Approaches to working with Aboriginal adults with acquired brain injury : exploring perspectives of speech-language pathologists

Efforts to raise awareness of culturally safe speech-language pathology services for Aboriginal populations have grown in recent years. However, while most of the literature focuses on Aboriginal children and families, few studies are tailored towards the adult population. Furthermore, little is known in Canada or internationally about approaches to providing culturally safe care to Aboriginal adults with acquired brain injury in a speech-language pathology context. The purpose of this qualitative study is to explore perspectives of speech-language pathologists working with Aboriginal adults with acquired brain injury (ABI) to develop an understanding of the supports, barriers, and facilitators in working with this population. Semi-structured, participant-driven interviews were conducted with seven speech-language pathologists from different geographical locations and health care settings across British Columbia. The data were interpreted using a method called thematic analysis to identify common topics and themes. A wide range of participant perspectives highlighted the diversity in participants’ experiences. A total of four topics were identified: (1) a description of service delivery for adults in British Columbia revealing various barriers and facilitators; (2) working with patients and families within the context of service delivery; (3) participants’ concerns that they considered to be specific to Aboriginal peoples; and (4) participants’ perspectives on cultural safety. Seven themes that reflect participants’ personal statements emerged from the second, third, and fourth topic: building relationships with patients; family and community support; Aboriginal languages, culture, and identity; awareness of the impacts of colonization in health care; move towards holistic practice; participants’ feelings of uncertainty; and role of building relationships in the provision of culturally safe care. This study shows the need for broader research to develop a deeper understanding and explore Aboriginal views on cultural safety in speech-language pathology practice with Aboriginal peoples with ABI. It is also critical for clinicians to become culturally competent through continuing education in order to increase their ability to provide culturally safe care.Medicine, Faculty ofAudiology and Speech Sciences, School ofGraduat