Kaiwhakaora Ngangahau o Ara Potauma o Tāmaki Makaurau.
Ko Helen Wilkinson ahau.

I am a six-generation kiwi born of English and Irish descent raised in Dunedin Te Wai Pounamu. My working-class roots steered me towards a career in health and wellbeing having worked as a registered Occupational Therapist since 1991. I have worked in many primary/ secondary physical and mental health settings in Britain and Aotearoa, New Zealand. I have a lifelong love of travel and experiencing different cultures which underpins my passion for social justice and empowering people. Since 2019 I have worked as a mental health clinician for the Department of Corrections in a maximum security women’s prison in Auckland and look forward to kōrero about collective experiences in challenging times.

Melanie

Kō Ngā Puhi, Kō Ngāti Manu, me Ngāti Pākehā ngā iwi
Kō Ngāti Manu te hapū
He kaiako ahau ō Te Kuratini Tuwhera o Aotearoa
He Kaiwhakaora Ngangahau
Kō Melanie Smith ahau

Of Māori and Pākehā descent, I descend from Kupe, a known Māori navigator and from Rangatira, Te Whareumu. I whakapapa to two signatories on the Māori version of Te Tiriti o Waitangi. Growing up with a predominantly Pākehā lens amongst my English and Welsh extended whānau in the Waikato. With the knowledge that the Māori land confiscation line bordered one side of the land.
I am a registered Occupational Therapist with 28 years’ experience across many sectors of health and wellbeing including Māori health. For the past 4 years I’ve also lectured at the Open Polytechnic in Health and Wellbeing. I am passionate about Māori wellbeing and educating others regarding cultural safety and mana enhancing and protecting practices.

Abstract

Introduction:
As a profession, Occupational Therapy was not prepared for working under uncertainty, restrictions, and the challenges of Covid-19. Pandemic responses were not part of undergraduate training. There is international recognition that sharing of knowledge in this area is required. Collectively, Aotearoa Kaiwhakaora Ngangahau offer unique perspectives to this kōrero. Being skilled problem-solvers, creative and innovative in our everyday practice.

Objective:
Many successful innovative practices have arisen out of Covid-19 times. Including adapting to the challenges of: new guidelines, impacts on work practices, workloads and expectations. Innovations within policy development, assessment, equity, diversity, face to face practices, telehealth, digital resources, specific settings.

Approach:
The facilitators will briefly present their own innovations.
1. Adapting therapeutic practices and assessment practices to protocols and restrictions within a prison setting
2. and promoting equitable outcomes for Māori and whānau within a newly formed early supported discharge community rehabilitation team.
These presentations will identify: the context, problem recognition, strategies for improving outcomes, the essence of the process and reflections.
The larger focus of the session will provide opportunity for discussion. Exploring a need for sharing innovations within the profession. Plus generating suggestions around how and where this information can be shared and collated in a user-friendly way.

Practice Implications:
Occupational Therapists are skilled at collaboration. Collaboration has the potential to boost morale and confidence in working under Covid-19 conditions. The sharing of knowledge and resources can help the profession be prepared and adapt; promote leadership opportunities amongst multi-disciplinary settings and Health and wellbeing sectors; plus improve outcomes for tangata whaiora, Māori and whānau.

Conclusion:
Occupational Therapists have found solutions within short timeframes to deal with unknown and new factors, often in isolation from other Occupational therapists. In being prepared, sharing ideas and being connected this can assist resilience, adaptability, opportunities and best outcomes for tangata whaiora.

The Five Finger Framework: Enabling local best practice, enhancing lifelong learning

Sharon Bryant

Helen Jeffrey

Biographies

Sharon Bryant

Te taha o taku papa (my fathers side)
Ko Kopukairua, Mangatawa ngā maunga
Ko Tauranga te moana
Ko Waitao te awa
Ko Mataatua te waka
Ko Tahuwhakatiki te marae
Ko Ngā Potiki te hapū
Ko Ngāi Te Rangi te iwi
Ka huri ki te taha o taku māmā (my mothers side)
Nō Kōtarana, nō Weira ōku tipuna
He kaiwhakaora ngangahau Māori ahau.

