Client-Centered Therapy Overview

Client-Centered Therapy

• Client-centered therapy is an approach to service that prioritizes respect and partnership with clients. It emphasizes the client's rights to make choices regarding their care.
• It aims for a collaborative effort involving clients, patients' families, friends, doctors, and other health professionals.
• A client-centered approach focuses on the clients needs, with wellness as the primary outcome, rather than focusing exclusively on acute outcomes.
• The client-centered approach began in the 1960s and is based on deinstitutionalization efforts.

Learning Objectives

• Identify models that affect occupational therapy practice.
• Understand the importance of different models used in occupational therapy.
• Understand occupational therapists' client-centered practice.
• Discuss the principles of client-centered practice.

Introduction

• Models of healthcare influence occupational therapy at national and global levels. These models provide context for understanding practice.
• Models like the medical model, the international classification of functioning, disability and health, client-centered practice, and the American Occupational Therapy Practice Framework (AOTA, 2020), all contribute to the field.

Definitions

• Client-centered care embodies a philosophy of respect and partnership with clients.
• Client-centered care is a collaborative effort involving clients, patients' families, friends, doctors, and other health professionals to address client needs.
• Client-centered care focuses on clients' care needs and considers their caregivers' needs.

Features Derived from Definitions

• Respect for client values, needs, and preferences.
• Collaboration between the client (including their family) and the professional care team.
• Client/patient/person as the central focus of health services. Services should be centered around the user, not funders or professionals.

Client-Centered Practice

• Client-centered practice emerged in the 1960s.
• It was developed and founded by the Canadian Occupational Therapy Association (CAOT, 1997).
• It is considered the basic therapy model for the AOTA Practice Framework (2020).

Assumptions of Client-Centered Practice

• Clients have knowledge of what they need and want from therapy.
• Clients' perspectives on their problems are paramount.
• Professional dominance in therapy is counterproductive to client success.
• Therapists facilitate change; they are not agents of change themselves.

Canadian Model of Occupational Performance (CMOP)

• Client-centered practice aligns with the Canadian Model of Occupational Performance (CMOP).
• The CMOP illustrates how occupational performance arises from interactions among the person, environment, and occupation. (person, context, and activity)

General Points - CMOP

• Functional ability depends on interactions between the person, occupation, and environment.
• Changes to any part of this interactive system can affect occupational performance.
• Motivation is an intrinsic aspect of client engagement and is enhanced by client participation in defining meaningful goals.
• There isn't a specific plan for applying the therapeutic process: general strategies like facilitating, guiding, and supporting clients are often used.
• The therapeutic process is guided by the principles of client-centered practice.

6 Principles of Client-Centered Practice

1. The client is capable of choice.
2. Therapists use flexibility and individualized approaches.
3. Therapists are enablers who share power and empower clients.
4. Success is measured by clients achieving their goals, as defined by them.
5. Interventions must fit within the client's life context.
6. Clients are ready to use therapist expertise, at their own pace and choice.

Law et al (1995) Key Concepts to Client-Centered Practice

• Autonomy and choice
• Partnership and responsibility
• Enablement
• Contextual congruence
• Accessibility
• Flexibility
• Respect for diversity

Autonomy and Choice

• Client opinions and values are sought.
• Client dignity is upheld.
• Clients have the right to receive information in an understandable manner, which aids them in making decisions about their care.

Partnership and Responsibility

• Each partner in the collaborative relationship brings specialized knowledge.
• Each participant is responsible for contributing to the relationship.

Enablement

• Client-centered practice shifts focus from illness to wellness and from measuring acute care outcomes to measuring life satisfaction.
• Considering clients' capabilities rather than deficiencies is critical in this paradigm.

Contextual Congruence

• Understanding the client's roles, values, interests, environment, and culture is crucial to provide relevant client-centered care.

Accessibility

• Services provided in a timely and accessible manner to meet a client's needs.

Respect for Diversity

• Therapists respect differing values and beliefs.
• Power imbalances within the therapist-client relationship are acknowledged and mitigated.

This quiz explores the principles and models of client-centered therapy in occupational therapy. Discover how respect and partnership with clients enhance wellness outcomes. Test your understanding of the importance of client-centered approaches and their historical context in therapy practices.