Client-Centred Rehabilitation - Arthritis Community Research ...

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expertise. Rehab specialists don’t
know that much. MS #1
Participation in decision-making and goal
setting
When clients talked about positive
experiences with rehabilitation they usually
referred to situations in which they were
actively involved in collaborative decisionmaking
with staff.
“So I had a great experience. The
next meeting they forewarned me
and then reminded me that it was
going to be a goal-oriented session
and that if there were any services
that I deemed necessary for myself,
please feel free to provide that
information” ABI #1
Much of this individualization referred to
goal-setting specific to the client’s needs and
wants.
“What was excellent about it was
that she catered not to the general
rule but she was specific about my
situation. All of us are different and
brain injury is not going to be the
same for the next person.” ABI #1
Clients were less satisfied when they
encountered situations where they felt they
were being labeled or their outcome prejudged
on the basis of their diagnosis alone
with no consideration of their individual
needs.
“But the physiotherapy wasn’t
[client-centred] for a long
while….she basically said that
somebody with my injury had a low
probability of walking so that’s what
she assumed was going to happen [to
me], without trying to build me up so
that I could walk. SCI #1
“…they had certain guidelines that
your knee should bend to a
maximum of 100. That was for
everybody. That’s the ideal. But
hey, if my knee will bend to 75 and I
can walk, I’m happy. Now take a
look at the individual person and
what their needs are.” ARTH #3
Routinized programs or group work were
not usually perceived to be associated with
individualized goal setting.
“But once you’re in therapy, they
don’t say, ‘How about you sit down
and we’ll talk about what you can
and cannot do, what you would like
to do’. They say, ‘This is your
program. This is what you do.” MS
#1
Participation in goal setting was positive if
the client fit into the mold that the program
provided.
“When I came…they asked me to
choose three objectives. I said, I
want to be able to shower, they said,
we can fix that…I want to be able to
walk upstairs, they said we can fix
that…and I want to be able to work
in the garden, they said we can fix
that.” COPD #1
Participants reported more difficulties when
their goals did not match those of the
program.
“…it’s a combination of not seeing
the vision or maybe we’re not
communicating. Although wanting
to walk or wanting to get back to
where you were the day before your