Client-centered and Evidenced-based Practice

Two main principles guide occupational therapy practice: client-centered practice and evidenced-based practice.

Client-centered practice

• The term was coined in the 1930s by the psychologist, Carl Rogers, to describe a counseling approach thats main goal is to focus on the issues that are brought up by the clients themselves.
• There are seven key concepts of client-centered pratice:
• Respect for clients and their families and the choices they make.
• Recognition that clients and families have the ultimate responsibility for decisions about daily occupations and occupational performance.
• Provision of information, physical discomfort, and emotional support with an emphasis on person-centered communication.
• Facilitation of client participation in all aspects of occupational therapy service.
• Delivery of flexible, individualized occupational therapy services.
• Faciliation of the capacity of clients to solve thier occupational performance issues.
• Recognition of and focus on the person-environment-occupation relationship (Crepeau, Cohn, & Schell, 2009)
• Although there is little research evidence to support the client-centered approach in occupational therapy, there is a growing amount of research that supports the benefits of using client-centered principles in practice.
• Some of the benefits include:
• improved functional performance in meaningful areas of occupation
• Continuation of life roles
• Reduced pain
• Improved client satisfaction of therapy and outcomes

Evidence-based Practice

• Pracitioners should use current and most appropriate evidence from research studies to select the most effective tools for assessments, interventions, and outcome measures.
• In addition to information gathered from research studies, pracitioners should also use their clinical experience, ethics, client-centered values and theory to guide their practice.
• There are four steps to evidence-based practice:
• Writing a clinical question that has the ability to be answered
• Collecting the most current evidence from different disciplines
• Reviewing the evidence to ensure that one has found the best possible answer
• Passing on the evidence to client, family, and other stakeholders in order to make a decision (Crepeau, Cohn, & Schell, 2009)