Communication research in the context of te whare tapa whā model of health

Abstract

Purpose: Te whare tapa whā represents a Māori view of health and wellness in four dimensions: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whānau (family health). This model of health focuses on indigenous Māori in Aotearoa/New Zealand but has relevance for all people. Speech-language pathologists, including those not familiar with this model, recognise that all four dimensions are needed to support health and wellbeing. Taha wairua includes the importance of culture and heritage to personal identity, an area that speech-language pathology (SLP) recognises as key to clinical competency. Taha hinengaro includes the need to express thoughts and feelings, another area particularly salient to SLP. The other two dimensions taha tinana (physical health) and taha whānau (family health) are arguably more familiar in the day-to-day work of speech-language pathologists.

Method: Two broad strands of research are examined within this model of health exploring the challenges faced by vulnerable populations namely: (1) two community based groups (a Choir and a Gavel Club) for people with acquired neurological conditions such as stroke and Parkinson’s disease, and (2) diagnosis and management of hearing loss and auditory processing disorder.

Result: Community based groups, explored through the CeleBRation Choir and the Gavel Club, highlighted the application of all aspects of te whare tapa whā to the experiences of people with neurological conditions participating in these community therapies. In the area of hearing loss and auditory processing disorder, gaps across all four dimensions of taha wairua, taha hinengaro, taha tinana and taha whānau were identified in the available literature and in examination of clinical provision for participants.

Conclusion: Te whare tapa whā provides a framework to consider all the elements that contribute to people living well while experiencing communication challenges within their whānau (extended family). This approach relies on strong partnerships between clinicians, extended family, researchers, communities, organisations and other professionals. Clinicians and researchers are encouraged to consider how their beliefs, practices and impact could improve through consideration of Indigenous health models such as te whare tapa whā.

Keywords:

• te whare tapa whā model
• indigenous health
• community-based therapy
• hearing loss
• auditory processing disorder
• youth justice

Acknowledgements

I acknowledge my own Māori iwi (people), Te Rarawa and NgāiTakoto. Many thanks to my colleagues and students in Aotearoa/New Zealand and overseas and the people who have generously participated in our research and contributed to the preparation of this manuscript. Special thanks to my University of Auckland Speech Science colleagues and to many others in the field who have been my kaiārahi (guide, counsellor, mentor, usher) throughout my SLP journey. Funding support for research by the author and co-investigators referred to in this manuscript has come from a range of sources, including the Health Research Council of New Zealand, Centre for Brain Research, A + Charitable Trust, and Joyce Fisher Charitable Trust.