Threading a decolonial feminist response to COVID-19: One community psychologist's reflection on the assemblages of violence.

To challenge and interrogate the assemblages of violence produced by racial capitalism, and exacerbated by the COVID-19 pandemic, community psychologists must engage in a transdisciplinary critical ethically reflexive practice. In this reflexive essay, or first-person account, I offer a decolonial feminist response to COVID-19 that draws strength from the writings of three women of Color decolonial and postcolonial feminist thinkers: Gloria E. Anzaldúa, Sylvia Wynter, and Arundhati Roy. Through their writings I share my reflections on the sociopolitical moment associated with COVID-19. Of importance, I argue in support of engaging a decolonial feminist standpoint to understand the inequitable and dehumanizing conditions under COVID-19, and the possibilities for transformative justice. I offer this reflexive essay with the intention of summoning community psychology and community psychologists to look toward transdisciplinarity, such as that which characterizes a decolonial standpoint and feminist epistemologies. Writings oriented toward imagination, relationality, and borderland ways of thinking that are outside, in-between or within, the self and the collective "we" can offer valuable guidance. The invitation toward a transdisciplinary critical ethically reflexive practice calls us to bear witness to movements for social justice; to leverage our personal, professional and institutional resources to support communities in struggle. A decolonial feminist standpoint guided by the words of Anzaldúa, Wynter, and Roy can cultivate liberatory conditions that can materialize as racial freedom, community wellbeing, and societal thriving.

Meaningful engagement through critical reflexivity: Engaging people with lived experience in continuing mental health professional development.

Engaging people with lived experience of mental health system encounters in the design and actualization of continuing professional development initiatives for mental health professionals can have transformative systemic impacts. Yet, despite evidence that involving people with lived experience benefits mental health professional education, far less focus has been placed on how to engage people with lived experience in continuing professional development initiatives. Tensions persist regarding the role of lived experience perspectives in continuing professional development, as well as how to establish people with lived experience as partners, educators and leaders in a thoughtful way. We propose that meaningful and equitable partnerships with people with lived experience can be realized by engaging in critical reflexivity and by systematically challenging assumptions. This paper explores three topics: (1) the current state of engagement with people with lived experience in continuing professional development initiatives; (2) barriers to meaningful engagement and (3) recommendations for using critical reflexivity to support the involvement and leadership of people with lived experience in continuing professional development for mental health professionals. PATIENT OR PUBLIC INVOLVEMENT: This viewpoint manuscript was co-designed and co-written by people with diverse lived and learned experiences. Each author's professional roles involve meaningfully and equitably partnering with and centring the perspectives of those with lived experience of mental health system encounters. In addition, approximately half of the authorship team identifies as having lived experience of accessing the psychiatric system and/or supporting family members who are navigating challenges related to mental health. These lived and learned experiences informed the conception and writing of this article.

Critical Reflections From Doctoral Students Engaging in Local and Transnational Community-Based Participatory Research (CBPR) Approaches to Health Promotion.

Social work scholars have increasingly adopted Community-Based Participatory Research (CBPR) approaches to center community voice in research and action to promote youth's healthy development. While valuable contributions have emerged to engage in further dialectical learning processes, limited research has examined in depth the participation, critical reflection, and training of social work graduate students pursuing CBPR. This article emphasizes the role of critical reflexivity and collaboration by presenting four social work doctoral students' efforts designed to engage community and youth in CBPR to enhance health promotion initiatives. We conclude by discussing the importance of engaging graduate social work students in CBPR, the influential role faculty and mentors play in providing opportunities for students to gain experience in CBPR, and recommendations and potential strategies for future social work education and training.

Where is critical analysis of power and positionality in knowledge translation?

In Canada, the Eurocentric epistemological foundations of knowledge translation (KT) approaches and practices have been significantly influenced by the Canadian Institutes of Health Research (CIHR) KT definition. More recently, integrated knowledge translation (IKT) has emerged in part as epistemic resistance to Eurocentric discourse to critically analyse power relations between researcher and participants. Yet, despite the proliferation of IKT literature, issues of power in research relationships and strategies to equalize relationships remain largely unaddressed. In this paper, we analyse the gaps in current IKT theorizing against the backdrop of the CIHR KT definition by drawing on critical scholars, specifically those writing about standpoint theory and critical reflexivity, to advance IKT practice that worked to surface and change research-based power dynamics within the context of health research systems and policy.

