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Power and client-centred practice: an insider exploration of occupational therapists' experiences. 2006

W Bennett Mortenson, and Isabel Dyck
University of British Columbia, School of Rehabilitation Sciences, Vancouver, Canada. bmortens@interchange.ubc.ca

BACKGROUND Although problems with power sharing are frequently described in discussions about client-centred practice, little research has explored occupational therapists' experiences with this model of service delivery. To critically examine this aspect of occupational therapy, an insider study was conducted. OBJECTIVE The objectives of the study were to explore therapists' experiences with client-centred practice and to reveal how power works within this practice and in the health service environment. METHODS Semi-structured interviews with 9 therapists were conducted, and a thematic analysis of these transcripts was completed. A variety of institutional documents were reviewed and analysed. RESULTS Three main themes were identified: the different interpretations of occupational therapy discourse, the power of context, and the continuum of client-therapist interactions. CONCLUSIONS It is important to consider the various competing discourses and institutional practices that frame the therapeutic relationship when evaluating methods to improve client-centred practice.

UI MeSH Term Description Entries
D009788 Occupational Therapy Skilled treatment that helps individuals achieve independence in all facets of their lives. It assists in the development of skills needed for independent living. Ergotherapy,Therapy, Occupational,Ergotherapies,Occupational Therapies,Therapies, Occupational
D011209 Power, Psychological The exertion of a strong influence or control over others in a variety of settings--administrative, social, academic, etc. Power (Psychology),Power, Personal,Power, Professional,Power, Social,Power,Personal Power,Powers, Psychological,Professional Power,Psychological Power,Psychological Powers,Social Power
D011369 Professional-Patient Relations Interactions between health personnel and patients. Contacting Clients,Pharmacist-Patient Relations,Professional Patient Relationship,Client, Contacting,Clients, Contacting,Contacting Client,Pharmacist Patient Relations,Pharmacist-Patient Relation,Professional Patient Relations,Professional Patient Relationships,Professional-Patient Relation,Relation, Pharmacist-Patient,Relation, Professional-Patient,Relations, Pharmacist-Patient,Relations, Professional-Patient,Relationship, Professional Patient,Relationships, Professional Patient
D001955 British Columbia A province of Canada on the Pacific coast. Its capital is Victoria. The name given in 1858 derives from the Columbia River which was named by the American captain Robert Gray for his ship Columbia which in turn was named for Columbus. (From Webster's New Geographical Dictionary, 1988, p178 & Room, Brewer's Dictionary of Names, 1992, p81-2)
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D018802 Patient-Centered Care Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14) Nursing, Patient-Centered,Patient-Centered Nursing,Patient-Focused Care,Person-Centered Care,Medical Home,Care, Patient-Centered,Care, Patient-Focused,Care, Person-Centered,Cares, Person-Centered,Home, Medical,Homes, Medical,Medical Homes,Nursing, Patient Centered,Patient Centered Care,Patient Centered Nursing,Patient Focused Care,Person Centered Care,Person-Centered Cares

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