Lab 8: Client-Centered Therapy PDF

Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab Lab 8...

Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab Lab 8 Client-Centered Therapy 6 Principles of Client-Centered Practice: 1. The client is capable of choice 2. Flexibility & individualized approach 3. Therapist’s role as enabler (therapist shares power & empowers client) 4. Success measured by client’s attainment of goals (client sets own priorities) 5. Need for contextual congruence – (interventions have meaning in client’s own life settings) 6. Client readiness to use therapist expertise “CLIENT-CENTERED ASSESSMENT” OCCUPATIONAL PERFORMANCE: the activities (self-care, productivity, & leisure) carried out by a client; these are influenced by one’s environment and societal factors. Allowing the client to set therapy goals through the means of client-centered assessment increases the chances for active participation. The following diagram illustrates the Canadian Model of Occupational Performance (CMOP) which illustrates how occupational performance evolves from the interactions between the person, the environment, and the occupation itself. 1  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab DEVELOPMENT OF THE CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM) An outcome measure OT’s use to assess client outcome in areas of self-care, productivity, & leisure Identifies problem areas in occupational performance, assists in goal setting, & measures changes in occupational performance over course of therapy Reflects the philosophy of the model of occupational performance Incorporates roles & role expectations within client’s environment Considers the importance of the skill/activity to the client Measures client-identified problem areas in daily functioning (if unable to identify – i.e. child or person with dementia – caregiver may respond) FEATURES OF COPM Client centered, generic (not diagnosis specific), crosses developmental stages Used w/physically dependent client to evaluate control over their environment Considers importance, to the client, of the occupational performance areas Interested in client’s satisfaction with present performance Measure development, maintenance/restoration of function, & prevention of change ADMINISTRATION &SCORING OF THE COPM 5-step process; semi-structured interview (therapist & client or caregiver or both) Step 1 – Problem Definition What kind of occupational problems does the client have? These could be activities of selfcare, productivity & leisure. Step 2 – Problem Weighting The client is asked to rate importance to them of each of the identified problem areas on a scale of 1 (not important) – 10 (extremely important) 2  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab Step 3 – Scoring The client is asked to rate (a) ability to perform, and (b) their satisfaction with that performance of the 5 most important problems (1-10) Ability and satisfaction ratings multiplied by the importance rating to determine baseline scores Client & therapist then decide on goal of treatment (develop, restore, etc.) Step 4 – Reassessment The client is asked to rate their abilities and satisfaction with performance in the activities identified in Step 2 These values compared with original values to track change(s) over time This provides a concrete image of changes during the therapy process Step 5 – Follow-up Purpose is to plan for treatment continuation, follow-up, or discharge Therapist asks client/caregiver if the occupational performance problems remain NOTE: Try to find the most important functional activities, but those are difficult to be done independently by the client. These top 5 areas will be the focus of the therapy. Practice *Form groups of 4 students and practice the following: A- List examples of factors that can affect the functional performance relate to: 1- Person: 2- Environment: 3- Occupation: 3  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab B- List examples of following the principles of Client-centered therapy practice principles and other examples of violating these principles: Principle Principle Followed Principle Violated The client is capable of choice Flexibility & individualized approach Therapist’s role as enabler (therapist shares power & empowers client) Success measured by client’s attainment of goals (client sets own priorities) Need for contextual congruence – (interventions have meaning in client’s own life settings) Client readiness to use therapist expertise 4  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab C- Practice using the COPM: Choose one of the group members to be the client for this exercise. The client will come up with a case scenario that he/she is suffering from (any condition) Interview the client and fill out the COPM based on the hypothetical scenario 5  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203 – OT Fundamentals Lab 6