Therapeutic relationships in aphasia rehabilitation: Using sociological theories to promote critical reflexivity.

BACKGROUND: Therapeutic relationships are fundamental in aphasia rehabilitation, influencing patient experience and outcomes. While we have good understandings of the components of therapeutic relationships, there has been little exploration of how and why therapists construct and enact relationships as they do. Sociological theories may help develop nuanced understanding of the values, assumptions and structures that influence practice, and may facilitate critical reflexivity on practice. AIMS: To explore the potential for theoretical approaches from outside speech-language therapy to enable a deeper understanding of the nature and enactment of therapeutic relationships in aphasia rehabilitation. METHODS & PROCEDURES: An explanatory single case study of one speech-language therapist-patient dyad in an in-patient stroke rehabilitation setting. Data included observations of five interactions, two interviews with the client and three interviews with the speech-language therapist. Analysis was guided by analytical pluralism that applied aspects of three sociological theories to guide data analysis and make visible the contextual factors that surround, shape and permeate the enactment of therapeutic relationships. OUTCOMES & RESULTS: The analysis of this dyad made visible individual, interactional and broader structural features that illustrate the dynamic processes that practitioners and patients undertake to enact therapeutic relationships. Clinical practice could be viewed as a performance with each person continually negotiating how they convey different impressions to others, which shapes what work is valued and foregrounded. The patient and therapist took up or were placed in different positions within the interactions, each with associated expectations and rights, which influenced what types of relationships could, or were likely to, develop. Organizational, rehabilitation and individual practitioner structures assigned rules and boundaries that shaped how the therapist developed and enacted the therapeutic relationship. Whilst the therapist had some agency in her work and could resist the different influencing factors, such resistance was constrained because these structures had become highly internalized and routinized and was not always visible to the therapist. CONCLUSIONS & IMPLICATIONS: While therapists commonly value therapeutic relationships, social and structural factors consciously and unconsciously influence their ability to prioritize relational work. Sociological theories can provide new lenses on our practice that can assist therapists to be critically reflexive about practice, and to enact changes to how they work to enhance therapeutic relationships with clients. What this paper adds What is already known on the subject Therapeutic relationships are critical in aphasia rehabilitation. We have a good understanding of the different components of therapeutic relationships and how relationships are perceived by patients and practitioners. What this paper adds to existing knowledge This study is novel in its use of sociological lenses to explore contexts and complexities inherent in building and maintaining therapeutic relationships. These are often invisible to the practitioner but can have a significant impact on how relational work is enacted and what forms of relationship are possible. What are the potential or actual clinical implications of this work? This study will support clinicians to critically reflect on how they enact therapeutic relationships and may enhance awareness of the often-hidden factors which influence the ways in which they work.

Deconstructing identity: Professional relationships for sustaining morally habitable workplaces.

Our professional responsibility as nurses is to enact social justice by changing oppressive structures. However, this may be difficult with competing perspectives in healthcare environments. Deconstructing our identity is foundational if we are to understand how to develop professional relationships with peers to move forward as a collective to enact social justice. A paradigm shift, from one world view to multiplicity, will help us develop insight into our own identities and professional relationships to sustain morally habitable workplaces.

Difference Within and Without: Health Care Providers' Engagement With Disability Arts.

Re•Vision, an assemblage of multimedia storytelling and arts-based research projects, works creatively and collaboratively with misrepresented communities to advance social well-being, inclusion, and justice. Drawing from videos created by health care providers in disability artist-led workshops, this article investigates the potential of disability arts to disrupt dominant conceptions of disability and invulnerable embodiments, and proliferate new representations of bodymind difference in health care. In exploring, remembering, and developing ideas related to their experiences with and assumptions about embodied difference, providers describe processes of unsettling the mythical norm of human embodiment common in health discourse/practice, coming to know disability in nonmedical ways, and re/discovering embodied differences and vulnerabilities. We argue that art-making produces instances of critical reflection wherein attitudes can shift, and new affective responses to difference can be made. Through self-reflective engagement with disability arts practices, providers come to recognize assumptions underlying health care practices and the vulnerability of their own embodied lives.

Beyond vulnerability: how the dual role of patient-health care provider can inform health professions education.

