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Indigenous Identity and Client-Clinician Relationships (Part 2 of 3)

Updated: Jul 15, 2021

Content Warning: discussion of residential schools and death

Indian Residential School Support Line: 1-800-464-8106

Inuit & First Nations Hope for Wellness Line: 1-855-242-3310 (Online chat option)


This post was written with contributions from SLPs Michelle Dolmaya, Mikyla Grau, Janessa Tam, and Ibtissam Mustaq

In our last blog post, we had an introduction to Indigenous presence in Canada and common worldviews. We covered some ways that Speech Language Pathologists and other clinicians can be conscious of diverse learning styles. This week, we want to explore a deeper context behind Indigenous history and culture in Canada and how this impacts clients seeking therapy today.

Understanding Loss of Identity

It's important to recognize the harm done to Indigenous communities through colonization and the long-lasting impact that European settlement has caused. Colonizers arriving in what is now known as Canada held the view that Indigenous peoples, who held connections to the land, were "uncivilized" since they did not operate their communities in the same way (i.e. Christian, valuing money and possessions, punitive law, etc.).

Trading items at Fort Pitt, SK - 1884

Settlers continued to arrive and take whatever land they wanted, despite the Royal Proclamation of 1763 that was supposed to prevent this. In 1876, the Indian Act was introduced. Some of the major effects of the establishment of the Act throughout its 140 years of existence include:

  • the concept of "enfranchisement", meaning that one would have to give up their Indian status if they wanted to become a Canadian citizen – this was forced upon any First Nations person admitted to university

  • replacing the responsibilities of elders and women in leadership roles with a patriarchal system run by white men

  • banning potlatch ceremonies where older generations would pass on important oral histories, values and laws to younger generations

  • banning traditional dance

  • denying First Nations people the right to vote

  • denying women status

  • creating reserves and the band system

  • forcing Indigenous people to adopt European names

  • restricting First Nations people from leaving reserves without the permission of an Indian agent

Residential Schools

One of the most shameful acts committed by the Canadian government is the establishment of residential schools. It's important to remember that this is not buried deep in our past, but actually took place very recently with the last school closing in 1996. Communities and families continue to be affected and grieve to this day.

Armed with the goal to "kill the Indian in the child", children were taken from their homes and brought to these boarding schools for 10 months out of the year, many never returning to their families at all. They were forced to assimilate to Christian beliefs, forget their languages and reject their cultural values. Many of these children were also physically or sexually abused, and over 4000 children died from malnutrition, terrible sanitary conditions leading to tuberculosis, and other horrific acts.

There was absolutely no respect for Indigenous lives as countless deaths were unreported, many families still unsure about the fate of their loved ones today. Most recently, in May 2021, the discovery of the remains of 215 children at a former residential school in Kamloops, BC has highlighted the ongoing trauma that Indigenous communities face.

Listen to these survivors telling their stories:

The effects of residential schools cannot be overstated. Survivors, their children and grandchildren are all impacted by the loss of culture and language due to Canada's efforts to assimilate Indigenous peoples. The trauma inflicted by these schools as well as the long history of poor treatment towards Indigenous communities accounts for the lack of trust in settler forms of education that some Indigenous people have to this day.

Modern Loss

Although the residential schools weren't successful in erasing Indigenous cultures, they left the survivors with trauma that still impacts their communities today. The impact of residential schools is intergenerational, and the path to healing is not simple.

The minimal representation of Indigenous peoples in the media often perpetuates harmful stereotypes and reduces their diverse cultures and individual experiences to a one-dimensional character or even a mascot. These stereotypes dehumanize Indigenous people and ignore the history of trauma that has impacted these communities at the hands of the government, as well as the ongoing discrimination that they continue to face. We need to amplify the voices of Indigenous creators and activists to learn about their experiences and work to eradicate the biases which non-Indigenous people hold.

Racism pervades all areas of our society, from politics and law to everyday interactions. One area where this is evident is in the health care system. Joyce Echaquan, a 37-year-old mother from the Atikamekw nation of Manawan, was seeking medical attention in a Quebec hospital in 2020. As she lay in her bed in pain, two hospital staff members were heard mocking her and making blatantly racist remarks. Joyce would die shortly after.

