THE OT TIMELINE OF
                                                           *Timeline is a rough estimate with the
                                                   progression of the Occupational Therapy Practice
                                                       Frameworks used as a guideline. Underlined
                                                          texts contain clickable links to additional
                                                        resources on the concept-term definitions
     CULTURAL
     CONCEPTS
                                                 2000
                                                 The concept, Cultural Competence, was
                                                 introduced by Terry L. Cross in 1989
                                                 however, OT won't start developing
                                                 cultural competency models until a little
                                  2002
   OTPF 1st Ed. was published with reference     over a decade later leading to its gradual  
         to culture as a context, which "sets
                                                 acceptance 
       expectations, beliefs, and customs that
    can affect how and when services may be
                                                 2003 
   delivered". This broadly aligns with cultural
                                                 Cultural Relevance and
    competence as an aim to work effectively
                                                 Responsiveness were key concepts in
                           cross-culturally. 
                                                 the KAWA Model (Iwama), which
                                          
                                                 provides an eastern cultural perspective
        Originally a nursing concept, Cultural
                                                 in OT practice models. It encourages
    Safety was adopted by OT researchers as
                                                 therapists to look at clients in a socio-
    early as 2002 with an increased interest in
                                                 cultural context as cultural competence
    2005, as a way to move beyond sensitivity
                                                 models were rooted in the western
      and awareness through a sociopolitical
            overview of cultural competence      perspective.
                                  2007
        Muñoz further established Cultural
       Responsiveness in relation to OT by
                                                 2008
    building on previous studies, despite the
                                                 OTPF  2nd Ed. was published with the
        lack of empirical studies on cultural
                                                 updated term cultural context and
    competency models in the context of OT
                                                 environment with its explicit references
          practice. Cultural responsive care
                                                 to other OT domains. This indicates that
         expands on cultural competence in
                                                 culture is a part of the OT body of
       recognizing every client has a unique
                                                 knowledge, aligning closer to the
                     (multi)cultural identity
                                                 concept of cultural competence
                                  2011
                The Canadian Association of
       Occupational Therapists published a
     position statement on Cultural Safety       2012
                                                 Cultural Humility, coined in 1998, was
    emphasizing its importance in including
                                                 introduced to the OT profession by
    the sociopolitical perspective, which isn't
                                                 Beagan and Chacala. Unlike cultural
       prioritized in any other cultural term
                                                 competence, cultural humility
                                                 emphasized the power differences
                                  2014
                                                 between therapists and clients. It was
       OTPF 3rd Ed. was published without
                                                 further advocated for in the next
     change in the use of the term cultural
                                                 following years
        context and environment. Despite
     existing cultural terms such as cultural
    competence in OT research, these terms
           were not yet used in the practice
                                                2020
                               framework
                                                OTPF 4th Ed. was published with the
                                                addition of the terms Cultural Humility
                                                and Cultural Competence for the first
                                                time. The term "cultural context and
                                                environment" was removed. Instead,
                                                culture is mentioned as part of the
                                                environmental and personal contexts.
                                                Cultural humility and competence are also
                                                included in the new AOTA Code of Ethics
                                                indicating that these approaches are now
                                                an ethical responsibility of OT.
                                                Furthermore, AOTA released a statement
                                                of "Occupational Therapy's Commitment to
                                                Diversity, Equity, and Inclusion", which
                                                recommends the profession shift from
                                                cultural competency to cultural humility as
                                                humility doesn't imply an endpoint to
                                                learning about a client's culture