In order to prepare fully competent health care professionals, health professions education must be concerned with the relational space between patients and providers. Compassion and compassionate care are fundamental elements of this relational space. Traditionally, health professions educators and leaders have gone to two narrative sources when attempting to better under constructs of compassion: patients or providers. Rarely have there been explorations of the perspectives of those who consider themselves as both patients and providers. In this study, we interviewed nineteen health care providers who self-disclosed as having had a substantive patient experience in the health care system. We engaged with these participants to better understand their experience of having these dual roles. Anchored in Foucault's concepts of subjectivity and Goffman's symbolic interactionism, the interviews in this study reveal practices of moving between the two roles of patient and provider. Through this exploration, we consider how it is that providers who have been patients understand themselves to be more compassionate whilst in their provider roles. Rather than describing compassion as a learnable behaviour or an innate virtue, we theoretically engage with one proposed mechanism of how compassion is produced. In particular, we highlight the role of critical reflexivity as an underexplored construct in the enactment of compassion. We discuss these findings in light of their implications for health professions education.

Who Do We Think We Are? Disrupting Notions of Quality in Qualitative Research.

The purpose of this article is to illuminate our troubles with, and troubling of, the trustworthiness dimension of balancing subjectivity and reflexivity, in qualitative research. This article evolved from debriefing sessions between three novice researchers working on a qualitative research study aimed at building understandings of the relational dynamics between adults with developmental disability diagnoses (ADevD) and their caregiving families. Following data collection, coauthors discussed interview experiences they had personally found challenging. These experiences constitute a point of departure for our examination of our researcher positions. We present a delineation of three research tensions, in the form of short "reflexive vignettes," each rooted in concern with possibly contradicting our goals of facilitating and expanding participant autonomy. We follow with recommendations about how, as researchers, our endeavor to understand participants with less conventional communication can be used to reflect and inform navigating difficulties universal to qualitative research.

Critical Reflexivity in Indigenous and Cross-cultural Psychology: A Decolonial Approach to Curriculum?

Critical reflexivity is a mechanism for working toward decoloniality in higher education, with the potential to prompt students' to critique the contexts in which they are embedded, and facilitate transformative learning. We present a critical examination of the tensions surrounding decoloniality and critical reflexivity in an undergraduate unit on Indigenous and cross-cultural psychology at a large Australian university. We invited students in the unit to participate in a written reflexive exercise at the beginning (N = 44) and end of semester (N = 23) and analyzed these reflections qualitatively for level (four-category scheme for coding) and content (causal layered analysis) of reflection. Findings suggest that, while students' primarily demonstrate reflective engagement at levels preordinate to critical reflexivity, they are also engaged in active and nuanced processes of negotiating discomfort and uncertainty in this space. We pose critical commentary on the notion of safety in teaching practice, and consider the role of the academic institution in parametrizing the decolonial stance. This research holds application and transferability to higher education settings, and for the enduring project of engaging a decolonial approach to the curriculum within psychology.

Holding Firm: Power, Push-Back, and Opportunities in Navigating the Liminal Space of Critical Qualitative Health Research.

Critical qualitative health researchers typically occupy and navigate liminal academic spaces and statuses, with one foot planted in the arts and social sciences and the other in biomedical science. We are at once marginalized and empowered, and this liminality presents both challenges and opportunities. In this article, we draw on our experiences of being (often the lone) critical qualitative health scholars on thesis advisory committees and dissertation examinations, as well as our experiences of publishing and securing funding, to illuminate how power and knowledge relations create conditions that shape the nature of our roles. We share strategies we have developed for standing our theoretical and methodological ground. We discuss how we use the power of our liminality to hold firm, push back, and push forward, to ensure that critical qualitative research is not further relegated to the margins and its quality and integrity sustained.

Approaches to culture and diversity: A critical synthesis of occupational therapy literature.

BACKGROUND: The 2007 position statement on diversity for the Canadian occupational therapy profession argued discussion was needed to determine the implications of approaches to working with cultural differences and other forms of diversity. In 2014, a new position statement on diversity was published, emphasizing the importance of social power relations and power relations between client and therapist, and supporting two particular approaches: cultural safety and cultural humility with critical reflexivity PURPOSE: This paper reviews and critically synthesizes the literature concerning culture and diversity published in occupational therapy between 2007 and 2014, tracing the major discourses and mapping the implications of four differing approaches: cultural competence, cultural relevance, cultural safety, and cultural humility. KEY ISSUES: Approaches differ in where they situate the "problem," how they envision change, the end goal, and the application to a range of types of diversity. IMPLICATIONS: The latter two are preferred approaches for their attention to power relations and potential to encompass a range of types of social and cultural diversity.