This incident was recorded by Joyce via Facebook live and gained media attention, but this raises the question of how many Indigenous patients suffer in silence without recorded evidence to back up their claims? How many health care workers come to work with racist perspectives? An investigation of B.C. alone found that 84% of Indigenous respondents had experienced discrimination in the health care system. This is a systemic problem that needs to be addressed at a national level.

The Road to Reconciliation

Since first contact between European settlers and Indigenous peoples, there has been a foundation of distrust. As mentioned above, royal declarations in 1763 did not stop settlers from taking over the land rightfully owned by Indigenous people. The Indian Act in 1876 undermined also Indigenous peoples' nationhood, classifying them as children of the state with little control over the regulations placed on them.

First Nations Flag (Montreal, 2015) - Mathieu Côté

A “Statement of Reconciliation” was issued in 1998 establishing the Aboriginal Healing Foundation focusing on community-based initiatives for survivors of physical and sexual abuse. This, however, was only a temporary remedy. The "Statement of Apology" acknowledging the government's role in residential schools and the trauma affecting everyone who attended was not issued until 2008, and some still question its sincerity.

The Truth and Reconciliation Commission of Canada (TRC) was established in 2008 with the goals of acknowledging the abuse that occurred, responding to the needs of survivors, and bringing awareness to the public. After six years of listening to testimonies and conducting research, the final report was published in 2015.

They provided the government and citizens of Canada with 94 calls to action. In a 2020 report by the Assembly of First Nations, we can see that while a few areas have achieved significant progress, the majority of calls to action have received little to moderate progress.

Connection to Speech Language Pathology

It's important for Speech Therapists to understand the history and continuing impact of colonialism within North America. We need to be patient and understand the context from which Indigenous clients might be coming to us; this means taking the time to build relationships and trust with Indigenous communities and establishing safe spaces within clinics for clients to share their experiences and feel heard.

Mural by The Cultch Youth Program; Photo by Ted McGrath

It's not enough to simply read about Indigenous issues and stay silent. We need to actively tear down stereotypes and discrimination and bring awareness to why this is unacceptable. We should also be working alongside Indigenous families to preserve endangered cultures and languages.

  • Review the language used in clinic resources and replace materials that are outdated (e.g. resources using the word "Indian")

  • Examine how Indigenous identities are portrayed in your resources and remove those that are based on stereotypes (e.g. red skin, totem poles, tomahawk, feathers, Pocahontas, Peter Pan, Dr. Seuss books)

  • Have a discussion with the client to understand their unique needs and preferences. Be open to respectfully implementing appropriate Indigenous terminology into therapy since there are often no English equivalents.

When we think about colonialism and the harm done to Indigenous peoples, it's important not to speak about this as solely an issue of the past, because the after-effects are still very much present. Continue to inform yourself about current Indigenous issues but don't forget to acknowledge the resilience of these communities and their triumphs, as well. We can all be allies working to make the field of Speech Language Pathology more welcoming and free from prejudice.


Bellrichard, C. (2020, November 30). Investigation finds widespread racism against Indigenous peoples in B.C. health-care system. CBC News.

CBC/Radio Canada. (2021, May 27). Remains of 215 children found buried at former B.C. residential school, First Nation says | CBC News. CBC News.

Feith, J. (2020, September 30). Indigenous woman records slurs by hospital staff before her death. Montreal Gazette.

Joseph, B. (2016, April 14). 21 things you may not know about the Indian Act . CBC.

Miller, J. R. (2012, October 10). Residential Schools in Canada. The Canadian Encyclopedia.,funded%20residential%20school%20in%20Canada.

Turner, A. (2020). (rep.). Progress on Realizing the Truth and Reconciliation Commission’s Calls to Action. Assembly of First Nations. Retrieved from

University of Alberta (Producer). (2015). Indigenous Canada: Looking Forward/Looking Back [MOOC]. Retrieved from


Andalusia Speech Therapy has multiple clinics across Ontario and offers virtual therapy to clients anywhere in the world. Contact us more for information.

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