Deborah Corring

Client-Centred Care Means that I am a Valued Human Being

Canadian occupational therapists have increasingly adopted a client-centred approach to practice. Interpretation of what “client-centred” means has been diverse and varied. Professionals have written about the characteristics of this approach to care but no reported studies could be found that examined the clients perspective. The omission of the client perspective is puzzling when partnership, client involvement in decision making, and client empowerment are thought to be fundamental elements of this approach to practice. A qualitative research approach, using focus groups was employed to explore the opinions and perspectives of individuals with experience of mental illness and the mental health service delivery system. Seventeen individuals participated in three focus groups to discuss the meaning of a client-centred approach to practice. Participants assessed the inadequacies of past and present practices and recommended needed changes. Their central message was the need for individuals with mental illness to be viewed as valuable human beings by service providers and by society.

A systematic review of the views and experiences of subjects of community treatment orders

OBJECTIVE CTOS have been the subject of many qualitative and quantitative research studies. Both research approaches add value to our understanding of CTOs. Qualitative studies provide an understanding of CTOs and the experience of being on a CTO that quantitative studies cannot provide. Many qualitative studies that have examined the views of subjects of CTOs have been published. However, authors of these studies continue to note that views and experiences of the subjects of these orders are not well known. This paper provides the results of a systematic review of qualitative studies focused on understanding the experiences of individuals who have been the subjects of CTOs. METHOD Relevant databases and grey literature were searched. To be included, a study had to have used a qualitative methodology for data collection and analysis, and focus on examining stakeholder perspectives on the lived experience of CTOs. RESULTS After a rigorous review of the abstracts, we identified 22 papers that met the criteria. These papers were analysed in detail in order to examine the existence of common themes. The 22 papers represented the views of 581 participants from 7 countries around the world. Ten themes were found to be common among the research findings of the 22 papers. Three themes in particular were highlighted: feelings of coercion and control, medication seen as the main reason for a CTO and that the perception of CTOs as a safety net. Findings also highlight the ambivalence that subjects of CTOs experience, the importance of the therapeutic relationship for successful engagement of the subject of the CTO and the complex role of coercion. RECOMMENDATIONS We have made a number of recommendations about how clinicians might use the views of the subjects of CTOs achieve a more positive experience of a CTO.

Cognitive remediation for inpatients with schizophrenia or schizoaffective disorder using smart technology in a simulated apartment: a feasibility and exploratory study

This study aimed to examine the feasibility of using and evaluating SMART (Supported Mental Assessment, Rehabilitation and Treatment) electronic technology as part of providing cognitive remediation for tertiary mental health care in-patients diagnosed with schizophrenia-related cognitive impairments that are considered a barrier to their independent living. This was an uncontrolled intervention feasibility and exploratory study. The study involved eight participants in total. Both qualitative and quantitative research strategies were used. Results to date are promising. Participating patients expressed satisfaction with the simulated apartment and the smart technology and patients were able to learn and use skills relevant to independent living.

A Smart Apartment for Psychiatric Inpatients

The Frontline Reports column features short descriptions of novel approaches to mental health problems or creative applications of established concepts in different settings. Material submitted for the column should be 350 to 750 words long, with a maximum of three authors (one is preferred) and no references, tables, or figures. Send material to Francine Cournos, M.D., at the New York State Psychiatric Institute (fc15@columbia.edu) or to Stephen M. Goldfinger, M.D., at SUNY Downstate Medical Center (smgoldfingermd@aol.com).