Implementing a client-centred approach in rehabilitation: an autoethnography

Disabil Rehabil. 2012;34(12):997-1004. doi: 10.3109/09638288.2011.629712. Epub 2011 Nov 15.

Abstract

Purpose: Client-centred practice is widely considered a key element of rehabilitation. However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalized during a clinical trial of innovative goal-setting techniques.

Method: This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data.

Results: The primary way that client-centred practice was operationalized was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilizing mindful listening, allowing time, supporting clients to prioritize what is meaningful and viewing the therapists' role differently.

Conclusion: While technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropology, Cultural
  • Communication
  • Humans
  • Patient Participation*
  • Patient-Centered Care*
  • Professional-Patient Relations*
  • Qualitative Research
  • Rehabilitation*
  • Self Report