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Client-Centered Care

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									Client-Centered Care
Tracey Vause Earland, MS, OTR/L EPaD GEC Interprofessional Geriatric Education Fellowship 6/18/09

• Understand key components of client-centered practice • Review the origins of using a client-centered approach • Identify the challenges in facilitating collaboration with our clients • Describe methods/strategies to implement clientcentered practice in your practice arena

Client- Centered Care
• “A partnership that uses a multidimensional process that encompasses joint decision making, listening, collaboration throughout service delivery” (Elliott, S., & Coppola,
S., 2008, p.320 )

• Power is shared and used to achieve results that are in the best interest of the client.

Roots of Client-Centered care: Carl Rogers
• Psychologist, founder of professional counseling
-Need to facilitate client’s development of self-awareness - “It’s only the client who knows what hurts, what direction to go, what problems are crucial, what experiences have been deeply buried.” (Rogers, CR, 1961, p.11)
- Client is a partner in the therapeutic process; must take an active part in his intervention

Rogerian Concepts
• Client-centered approach:
Enabler Facilitator Coach

• Respect of the client’s uniqueness as an individual and ability to exercise choice & determine priorities.
(Rogers, C. 1950)

Guidelines for the Client-Centered Practitioner:
• Exhibit empathy • Adopt an attitude of flexibility • Willingness to actively engage with the client • Listen to the client’s story (concept of “storytelling”) • Share your expertise; acknowledge the client’s expertise • Advocacy
(Coppola, S., Elliot, S., Toto, P., 2008)

Guidelines for the Client-Centered Practitioner:
• Collaborate on goals and objectives (& all levels of care) to help the client re-engage in meaningful activity that supports his or her roles. • The client is a significant team player in your practice • Collaboration encompasses sharing power, establishing mutual trust, congruence

Changing your Language in ClientCentered Care
• Your language shows a shift in perspective • “patient” vs. “client” • Using the client’s terminology in discussion

Challenges to Client-Centered Care
• Lack of awareness of the approach & the client’s role in the process • Low cognitive level or inability to voice opinions • Poor motivation to gain Independence/improve • Preference NOT to assist in goal setting • Domination of medical model • Incongruence between the goals of the practitioner & the client
(Coppola, S., Elliot, S., Toto, P., 2008)

Ways to Overcome Challenges & Facilitate Client-Centered Care
• Educate & train practitioners on this model of care • Gain peer, facility and administrative support • Present case studies exemplifying client-centered practice • Discuss with team members-share approaches & strategies • Attend educational seminars to develop skills and confidence in the use of a client-centered approach

Summary: Take home strategies to facilitate Client-Centered care
• Acknowledge the lifetime experience of the older client • Simulate/empathize the conditions the older client faces • Listen to their story; Adjust your communication • Explain the client-centered partnership approach

Summary: Take home strategies to facilitate Client-Centered care
• Exhibit trust, show genuine interest, empower confidence-they have impact on their own health • Collaborate on all aspects of services • Advocate – view client in a holistic manner


Satisfied Clients!

• Elliott, S, & Coppola, S. (2008). Best Practice in Gerontology. In S. Coppola, S. Elliott, & P. Toto (Eds.), Strategies to Advance Gerontology Excellence: Promoting Best Practice in Occupational Therapy (pp.320-324). Bethesda, MD: AOTA Press • Hobson, S. J. G.(1999). Using a client centered approach with elderly people. In T. Sumsion (Ed.), Client-centred occupational therapy (pp.61-74). Edinburgh, UK: Churchill Livingstone. • Ikiugu, M. (2007). Psychosocial Conceptual Practice Models in Occupational Therapy: Building Adaptive Capability. St. Louis, Missouri: Mosby Elsevier • Law, M. & Mills, J. (1998). Client-centered Occupational Therapy. In M. Law (Ed.), Client-centered occupational therapy (pp.1-18). Thorofare, NJ: Slack. • Rogers CR (1950). A Current Formulation of client-centered therapy. Social Service Review 24: 442-450. • Rogers CR, (1961). On Becoming a Person. Boston, Mass.: Houghton Mifflin

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