Understanding the Theories and Frameworks That Guide Occupational Therapy Practice With Black Populations: A Scoping Review.

Abstract

Importance: Globally, the occupational therapy profession has neglected to address the anti-Black racism in its therapeutic services. Although discussions on ethnic/racial issues have grown in the field in recent years, few studies have investigated the theoretical and methodological frameworks that inform the practices of occupational therapy practitioners who work with Black populations.

Objective: To describe and analyze the theoretical and methodological frameworks available to occupational therapy practitioners who provide services to Black populations.

Data sources: MEDLINE, CINAHL, PsycINFO, LILACS, SCIELO, Web of Science, and Scopus were searched for articles published in English and Portuguese from 2013 to 2024.

Study selection and data collection: Scoping review procedures as outlined by Arksey and O'Malley (2005) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) were used to identify articles that reflect theoretical and methodological frameworks that guide the practices of occupational therapy practitioners who work with Black populations.

Findings: Forty-eight articles met the inclusion criteria and were organized into four themes: humanities and social sciences: theories and frameworks; occupation-centered approaches; addressing systemic inequalities through collective occupations, intersectionality, and the incorporation of Black epistemologies into occupational therapy practices; and methodological approaches.

Conclusions and relevance: Findings suggest that occupational therapy practitioners must adopt an antiracist approach with Black populations and be guided by counterhegemonic and decolonial frameworks. More studies are needed to investigate the effectiveness and limitations of frameworks that guide therapeutic practices with Black populations. Plain-Language Summary: This scoping review interrogates anti-Black racism in occupational therapy practice and the relevant frameworks available to occupational therapy practitioners working with Black populations around the world. The authors identify practice and research gaps that remain in the discourse and provide pathways for action that address the needs and demands of these populations from an antiracist lens. Positionality Statement: The authors are Black, cisgender, heterosexual, female-identifying occupational therapy practitioners and academic activists who engage in research and practice at the intersections of antiracism, gender, and ableism in occupational therapy and occupational science. The first and third authors live in different regions of Brazil and speak Portuguese. The first author is from a state in northeastern Brazil, which has the largest percentage of Black residents outside the African continent. The third author is from southeastern Brazil, a region with a significant percentage of White individuals. The second author is from the southern United States, is a native English speaker, and has practiced, taught, and conducted research with Black populations in the United States. These social markers shape how we do everyday life, being members of the Black community in our respective countries, belonging to an antiracist movement, and becoming transformative agents to change approaches to engaging with Black occupational therapy service recipients.