Client-Centred Rehabilitation - Arthritis Community Research ...

1) autonomy / choice: each client is a
unique individual who should be
afforded information provided in a
format understandable to them and
upon which they may base their
choice;
2) partnership and responsibility:
there is a shift in power from the
traditional medical paradigm such that
both therapist and client work
collaboratively, sharing responsibility
in the provision of information,
establishment of goals, selection of
treatment and evaluation of outcomes;
3) enablement: there is a shift in
paradigm from the traditional
medical model of remediation to
one of prevention, remediation,
development or maintenance of
occupational performance
established collaboratively;
4) contextual congruence:
consideration of the context in
which a client lives (clients= roles,
interests, environments and
culture) are central to clientcentred
occupational therapy
practice;
5) accessibility and flexibility:
services are provided in a timely,
accessible manner which are
constructed to meet the clients
needs;
6) respect for diversity: demonstrates
respect for client values, and
therapist does not impose his/her
values
The Canadian Association of Occupational
Therapists identified twelve guiding
principles in client-centred practice:
11
♦ base practice on clients= values,
meaning, and choice as much as
possible
♦ listen to clients= visions
♦ facilitate processes for clients
envisioning what might be possible
♦ support clients to examine risks and
consequences
♦ support clients to succeed, but also to
risk and fail
♦ respect clients= own styles of coping
or bringing about change
♦ guide clients to identify needs from
their own perspective
♦ facilitate clients to choose outcomes
that they define as meaningful even
if the occupational therapist does not
agree
♦ encourage and actively facilitate
clients to participate in decisionmaking
partnerships in therapy,
program planning, and policy
formation
♦ provide information that will answer
clients= questions in making choices
♦ offer services that do not overwhelm
clients with bureaucracy
♦ foster open, clear communication
♦ invite clients to use their strengths
and natural community supports
(p. 51, CAOT, 1997)
2.3.1.2 Barriers to Client-Centred
Practice in Occupational Therapy
Barriers to the implementation of a clientcentred
practice in the occupational therapy
literature may be summarized as being
related to the client, the therapist, and/or the
organization (Law et al., 1995; Wilkins,
Pollock, Rochon and Law, in press).
Sumsion and Smyth (2000) conducted a
study using a postal questionnaire among 60
occupational therapists in the United
Kingdom in which therapists rated (5-point