Pursuing the Client's Goals Really Paid Off

This paper reports on a qualitative study undertaken to examine the barriers to the application of a recently created British definition of client-centred occupational therapy. Twelve therapists in one mental health National Health Service trust were engaged in semi-structured interviews. Three themes and a number of subthemes emerged from the analysis of the data. These three themes were initiating client-centred practice, therapist as partner and client as partner. Overall, the study found that there were barriers to the application of the definition of client-centred occupational therapy but that the therapists in this study found ways to overcome these barriers.

Goal setting in neurological rehabilitation: Patients' perspectives

PURPOSE

Goal setting has been described as the core skill of rehabilitation professionals, but there is little information about patients understanding of goal setting. This study explored how in-patients with neurological impairments experienced two different types of goal setting and identified the issues that underpin individuals' experience of goal setting.

METHOD

The study took place in a neurological rehabilitation unit in which two approaches to goal setting were being used that differed in the amount of patient involvement. A qualitative research design was adopted. Six focus groups were convened, three for participants experiencing usual participation and three for those with increased involvement in goal setting. A total of 28 participants (12 women, mean age 49 years) with a variety of deficits were recruited to the study over nine months. Thematic analysis was used to analyse the focus group transcripts.

FINDINGS

Four themes were identified which impact on the ways in which in-patients make sense of goal setting: The rehabilitation process; personal response to goal setting; previous experience and disease limitations.

CONCLUSIONS

Healthcare professionals working in rehabilitation need to explore patients' understandings of their disease and their experiences and expectations of goal setting to ensure goal setting is a meaningful activity.

Occupational therapy intervention to foster goal setting skills for homeless mothers

SUMMARY Occupational therapy intervention was provided to two mothers living in a homeless shelter to foster goal setting skills and the ability to develop a systematic method to meet those goals. The Model of Human Occupation (MOHO) was used as the theoretical framework to guide intervention. Both mothers were able to establish personal goals and work towards meeting those goals but the outcomes varied. The difference in outcomes between the two mothers is described using MOHO with analysis of how occupational therapy services can be used with homeless mothers.

A framework of strategies for client-centred practice

BACKGROUND

Implementing strategies to overcome barriers to client-centred practice is a challenge encountered by many occupational therapists in their daily practice. The Client-centred Strategies Framework is proposed as a tool to assist occupational therapists to consider barriers and implement strategies from a variety of perspectives.

DESCRIPTION

The framework consists of five categories: personal reflection, client-centred processes, practice settings, community organizing, and coalition advocacy and political action. Within each category are a number of actions that can be taken to facilitate client-centred practice. This paper describes the framework with elaboration of each of the five categories. A case example is used to illustrate how a therapist can use the framework to address client-centred practice issues.

PRACTICE IMPLICATIONS

This framework will assist therapists and students to problem-solve ways to enhance the use of client-centred processes within their own practice environments.