I began my journey into occupational therapy as a mature student and once graduated followed my passion into working with Māori whanau in kaupapa Māori mental health NGO’s within the Kirikiriroa.  I worked with youth in child & adolescent mental health and addiction as my interest lay in trying to prevent our youth from going down that long road to mental illness.    I then turned my interest to becoming an educator and have now been working for Otago Polytechnic as a lecturer.   I also spent 6 years as a tangata whenua council member at OTNZ-WNA gaining valuable governance skills.  My passion is working biculturally, teaching bicultural practice and the implementation of Te Tiriti o Waitangi  in practice, occupational justice and de-colonisation.

Helen Jeffery

I am fourth generation New Zealander of Scottish and Cornish descent. I was born in Tāhuna (Queenstown) and grew up on a farm in the foothills of Crown Peak, studied occupational therapy at the Central Institute of Technology and after graduating in 1982 lived in Kaitaia in Te Tai Tokerau for my first two years of practice. The Pakeha farm girl in me relished this emersion in te ao Maori, this experience helped me understand my own culture and set me up to cope with the many diverse cultures and world views I would connect with in the years to come. I have worked in a variety of roles (primarily mental health) and in a variety of locations in New Zealand and internationally. After 35 years away I have returned to my tūrangawaewae and live in Arrowtown with my whanau. I work from home for Otago Polytechnic, am connected to the Adventure Therapy Aotearoa community.

Please add here a short biography about each presenter that includes your background, culture and bi-cultural world view. (250 word limit for one presenter, 300 word limit for 2 presenters, 350 word limit for 3 presenters.)

Abstract

The Five Finger Framework was developed following research into how evidence-based practice (EBP) is developed and nurtured in novice practitioners. Focus groups were conducted with year 3 students, and with clinicians from a wide spectrum of practice areas and geographical locations. Interviews were conducted with lecturers at the school of occupational therapy, Otago Polytechnic.

A qualitative descriptive methodology was utilised to understand current perceptions of participants regarding the uptake, use and development of EBP in novice practitioners, and to identify strategies used to nurture its development. Themes were identified and analysis found that what is evidence is broad, EBP and clinical reasoning concepts merge, and the client and environment influence the development of local best practice. Another strong theme was the need for novices to develop skills in professional reasoning that would hold them in good stead in terms of lifelong learning and ongoing continuing competence. Despite research questions being related to EBP, it became clear that in practice EBP merges with other aspects that guide professional reasoning.

The Five Finger Framework was consequently developed with the intention that it is used as a tool to enhance novice and experienced practitioners’ use of evidence in their professional decision making. The tool encourages practitioners to consider and question evidence from five areas as they grapple with professional decisions. These areas are knowledge e.g research literature, the context or environment including environmental resources and requirements, the clients’ situation and perspective, the expertise of others available to the practitioner, and the practitioners’ own knowledge, skill, and personal attitudes and beliefs.

The image and metaphor of a hand is used to provide a simple visual reminder of the five areas. The practitioner’s own knowledge, experience and self is situated on the thumb, illustrating the ease with which they can touch base with the other sources of evidence (fingers). All sources of evidence are valid, and none should be used at the expense of another. Using the framework enhances the practitioner’s ability to consider and respond to influences from cultural, client, and knowledge perspectives resulting in decisions that are right for the situation and for them.

Opening doors – Māori and their whānau: Finding equilibrium through the senses

Esme Schlotjes

Melanie Smith

Biography

Ko Esme Schlotjes ahau

A fifth generation New Zealander, descendant from English, Scottish, Welsh, Norwegian, Swedish. (discovered 2019). Growing up, my lens on the world was “Kiwi”.

My home, a mixed culture rural town, Hawkes Bay, with close relationships with Māori neighbours. School Kapa Haka was where I learnt and assimilated “Kiwi Culture” with Māori mentors.

An Occupational Therapist, 39 years’ experience, across health and wellbeing, includes:

Post Graduate Qualification (Health Science), specialty Mental Health.

Sensory Modulation Research Project Assistant to Dr Gilbert Azuela.  Co-developer of Sensory Modulation training.

Serving Leadership Groups: Occupational Therapy, Sensory Modulation, Zero seclusion – Health Quality & Safety Commission New Zealand, Te Pou National Sensory Modulation Practice Group.

As an Occupational Therapist for over 11 years in Acute Inpatient Mental Health, my passion is enhancing wellbeing, personal potentials, empowering and strengthening of others. Māori particularly require culturally safe, sensory modulating approaches to enhance mana.