Dis/re-orienting design through norm-critical gender lenses: an educational case in Turkey.

Design, as a practice of developing solutions beyond products, and increasingly services and policies, inevitably poses an impact on gender (in)equality which remains largely unrecognized by design practitioners. This paper advocates the urgent need for adopting gender lenses in design education for sustainable cultural transformation through proper recognition of the complexity of any societal and cultural issue, power relations and inequalities, and introduces an initial attempt through a graduate-level educational design project. Throughout the project, students critically reflected on existing orientations in designing to develop norm-critical gender lenses, contained the resultant disorientation emerging from the contrast between their critical approaches and local contexts, and explored novel directions as reorientation to address four different societal and cultural issues and develop 11 design outcomes aiming at gender equality, social justice-oriented empowerment, and cultural transformation. The authors analyzed the design processes and outcomes to reveal opportunities and challenges for developing and deploying norm-critical gender lenses in tackling complex, intersecting socio-cultural and political issues, under three themes: gender stereotypes, norms, expectations, and roles; intersectional power relations and inequalities embedded in the social structure; and social justice-oriented empowerment beyond the market-oriented individualistic neoliberal order. A shift in the perceptions of the role of designers, from creator/problem-solver to facilitator/participant, and design outcomes, from absolute solutions to intermediaries of sociological and political imaginations, is found crucial in this endeavor, which requires safe spaces for future designers to reflect on existing orientations, contain disorientation with negative capability, and explore novel ways through reorientation.

Ancestral Computing for Sustainability: Centering Indigenous Epistemologies in Researching Computer Science Education.

This article offers Ancestral Computing for Sustainability (ACS) to dismantle the logics of settler colonialism that affect accessibility, identities, and epistemologies of computer science education (CSE). ACS centers Indigenous epistemologies in researching CSE across four public universities in the United States. This paper describes Ancestral Computing for Sustainability and explores reflections of two students engaging as researchers in ACS inquiry. Drawing on Indigenous methodologies and Participatory Action Research, they share their reflections as co-researchers in ACS through storywork. These critical reflections include their relationship to computing, observations of the interdependent work within ACS, ethics and sustainability, and their experiences within the focus groups. The article ends with recommendations for furthering ACS as a decolonial approach that centers Indigenous epistemologies in CSE. Recommendations for CSE education include Ancestral Knowledge Systems and adding sustainability as a topic within computing education pathways and building student-faculty relationships based on trust is recommended to foster students' academic and personal growth within CSE education and research.

Critical reflections and reflexivity on responding to the needs of LGBTQ+ youth in a global pandemic.

The global community has been significantly impacted by the COVID-19 global pandemic. LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, queer, etc.) youth may face increased stressors amidst the pandemic given their significant mental and sexual health disparities, pervasive rejection - including quarantining in homes with heightened risk of abuse and victimization, and a lack of access to essential resources. Responsive supports are needed at this time for vulnerable LGBTQ+ youth, particularly tailored mental health supports. This critical reflexive paper will highlight, as qualitative social work researchers and practitioners, the swift response to the needs of vulnerable LGBTQ+ youth across Canada during this pandemic. We provide a transparent account of how we have utilized critical reflexivity, cultivated through qualitative research, to support LGBTQ+ youth. This article will elucidate the importance of critical reflexivity in effectively transitioning essential offline mental health services for LGBTQ+ youth to a technology-mediated mental health affirmative intervention. The aim of this paper is to provide qualitative researchers and practitioners practical direction through important insights gleaned by supporting marginalized LGBTQ+ youth during particularly trying times such as a global pandemic.

Mobilizing Occupation for Social Transformation: Radical Resistance, Disruption, and Re-Configuration: Mobiliser l'occupation pour une transformation sociale : résistance radicale, perturbation et reconfiguration.

BACKGROUND.: Given the sociopolitical roots of widening occupational, social, and health inequities, it is imperative that occupational therapy move forward in mobilizing occupation for social transformation. PURPOSE.: Three key aims are addressed: articulating the imperative to mobilize occupation for social transformation; highlighting the political nature of occupation and occupational therapy; and providing guideposts for embracing a radical sensibility to inform moving forward in mobilizing occupation for social transformation. KEY ISSUES.: Conditions of possibility within occupational therapy leave the profession ill equipped to enact social transformation. Enacting calls to mobilize occupation for social transformation requires radically reconfiguring these conditions of possibility to inform practices that resist, disrupt, and re-configure sociopolitical conditions perpetuating occupational inequities. IMPLICATIONS.: Mobilizing occupation for social transformation holds much potential to contribute toward creating more equitable, humane societies. Realizing this potential involves committing to transforming our profession, as well as societal discourses, structures, systems, relations, and practices.

