Occupational Therapy Assessments: How Client-Centred Can They be?

Client-centred practiceClient-centred practice requires the involvement of the client throughout the assessment and therapeutic process; its background is outlined briefly.In order to consider how client-centred occupational therapy assessment can be, some of the complexities of implementing client-centred principles in assessment are presented in a fictitious case study. Development of a client-centred approachSince the 1950s, occupational therapy has progressively adopted client-centred views based on humanistic theories, such as those of Rogers.Law et al (1995) suggested that the Rogerian influence within the profession was manifested through: ■ The acceptance of the dynamic nature of the therapistclient interaction ■ The need for the client to have an active role in problem resolution ■ The need for honesty and openness in the therapeutic relationship ■ The recognition of the importance of cultural values determined by the client.A further consequence of this growing regard for humanistic principles within occupational therapy has been the development of models of practice that emphasise the importance of client-centredness.Baum (1998) identified seven such occupational therapy models, including the Model of Human Occupation (Kielhofner 1995), the Person-Environment-Occupational Performance Model (Christiansen and Baum 1991) and the Canadian Model of Occupational Performance (Canadian Association of Occupational Therapists 1997).These models can be used in a client-centred approach if the occupational therapist places the focus on the client' s goals and occupational needs. The assessment processThe initial step in client-centred assessment is for the occupational therapist to listen to the client' s concerns.The therapist and the client subsequently establish a partnership to enable the achievement of the client' s goals.For some clients, this will be an easy task; for others, the identification or resolution of occupational problems may be more difficult to achieve.