Client-Centred Practice: What does it Mean and Does it Make a Difference?

TLDR

Over the past 15 years, Canadian occupational therapists have worked to develop client‑centred practice guidelines, yet these guidelines lack a clear definition and discussion of core concepts. This paper discusses the key concepts of client‑centred practice—individual autonomy, partnership, shared responsibility, enablement, contextual congruence, accessibility, and respect for diversity. The authors illustrate these concepts with two practice examples that highlight obstacles to implementing client‑centred occupational therapy. A review of research evidence shows that client‑centred concepts improve client satisfaction, functional outcomes, and adherence to health service programmes.

Abstract

During the past 15 years, occupational therapists in Canada, through the Canadian Association of Occupational Therapists, have worked to develop and implement guidelines for practice of a client-centred approach to occupational therapy. One of the difficulties with the current Guidelines for the Client-Centred Practice of Occupational Therapy is the lack of a definition and discussion of the concepts and issues fundamental to client-centred practice. In this paper, key concepts of client-centred practice: individual autonomy and choice, partnership, therapist and client responsibility, enablement, contextual congruence, accessibility and respect for diversity are discussed. Two practice examples are used to illustrate these ideas and raise issues about obstacles to the practice of client-centred occupational therapy. Research evidence about the effectiveness of client-centred concepts in enhancing client satisfaction, functional outcomes and adherence to health service programmes is reviewed.