Kō Ngā Puhi, Kō Ngāti Manu, me Ngāti Pākehā ngā iwi

Kō Ngāti Manu te hapū

He kaiako ahau ō Te Kuratini Tuwhera o Aotearoa

He Kaiwhakaora Ngangahau

Ko Melanie Smith ahau

Of Māori and Pākehā descent, I descend from Kupe, a known Māori navigator and from Rangatira, Te Whareumu. I whakapapa to two signatories on the Māori version of Te Tiriti o Waitangi. Growing up with a predominantly Pākehā lens amongst my English and Welsh extended whānau in the Waikato. With the knowledge that the Māori land confiscation line bordered one side of the land.

I am a registered Occupational Therapist with 28 years’ experience across many sectors of health and wellbeing including Māori health. For the past 4 years I’ve also lectured at the Open Polytechnic in Health and Wellbeing. I am passionate about Māori wellbeing and educating others regarding cultural safety and mana enhancing and protecting practices.

Abstract

Introduction: Whakaāio ā-rongo (Sensory modulation) has origins within Whakaora Ngangahau, having gained recognition as an effective approach within oranga settings. We argue that therapeutic use of self and a strong therapeutic alliance is vital. Manaakitanga and The Re‐covery Model’s ‘Bridge of trust’ (Randal. et al. 2009) can build insight moments and successes that are ‘mana enhancing and protecting’ (Te rau matatini. 2016). This presentation seeks to explore how Māori and whānau have gained benefits from Whakaāio ā-rongo through the restorative process of whakawhanaungatanga, values approaches and toanga.  Together this empowers tāngata whaiora to gain insight and mastery to achieve rongo and help address any oranga ararau (complex needs).

Objective: Equity for Māori through provision of Whakaora Ngangahau that attends to the development of genuine therapeutic relationships that empower tāngata whaiora to embrace relevant healing sensory modalities. Currently Māori are experiencing higher rates of conflict and seclusion with poorer health outcomes. The whakaaro is for Māori and whānau to positively experience; feel recognised, honoured, safer and more connected, respected and heard; and have holistic needs met. Through hope inducing Interactions, promoting a sense of community and being a rangatira in their hīkoi.

Approach: Based on practice experiences of working in partnership with Māori tāngata whaiora and whanau, including feedback within a range of oranga settings. Our purpose is not to teach models but bring real sensory modulating practice examples that meet the whakaaro. These affirm best practice guidelines for Māori and whānau.

Practice Implications: The kōrero advances four insights to enhance practice with Māori:

1) there is no prescription but need for flexibility, creativity and an individualised kete;

2) paramount for success is a culturally safe and genuinely invested relationship;

3) focus remains on mana integrity and the skills, experiences and resources of the tāngata;

4) therapist reflection enhances the personal hīkoi of the tāngata and their potential, honouring relevant ‘doing’ experiences.

Conclusion: Our presentation traverses approaches honouring Māori and whānau within oranga settings to achieve Whakaāio ā-rongo. Practice examples will inspire a Māori values-based roopu and consider facilitation of a tangata whaiora centric kete.

Adventure therapy – actively connecting with others and with nature

Neeka Aicken

Helen Jeffrey

Biographies

Neeka Aicken

Ko Te Poho o Tamatea, Tuhiraki ka mauka
Ko Whakaraupo, Te Waihora, Te Roto o Wairewa ka wai
Ko Tākitimu te waka
Ko Rāpaki, Taumutu, Tuahiwi, Wairewa ka whenua
Ko Kai Tahu te Iwi
Ko Kati Wheke, Kati Moki, Kai Tuahuriri, Kati Irakehu ka hapū
Ko au tēnei
Ko Neeka Aicken tohoku ikoa
Ko Kegan Gilmore tohoku hoa rakatira

Nō reira, tena kōtou, tena koutou, tena kōtou, katoa

My whakapapa connects me to Canterbury and Banks peninsula where my maternal grandmother grew up in Lyttleton.   I live in Invercargill, where I was born and grew up and have returned after having lived and worked around NZ and in the UK and Canada.  I am still learning of my Māori heritage and connecting to Te Ao Māori as the two generations before me were encouraged to live in a colonised New Zealand and became more assimilated to pakeha culture.

Helen Jeffery

I am fourth generation New Zealander of Scottish and Cornish descent. I was born in Tāhuna (Queenstown) and grew up on a farm in the foothills of Crown Peak, studied occupational therapy at the Central Institute of Technology and after graduating in 1982 lived in Kaitaia in Te Tai Tokerau for my first two years of practice. The Pakeha farm girl in me relished this emersion in te ao Māori, this experience helped me understand my own culture and set me up to cope with the many diverse cultures and world views I would connect with in the years to come. I have worked in a variety of roles (primarily mental health) and in a variety of locations in New Zealand and internationally. After 35 years away I have returned to my tūrangawaewae and live in Arrowtown with my whanau. I work from home for Otago Polytechnic Occupational Therapy school, and am connected to the Adventure Therapy Aotearoa community.

