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Background/aim: Client-centred goal setting is fundamental to occupational therapy practice and has been increasingly embraced by all rehabilitation practioners. Goal setting in clinical practice is a highly individualised process...
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Background/aim: Client-centred goal setting is fundamental to occupational therapy practice and has been increasingly embraced by all rehabilitation practioners. Goal setting in clinical practice is a highly individualised process and may be more challenging with people with acquired brain injury. However, research examining practice is limited. We developed the Client-Centred Goal Setting Practice Framework to explain how client-centred goals are developed in brain injury rehabilitation. This framework was based on interview data and may reflect practitioner's theoretical knowledge rather than goal setting processes used in routine practice. The aims of this study were to explore the application of the framework to every-day practice, examine the extent to which goal setting was client-centred and refine the framework. Methods: A mixed methods approach was employed. Participants were community dwelling clients with ABI and their practitioners, drawn from a hospital outpatient service and community private practices. The communication exchange between practitioners and clients during routine goal setting was audio-recorded, transcribed verbatim and analysed using framework analysis. Quantitative measures evaluated the client-centredness of goals. Results: A total of 65 goal setting sessions with 36 clients and 17 practitioners (n = 8 occupational therapists) were analysed. The three goal setting phases of the framework and associated processes and strategies were represented. The 'establishing trust' process was interwoven throughout all phases and an additional strategy, 'social connection' was identified. Conclusion: The framework provides preliminary evidence about the core processes and strategies which uses establishing trust to engage clients with ABI in goal setting, and may be a useful tool to guide client-centred goal setting practice in similar services.
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Purpose: Client-centred practice is widely considered a key element of rehabilitation. However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalized durin...
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Purpose: Client-centred practice is widely considered a key element of rehabilitation. However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalized during a clinical trial of innovative goal-setting techniques. Method: This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data. Results: The primary way that client-centred practice was operationalized was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilizing mindful listening, allowing time, supporting clients to prioritize what is meaningful and viewing the therapists' role differently. Conclusion: While technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services. Implications for Rehabilitation At face value, clinical practice may appear to be client-centred. However, critical reflection of existing practice suggests that in reality, it is not well operationalized. Prioritizing getting to know the client, their story and what is meaningful to them appears fundamental to client-centred practice. A number of strategies may facilitate this process, including mindful listening on the part of the clinician and allowing time. Structures and processes need to be instituted to support implementation of client-centred practice. Autoethnography is an approach that may support clinicians' to reflect on their practice.
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AimThis study aimed to develop, implement and evaluate an online interprofessional education (IPE) dementia case study for health science students. The IPE initiative aimed to develop collaborative interprofessional capabilities a...
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AimThis study aimed to develop, implement and evaluate an online interprofessional education (IPE) dementia case study for health science students. The IPE initiative aimed to develop collaborative interprofessional capabilities and client-centred mindsets that underpin high-quality dementia care.
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The Community Occupational Therapy Service (Equipment and Adaptations) at Worcestershire Health and Care National Health Service Trust, Redditch and Bromsgrove Locality identified the need to find an outcome measure that would det...
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The Community Occupational Therapy Service (Equipment and Adaptations) at Worcestershire Health and Care National Health Service Trust, Redditch and Bromsgrove Locality identified the need to find an outcome measure that would determine its effectiveness. The Canadian Occupational Performance Measure was chosen as a client-centred, reliable, and validated outcome measure that was integrated within existing paperwork. The process followed is outlined in this practice analysis. The service completed 1,869 Canadian Occupational Performance Measure scores, which showed a statistically significant increase in client ratings of performance and satisfaction in 90% of clients, illustrating the effectiveness of the service. The aim of this practice analysis is to explain the process that this service followed to integrate the Canadian Occupational Performance Measure into practice and, thus, share the benefit of using it as an outcome measure with colleagues who work in a similar setting. The authors highlight the importance of continuing with the Canadian Occupational Performance Measure and look to develop its use further.
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Background/aimCoaching has been identified as a core enablement skill of occupational therapists. Occupational therapists have begun to embrace the use of coaching as a therapeutic tool to promote client-centeredness in their prac...
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Background/aimCoaching has been identified as a core enablement skill of occupational therapists. Occupational therapists have begun to embrace the use of coaching as a therapeutic tool to promote client-centeredness in their practice. As the use of coaching becomes more popular it is important to examine and evaluate coaching use in occupational therapy practice to clarify what is meant by coaching and inform future research and practice in this area.
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From a historical and demographic perspective, a generation is viewed as the average interval of time between the birth of parents and the birth of their children. Traditionally, this implies that a generation typically spans arou...
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From a historical and demographic perspective, a generation is viewed as the average interval of time between the birth of parents and the birth of their children. Traditionally, this implies that a generation typically spans around 20 years, and this matches the generations up to and including the Baby Boomers. Baby Boomers were born between 1946 and 1964, while Generation X generally includes individuals born in the mid-1960s up to the early 1980s. Generation Y comprises individuals bom between 1982 and 1994 (Howe and Straus 2000). They claim to be different from the previous generation in their familiarity with communications, media and digital technologies, and in the regularity and acumen with which they use them.
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The Going Global workshops emerged from the theory and practice of Carl Rogers’ person-centred approach. They are specifically influenced by Rogers’ ground-breaking developmental work with large group process and his specialized...
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The Going Global workshops emerged from the theory and practice of Carl Rogers’ person-centred approach. They are specifically influenced by Rogers’ ground-breaking developmental work with large group process and his specialized application of it to working with groups in conflict. This article is written by the team which created the Going Global workshops and provides an historical context for our work and an exploration of the knowledge, skills, and attitudes that are required to increase communication, promote peace, and reduce interpersonal and intercultural violence.
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Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative rese...
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Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach.
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Aim: A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment t...
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Aim: A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. Findings: The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and wellbeing. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Conclusion: Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.
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Introduction: Goal-setting in client-centred occupational therapy is often problematic. The Assessment of Client's Enablement was developed to measure the gap between an occupational therapist's and client's ratings of occupationa...
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Introduction: Goal-setting in client-centred occupational therapy is often problematic. The Assessment of Client's Enablement was developed to measure the gap between an occupational therapist's and client's ratings of occupational performance. This study examines the reliability and convergent validity of the assessment.
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