Poverty is a significant global issue that is internationally recognised as a violation of human rights, and the United Nations is committed to the eradication of extreme poverty. Although New Zealand does not experience the extreme deprivation seen in developing nations, poverty is an area of growing concern in New Zealand society. Because of the widespread nature of poverty in New Zealand, it is important for occupational therapists to be aware of the impact of poverty on their clients, and on therapeutic interventions.
The aim of this research was to explore how occupational therapists engage with issues of poverty in their practice. Using an interpretive descriptive methodology, interviews were carried out with 9 occupational therapists from a range of practice areas across New Zealand. The occupational therapists were asked to reflect on what they have seen in relation to poverty in their practice, the impact of poverty on their client’s occupational participation and engagement with therapy, how therapists are able to respond to poverty within their roles, and specific challenges they face when engaging with clients who are impacted by poverty.
The participants in this research demonstrated that they engage with poverty in a holistic way. Poverty was identified as a multifaceted issue that encompasses a range of personal and social factors, not simply limited to inadequate finances or physical resources. Poverty impacts clients of occupational therapy, carers and support staff that work alongside occupational therapy clients, community organisations and charities that support vulnerable members of society, and even the very services that employ occupational therapists.
When faced with poverty in practice, occupational therapists engage with their hearts, heads, and hands. That is, the take the time to understand and empathise with their client’s situations; they grapple with issues of poverty, specifically as these issues relate to ethics, justice and human rights; and finally they act in practical ways to address issues of poverty.
The strategies used by occupational therapists to address poverty for their clients were the tools and strategies that occupational therapists use every day in the presence or absence of poverty – referrals, documentation, clinical reasoning, peer support and supervision, advocacy, and occupational engagement. Occupational therapists also reflected on the way in which personal experiences and professional values shape the way they engage with issues of poverty and deprivation.
While this study has demonstrated the ways in which occupational therapists in New Zealand already engage with poverty in their practice, there was also a sense from most of the research participants that occupational therapy is not yet doing enough to engage with and address the ways in which poverty violates human and occupational rights. This research wishes to first celebrate the tireless work that occupational therapists in New Zealand are doing to engage with and address poverty in their practice. A further aim of this research is to increase the discussion about poverty in occupational therapy practice, both about the successes and the challenges of engaging with this widespread injustice. Recommendations are given regarding the use of an ethical framework for guiding discussion, reasoning and further action to engage with and address poverty for individuals, families and whanau, communities, and New Zealand society as a whole.