The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition

Disabil Rehabil. 2016 Aug;38(16):1567-77. doi: 10.3109/09638288.2015.1107628. Epub 2016 Feb 6.

Abstract

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. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

Keywords: Client-centred practice; neurological rehabilitation; qualitative research.

MeSH terms

  • Adult
  • Grounded Theory
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Nervous System Diseases* / psychology
  • Nervous System Diseases* / rehabilitation
  • Neurological Rehabilitation* / methods
  • Neurological Rehabilitation* / psychology
  • Occupational Therapy / methods*
  • Patient Preference*
  • Patient-Centered Care / methods*
  • Professional-Patient Relations
  • Qualitative Research
  • Rehabilitation Centers