There are many reasons why keeping up to date with current trends in different cultures throughout the world, especially when working in a field such as occupational therapy, is important. An example of this is with current day Germany. Still to this day some people’s first thought at the mention of Germany is stern, unpleasant, and maybe even slightly scary people. These are the kind of stereotypes that arise when effort towards staying culturally rounded diminishes. In a field such as occupational therapy, it is imperative that one stays current on trends in cultures outside of their own in order to effectively treat clients that share different views and remain professional. Throughout the world there are millions of different cultures, even in one country there could be multiple cultures. This variation can influence the presentation, type, and time of intervention greatly. An individual from the United States with a goal of independent driving and an individual from Germany with the same goal will receive very different interventions. An added obstacle for the individual from Germany would be that automatic transmission cars are rare. Accordingly, the individual will need increased focus on cognition, sequencing, bilateral integration, and multitasking elements in treatment.
Current trends in Germany show that family is important to most even though they tend to only involve their nuclear family which consists of the mother, father, and their children where they live, and the man is not the only head of the house but the woman is treated as equal (IES, 2018). Where the cultural differences between East and West Germany start to differ is with women’s view after childbirth. Whereas a woman from Eastern Germany might return to work because they are taught the importance of being a full-time employee; a woman from Western Germany would stay home to take care of her child herself (IES, 2018). Also, in an article titled “Job Insecurity and the Timing of Parenthood: A comparison between Eastern and Western Germany,” it provides critical information about the typical patterns of parenthood in both the eastern and western hemispheres of Germany. It is discussed in this article that the Western portion of Germany takes a more sequential, predictable approach to entering parenthood by having a relatively secure job before starting a family. Whereas in the Eastern portion of Germany takes a more parallel view on this. German families in the East will often work towards a secure job while also starting a family, and finding a balance (Bernardi et al., 2007). There are several major differences between Western and Eastern portions of Germany still to this day even though the reunification of Germany is now at its twenty-eight-year anniversary. Eastern Germany is not as prosperous and has an older, less religious population compared to Western Germany. This is why it is essential to know the background of this culture and the varying importance, values, and beliefs of each the Western and Eastern population. Just this one fact can determine a variety of things during treatment in a facility. For example, during an occupational therapy session an OT would more likely incorporate maternal, nurturing functional activities for the mother coming from the western portion of the country, and a work assessment for the mother from the eastern portion.
Occupational therapy focuses on rehabilitation of an individual to remerge back into their daily activities that they deem important. They do this by incorporating occupation-based intervention as well as meaningful activities. Different cultures influence these interventions, and accordingly every intervention is individualized. In Germany, the field of occupational therapy is not as plentiful with only 35,000 practicing OTs in the entirety of the country according to the Council of Occupational Therapists for the European Countries (COTEC), and it is put into perspective with the statistic of 42.5 practicing OTs per 100,000 head in Germany (COTEC, 2018). The statistics for OT in Germany are not strong, but what the focus on during intervention is for the individuals that requires these services. In Germany, leisure time is very important and basically everything closes on Sundays to have time for relaxation and have quality time with loved ones. Germany has even taken it to the extent to outlaw the use of power drills on Sundays because they take this leisure day so seriously (Cichanowicz, 2016). This is important to note for occupational therapists in order to attain information on important leisure activities to incorporate into treatment sessions. OTs can ensure that they obtain this information through assessments and leisure checklists in the initial session with individuals. There are quite a few do’s and don’ts with the presentation of intervention with individuals from Germany. According to “German Culture-Do’s and Don’ts,” it is better to get straight to the point, they will be open and honest stating if a mistake was made (they also expect it to be reciprocated), and asking permission before taking a picture or video of them is important. Also, according to “German Culture-Do’s and Don’ts,” it is important to avoid shouting across rooms, do not press a German to revise their decision on a matter if they have already given their response, and avoid cancelling at last minute (IES, 2018). Taking all of this into account it will shape the way intervention is presented and the progression of treatment by taking a more direct approach when speaking to the client/patient, and not “sugar-coating” information out of respect to their beliefs.
Another thing to note for not only the field of occupational therapy, but with the healthcare industry as a whole is that it has been reported that another difference between the Eastern and Western portions of Germany is that individuals from Eastern Germany are more reluctant to engage and participate in decisions regarding their health (European Journal of Public Health, 2011). This is critical for all of the health care industry because it will most likely take more coaxing, different presentations of information, and encouragement of the workers in this industry to help individuals of this population engage in their well-being. This is why it is important to be knowledgeable of these two differing cultures in Germany to know what technique is most beneficial during intervention/treatment.
In Germany it is required by law that everyone obtains health insurance, “…even international students, must be medically insured regardless of their income” (Studying in Germany, 2018). The German health insurance system is comprised of either the Government Health Insurance System (GKV) or a private-insurance. While most of the population in Germany are members of the GKV, these individuals do not get the best medical services. When having the Private Health Insurance (PKV), it gives the recipients “a wider choice of medical and dental treatment and provide broad geographical coverage. By having private health insurance [,] you are considered a private patient and can expect more service from the medical profession” (Matz-Townsend, 2018). As well as buying into either one of these insurance policies, there are also separate policies that will need to be purchased in order to obtain certain services. For example, the GKV only covers the basics of dental and does not cover a private room in a hospital (Matz-Townsend, 2018). A separate dental policy would need to be purchased to get further care for the individuals with this type of insurance. Regarding occupational therapy services, it is not clearly stated if these policies cover services there, but there is another policy that can be purchased in order to receive payment despite occupational disability. This policy is referred to as the Occupational Disability Policy. In an article it states:
“If occupational disability is determined, the occupational disability insurance pays the stipulated insurance sum, the so-called disability pension. Every month the insured person receives a fixed amount that allows him/her to make a living. Many insurance policies depend on the degree of occupational disability; the higher this degree, the higher the amount paid out to the insured person” (Studying in Germany, 2018).
While this is not directly related to occupational services it does provide proof that in German government provides individuals with proven disabilities which prevent occupational performance with aid. Plus, it gives people with permanent disabilities the opportunity to receive enough money to sustain everyday life.
In conclusion, it is imperative to understand the workings of different cultures to enhance the service received by those individuals of differing cultures. Without knowing the differences discussed throughout this research one wouldn’t know how to efficiently treat an individual from Western Germany versus an individual from Eastern Germany. Even though these individuals are from Germany the coaxing and presentation for the individual from Eastern Germany will require more effort from the therapist rather than the individual. These are a few critical examples of how the treatment of individuals can be changed greatly due to different cultures, beliefs, and views on life. Consequently, knowledge and respect of different cultures is an essential quality for those working in the healthcare industry.