The Concept of Oppression and Occupational Therapy: A Critical Interpretive Synthesis.

Background. Occupational therapy and occupational science literature include growing attention to issues of justice, marginalization, and rights. In contrast, the concept of oppression has scarcely been employed. Purpose. This paper investigates how adding the concept of oppression may enhance occupational therapy approaches to injustice, prioritizing a focus on structural causes, and facilitating conscientious action. Method. A critical interpretive synthesis explored insights from authors who name oppressions in occupational therapy and occupational science literature. In total, a sample of 28 papers addressing oppression, ableism, ageism, classism, colonialism, heterosexism, racism, and/or sexism was selected for inclusion. Findings. Four themes were identified: oppression and everyday doing; effects of structures and power; responding and resisting; and oppression within occupational therapy. Implications. Incorporating oppression within the plurality of social discourse may help occupational therapists to avoid individualistic explanations, attend to relationships between social structures and constrained occupations, frame intersectional analysis, and engage in praxis.

Critiquing the Canadian Model of Client-Centered Enablement (CMCE) for Indigenous Contexts.

Background. The Truth and Reconciliation Commission of Canada outlines the need for health care professionals to create more welcoming spaces for Indigenous Peoples. The scope of occupational therapy is continually expanding-yet the profession itself is grounded in and derived from a dominant Eurocentric worldview, and practice is designed to serve a homogenous Western populace. Purpose. To critically examine the Canadian Model of Client-Centered Enablement (CMCE) for its value within Indigenous contexts. Key Issues. The CMCE is positioned as a client-centered model, however there is a clear hierarchical client-professional relationship threaded throughout. Concepts such as enable, advocate, educate, coach, and coordinate demonstrate paternalistic authority, lacking reciprocity, knowledge-sharing, and power redistribution. Implications. Reimagining health care relationships as entrenched in social interconnectedness demands critical reflection and action. A model of practice that endorses social change and actively addresses colonial power inequities must root its paradigmatic foundations in postcolonial views of health care as a social relationship.

A Critical Reflexion on Two Conceptual Tools From a Global South Perspective: Réflexion critique sur deux outils conceptuels selon la perspective des pays du sud.

BACKGROUND.: Occupational therapy's conceptual tools need to be considered from Global South perspectives to make them more culturally relevant and safe. PURPOSE.: This paper uses an empirical example, and the author's professional and academic experiences, to analyze the strengths, limitations, and potential refinement of the Critical Thinking Tool (CTT) and the Participatory Occupational Justice Framework (POJF). KEY ISSUES.: The paper describes processes of critical reflexivity and intercultural translation to compare concepts used in the CTT and POJF with the findings of a study about olive growing in Palestine to consider the applicability of these tools in Global South settings. The CTT should be amended to address collective occupations, and global and historical contexts, and the POJF should embed intercultural translations and solidarity into its philosophy and processes. IMPLICATIONS.: These refinements would enhance the cultural safety of the CTT and the POJF. Tools in occupational therapy will benefit from more evidence to enhance their global utility in an increasingly interconnected world, in which occupational therapists share the duty to tackle social and occupational injustices.

Occupational Therapy Roles in an Indigenous Context: An Integrative Review.

BACKGROUND.: Indigenous peoples experience health inequities linked in part to lack of access to culturally-relevant health care. The Truth and Reconciliation Commission of Canada (TRC) calls on all health professionals, including occupational therapists, to reduce health inequities through improved work with Indigenous communities. PURPOSE.: This integrative review of the literature explores how occupational therapists can improve their work with Indigenous peoples. KEY ISSUES.: Communication and building relationships are central to effective work with Indigenous communities, along with reciprocity regarding knowledge exchange. Issues surrounding service provision are a significant concern, yet improvements are unlikely to be effective unless therapists can critically examine the (mainstream) Western cultural assumptions that infuse the profession and their own practices. IMPLICATIONS.: Though nascent, there are identified directions for occupational therapists to meet the TRC's calls for more competent health care. Researchers should explore best ways for therapists to critically interrogate taken-for-granted professional assumptions mired in Western colonialism.