Abstract

Adventure therapy in Aotearoa New Zealand is a developing community of practice incorporating allied health professionals, outdoor facilitators, primary and secondary teachers, and counsellors. The profile of occupational therapy in adventure therapy practise is growing. Adventure therapy practice generally uses outdoor activities and experiential learning theory to facilitate positive changes, including capacity to manage self and emotions, to relate to and build relationships with others and to develop resilience. Whilst applicable every life stage, adventure therapy is commonly integrated into services with young people who are struggling with challenges to mental health and social connection.

This presentation reports on the findings of research into what Aotearoa New Zealand adventure therapy practitioners consider to be key elements of adventure therapy practice, and how these elements effect a therapeutic change. Key themes that will be presented are relationship, connection with nature, and the place of experiences or activity in therapy. These themes will be informed by theory that enhances our understanding of the importance of connection with each other, with nature and with the doing elements of therapy through indigenous and western ways of knowing.

Strategies for the integration of elements of adventure therapy practice into every-day occupational therapy will be presented.

What’s the worst that could happen?

Ellie Christoph

Biography

Ellie entered the insurance industry first in New Zealand before making the jump to Australia. She has six years of experience across both countries. Having lived most of her life in Auckland, she is enjoying her time in Melbourne, Australia. Ellie has extensive knowledge in both corporate and SME products, having worked in both fields throughout her years in the industry. At BMS Ellie has worked on many Allied Health programs, her focus being providing insurance solutions for members.

Abstract

We will begin with an introduction explaining who BMS are and what we offer. The program will then outline OTNZ-WNA member insurance, student insurance and the importance of Professional Indemnity for occupational therapists (members and non-members). Lastly we will touch upon claims, notification and typical complaints with the focus on what could happen and how best to prepare. Although our session will be based around the OTNZ-WNA member program, there will also be valuable information for any practising allied health professional.

Discussion on the ethical basis of occupational therapy in Aotearoa

Clare Hocking

Isla Emery-Whittington

Biography

The Hocking whanau are Caucasian and were amongst the early English settlers to Aotearoa. Clare’s mother was a post-war immigrant from Canterbury in England. Clare grew up at the feet of the Rimutaka ranges, east of Te Whānganui-a-Tara/Wellington, in a valley colonised by settlers who displaced (and feared) the Te Ātiawa hapū who had been displaced. Clare graduated from the School of Occupational Therapy in Heretaunga, a suburb in Orongomai (Upper Hutt), and has taught kaiwhakaora ngangahau students at AUT over the last 30 years. She has provided leadership in thinking about occupational justice and is growing into the responsibilities attendant on the role of being a Te Tiriti partner.

Isla Emery-Whittington (She/her/ia)
Rereahu, Ngāti Kauwhata
Kei taku wehi ki te rangi, kei taku ihi ki te whenua, e rau rangatira ma, tēnā tātou katoa. He uri tēnei nō Tainui, Tākitimu waka. Nō reira, he mihi o koutou tini waka, tini maunga, tini awa huri noa i te motu. I live in Tāmaki Makaurau and am currently a PhD candidate with SHORE Whāriki Research Centre, Massey University. The research is a philosophical exploration of mātauranga Māori and practices of everyday occupations. The research examines links between colonisation and everyday occupations to highlight the hidden everyday mechanisms that produce, maintain and disrupt colonialism. Isla is a Tiriti, antiracism and decolonisation workshop facilitator and is active in the DisruptOT global movement.

Abstract

On its journey to becoming a te Tiriti aligned organisation, the Occupational Therapy Board has worked to refresh its key documents, including the Code of Ethics. One of the things that process revealed is that the current code is embedded in Western bioethics (beneficence, non-maleficence, respect for people, justice). In research and other professions, ethical principles derived from a Māori worldview have been identified and realised through policy and practice. For example, human ethics committees use the concepts of whakapapa, tika, whanaungatanga, mana, manaakitanga, and aroha. In health contexts, the concepts of rangatiratanga and kotahitanga are given expression, amongst others.

