Client-Centred Rehabilitation - Arthritis Community Research ...

Articles considered relevant from the search
pattern were reviewed by the Client-Centred
Rehabilitation Group in ACREU and
entered into a reference manager database.
The database focused on the following
areas:
General Practice
Rehabilitation (OT, PT, SLP, Audiologists)
Healthcare / care
Hospital/Long term care
Clinic
Specialist
Social Work
Nursing
The articles reviewed could be broadly
categorized as professional level and
systems level. The professional level articles
give attention to interactions between the
health professional and the client. The
systems level articles focus on the context in
which care is provided.
2.2 Defining Client-Centred
Rehabilitation
One of our first challenges was to find a
consistent, overarching definition of clientcentred
rehabilitation. A client-centred
approach is identified in the paper
“Managing the Seams: Making the
Rehabilitation System Work for People”
(Provincial Rehabilitation Reference Group,
2000) as one that facilitates responsive,
individually appropriate, functionally-based
goal setting involving the active and
informed participation of the client.
Beginning with this definition, we searched
the literature for definitions and conceptual
models that would help us further define the
components of client-centred rehabilitation.
In particular, we were looking for
definitions and models that would apply to
the rehabilitation of adult clients with
chronic physical disability. We took a broad
systems approach that examined clientcentredness
at a variety of levels such as
individual client/practitioner encounters,
programs and organizations.
We quickly found that the terminology used
in the literature is inconsistent and includes
a variety of terms such as client-centred
practice, patient-centred care, and patient
focused care. We identified two main
categories of literature: individual client/
practitioner level literature and system level
literature. Within these literatures, the three
terms above are used with different
meanings.
Much of the work on the individual client /
practitioner relationship tends to be
profession-specific. Different professional
literatures reveal varying definitions and
approaches to client-centred care. These
professional definitions tend to focus on
individual client/practitioner interactions
from each profession’s perspective. Some
professions are much further along in their
thinking in this area than others.
Occupational therapists in particular have
been talking about client-centred practice for
almost 20 years and are much further down
the road than some other groups.
In the Canadian Occupational Therapy
literature client-centred practice refers to
“collaborative approaches aimed at enabling
occupation with clients who may be
individuals, groups, agencies, governments,
corporations or others. Occupational
therapists demonstrate respect for clients,
involve clients in decision making, advocate
with and for clients in meeting clients=
needs, and otherwise recognize clients=
experience and knowledge@ (p.49,
Townsend et al., 1997). This definition
seemed closest to what we were trying to
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