Philosophical underpinnings of the study

Despite thirty years of occupational therapy training in Zimbabwe, occupational therapy practice and research have remained largely influenced by Western ideologies that shaped the development of the training curriculum. Hammell (60) argued that the occupational therapy theorists who pioneered the profession were “well-educated, urban, middle-class, middle-aged, able-bodied and anglophone with Judeo-Christian backgrounds” and they developed ideas from their own contextual and cultural perspectives. As a result, these Western theories and ideologies pay little attention to the context as well as cultural beliefs, norms and values of indigenous

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Zimbabweans accessing occupational therapy services in the public sector. Recently, researchers (60)(61) in occupational therapy have acknowledged that occupational therapy should be informed by indigenous knowledge and proposed the development of new theories of occupational therapy and models that are contextually relevant and respond to the indigenous and cultural values. It is in this regard that the philosophical underpinnings of this study were grounded in the principles of decoloniality. (62)(63)(64)(65)

Decoloniality also referred to as “decolonial thinking” or the “decolonial turn” denotes a “family of diverse positions that share a view of coloniality as a fundamental problem in the contemporary world”. (62) (p2) According to Grosforguel, (65) the decolonial turn in research is aimed at “ transcending and decolonising the W estern canon epistemology”. (p.211)

The concept of decoloniality of research methods dates back to the work that was done in Australia, Canada and New Zealand on marginalised populations such as the aborigines in Australia. (65) Maldonaldo-Torres (62) defined coloniality as the “longstanding pattern of power that emerges as a result of colonialism but define culture, labour, intersubjective relations and knowledge production well beyond the limits of the colonial administration”. (p117) While this definition highlights the existence of coloniality within the realms of power, knowledge and being, decoloniality in research is mainly focused on coloniality of knowledge. The central tenet of decoloniality of research methods is the need to affirm other ways of producing knowledge. Decoloniality of research methods goes beyond proposing a methodology. Rather, it requires deep engagement and rethinking of ways of being, knowing and doing which reflect contextual differences among communities on a global level. (63) Some decolonial scholars (62)(65)(66) proposed the need for decolonising knowledge through “shifting the geography of reason”. This shift entails opening the academic space for thinking and theorising that goes beyond the

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Western notions of knowledge production and validation. One of the ways that has been proposed to facilitate the shifting of the geography of reason is to practise “epistemic disobedience”. (67) Mignolo (67) defined epistemic disobedience as the process of de-linking from the Western epistemological assumption of a neutral and detached observational position through which the world in interpreted. He argued that epistemic disobedience allowed researchers to appreciate that knowledge is not universal.

Traditionally the definitions of what is normal and acceptable in research have been foregrounded in Western epistemologies which restricted researchers from marginalised countries from applying research methods that were contextually relevant in their research settings. (63) Therefore decoloniality of research methods provides researchers with an opportunity to rethink the existing research methods. It also allows for application of contextually relevant research methods in addressing local problems. These methods are not restricted by definitions of the ideal as conceptualised in the Western epistemologies.

In this study, I adopted the decoloniality perspective in an effort to apply a methodology that is culturally sensitive throughout the whole research process. During participant recruitment I took into account how Zimbabwean families collectively seek solutions to help a family member with a mental health problem. I therefore considered the family as my study unit. This included the individual with a substance use disorder and the family members who were affected by the substance use disorder. Since Zimbabwe is a patriarchal society, it was important for me to uphold the cultural values of approaching the head of the family unit who is usually the father or a male member of the family whenever an outsider wanted to visit the family. In this study I was the outsider and I contacted the head of the family units to seek permission to conduct interviews

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with their families even if the heads of the family units were not going to be present for the interviews.

In my presentation of the narratives I maintained the multiple voices of the family members as I generated the narratives. There is dearth of literature on the advantages and disadvantages of having multiple voices in a single narrative. However in this study this was deemed important as my study unit was the family. The decoloniality perspective also led me to appreciate the “richness of innovation”(66) by using the data gathered in this study to develop a contextually relevant treatment framework for the occupational therapy management of adults with substance use disorders in Zimbabwe. This framework included traditional and faith healers as key stakeholders in the management of substance use disorders. By including traditional and faith healers in the treatment framework, I acknowledged that occupational therapy interventions for substance use disorders should reflect differences in cultural norms, values and practises as they are applied in different settings.