This session offers a collegial space to gather together, to listen and share a range of views about ethics and practice. It is possible that the gathering might identify actions and directions towards deriving a unique set of ethical principles to inform occupational therapists/kaiwhakaora ngangahau in Aotearoa. We are excited to meet, re-connect, share kōrero and consider commitment to an ethics project to identify and articulate ethical practice within a dedicated community. During the various crises of this moment, ethical concepts and practice can contribute to practice that is grounded in Te Tiriti, sure and just.

Te Whakamau i ngā tikanga o te Tiriti o Waitangi: Making the mahi meaningful for workers in the health and wellbeing setting

Melanie Smith

Emma Weeks

Biographies

Ko Ngā Puhi, Ko Ngāti Manu rātou ko Ngāti Pākehā ngā iwi
Ko Ngāti Manu te hapū
He kaiako ahau o Te Kuratini Tuwhera o Aotearoa
He Kaiwhakaora Ngangahau ahau
Ko Melanie Smith ahau

Of Māori and Pākehā descent, I descend from Kupe, a known Māori navigator and from Rangatira, Te Whareumu. I whakapapa to two signatories on the Māori version of Te Tiriti o Waitangi. Growing up with a predominantly Pākehā lens amongst my English and Welsh extended whānau in the Waikato. With the knowledge that the Māori land confiscation line bordered one side of the land.

I am a registered Occupational Therapist with 28 years’ experience across many sectors of health and wellbeing including Māori health. For the past 4 years I’ve also lectured at the Open Polytechnic in Health and Wellbeing. I am passionate about educating others regarding the importance of Te Tiriti o Waitangi within health.

Ko Emma Weeks ahau
Kei Porirua ahau e noho ana
Ko England tōku kainga
Ko England me Wales ōku tūrangawaewae
He Lecturer Health and Wellbeing ahau o te Kuratini Tuwhera o Aotearoa

I am of English and Welsh descent. I grew up in rural England, moving to the city for work after finishing my education. I qualified as a Social Worker in the UK and moved to New Zealand with my husband in 2003. I have worked as a New Zealand Registered Social Worker for 13 years prior to my move to Open Polytechnic teaching alongside Melanie in the Health and Wellbeing team 4 years ago. Since arriving in New Zealand nearly 18 years ago, my bicultural worldview has developed substantially. I would acknowledge that it started mainly at a text-book level of understanding to a more appreciative awareness of its importance and relevance to all of Aotearoa.

Abstract

In 2019, the Waitangi Tribunal released the WAI 2575 report revealing breeches relating to health systems for Māori.
In August 2020 the Ministry of Health released the Whakamaua: Māori Health Action Plan and Te Tiriti o Waitangi Framework to work towards fulfilling its Te Tiriti obligations and address the inequities. The three principles of Te Tiriti o Waitangi guiding workers since 1988 have been updated to five principles to improve Māori health.

The presenters’ interpersonal experiences of supporting students in understanding and applying these principles will be shared, with reference to literature on the framework, cultural safety and the Ako learning model. This will guide Occupational Therapists to reflect on what they do and can do in practice.
The presentation will take the participant on a hīkoi regarding why the framework exists, what the five principles are, why they are important, how to put them into practice and the value of sharing this knowledge.
The Learning Outcomes are;
1. Developing confidence and comfort in applying the framework in this new era of health;
2. Strengthening the commitment to honouring Te Tiriti o Waitangi and better outcomes for Māori health;
3. Finding relevance and meaning in the framework principles;
4. Inspiration to share with colleagues.
This will be achieved by:
• Starting conversations about the framework;
• Exploring the framework as approachable and breaking down any discomfort;
• Affirming practices, experiences and encouraging reflection on new knowledge that can be applied;
• Inspiring commitment to the framework even when not working with Māori and their whānau.
The drive of this presentation is a commitment to honour and respect the mana of Te Tiriti o Waitangi in this new era of health. Feedback from the sector indicates students have an increased understanding of the necessity of equity for Māori, finding meaning and relevance of the Whakamaua framework in their mahi.

Occupational Therapy Board of New Zealand: Framework for audit

Hūhana Whautere

Dr Megan Kenning

Dr Margaret Jones

Biography

Huhana Whautere is a Māori occupational therapist who whakapapa backs to Ngāpuhi iwi. Huhana works as a manager for APM Workcare overseeing a multidisciplinary team working in community, vocational and neuro rehab. Huhana is currently doing her masters exploring what factors kaiwhakaora ngangahau consider in practice when working with Māori clients.

Margaret Jones is a Senior Lecturer at the Department of Occupational Science and Therapy at Auckland University of Technology, and she holds important family roles as a mother and grandmother. Her teaching, postgraduate supervision and research is focused on health, development, inclusion and wellbeing for tamariki, rangatahi, whānau, and their communities through participation in occupation

Megan Kenning has worked at the OTBNZ for the last 4 years. She trained and worked clinically as an Optometrist in New Zealand and Australia before completing her research degree in molecular biology. She has an interest in data, digital and new technology and how these can be used to promote wellbeing.

Abstract

In 2015 a new set of competencies was approved by the OTBNZ which included a specific reference to practising appropriately for bicultural Aotearoa. As part of quality improvement, the OTBNZ wished to review and audit how occupational therapists were demonstrating competence for this area of practice in their professional development e-Portfolios. The OTBNZ developed the framework for the audit using the national ethical standards for health and disability research and quality improvement as an ethical guide (National Ethics Advisory Committee, 2019) as there was little published literature related to audits of this nature. The audit responded to the Ethics Advisory Committee’s expectation that quality improvement activities be conducted to the same standard as research activity, regardless of the level of risk or if ethical approval is required. The standards required careful consideration and thought such as: who should do the audit, what was the objective of the audit, who would benefit from the audit findings, how would the audit be conducted safely and how the process of an audit could advance the ability of both the OTBNZ and the profession to practice authentic Tiriti o Waitangi based relationships.

The audit protocol and ethical framework were designed, refined, and repeated over the course of the two e-Portfolio audits with representation of tangata whenua and tangata tiriti members. The learning from this process will be presented followed by a discussion about co-design for audit or quality improvement processes in the Aotearoa New Zealand HPCA context.

To be true to Te Tiriti o Waitangi responsibilities, and to be effective, the process needed to bring together tangata whenua and tangata tiriti to work collaboratively. Insights that informed and benefitted the project were gained through involvement and collaboration amongst a whanau that embodied diverse viewpoints, and a rich variety of skills, knowledge, and experiences from around Aotearoa.

The project incorporated tikanga processes that facilitated safe conduct of the audit for members of the audit team. By coming to this process open, respectful, and keen to listen to one another’s perspectives we endeavoured to create a safe environment where we learned and gained strength and support from one another.

A partnership of principles: Ethics as a foundation for occupational therapy practice in Aotearoa New Zealand

Biography

Biography: Professor Mary Butler is currently Head of School at the Adelaide University of Occupational Therapy School.

I am an Irish woman, married to a Scotsman. I have lived for 30 years in Aotearoa/NZ and brought up three young men in this beautiful country.

I had a relatively slow start to my occupational therapy career. First I studied architecture, became the first female carpentry apprentice in Ireland, lived in various communes, worked as a folklorist and as an archaeologist. Then I discovered that occupational therapy was a ticket to NZ. As I studied, I accidentally fell in love with the profession, which has been a constant focus for my life ever since.
As an occupational therapist, I have worked in child psychiatry, brain injury, community, rheumatology, vision impairment. I worked in the old asylums, caught ferries at 5am to do home assessments on the western isles, worked in a spa hospital and have always had a strong association with various community groups.

I like doing research and, as my children grew up, I completed the journey from masters and PhD to postdoc and beyond. I have been an educator, and I have particularly loved working with master’s students as they articulate new forms of leadership in occupational therapy. A long association with Otago Polytechnic took me from lecturer to professor. I am now in the process of establishing a new school of occupational therapy in Adelaide, as professor and discipline lead.

My first and abiding loves have always been reading and meditation. These weave through my life and have taken me to all kinds of places – including many times to India. These days I also play the ukulele, walk my dog and cultivate a garden.

Abstract

In her research and teaching over nearly three decades Professor Butler has conceptualised occupational therapy as a fundamentally ethical endeavour. This talk will describe two sets of principles that can collectively form a basis for ethical occupational therapy practice and research: Te Ara Tika principles and the principles underpinning western ethical theories.

Te Ara Tika means ‘to follow the right path’, which are principles that have been shared over time by Māori communities that can also be applied to all people in Aotearoa/New Zealand (Hudson et al 2010). Western ethical theories offer different responses to the concept of intrinsic value. No assumption is made that these are identical principles, nor that one should take priority over the other. However, both address the idea of a good life, and when used together it is argued that they can strengthen ethical discourse in occupational therapy practice.