Thelma Sumsion

A Review of Evidence on the Conceptual Elements Informing Client-Centred Practice:

Background. Client-centred practice is a central concept in occupational therapy in Canada. Since 1980, Canadian occupational therapy publications have discussed the elements of a client-centred practice approach. Purpose. The purpose of this paper is to enhance the understanding of key elements of a client-centred approach and to highlight the implications for practice that arise from this discussion. Method. Literature about client-centred practice in health care from 1990–2005 was reviewed regarding thoughts and ideas about client-centred practice. The content was analyzed for thematic focus about client-centred practice conceptual ideas and their influence on practice. Results. Thematic conceptual elements emerging from the review include an overarching theme of power, with important underpinning themes of listening and communicating, partnership, choice, and hope. Selected definitions of client-centred practice and the link to best practice provide the context for the presentation of the concepts and recommendations for the implementation of client-centred practice. Practice Implications. The paper concludes with a discussion of practice implications through the presentation of questions for therapists to consider as a quick reference tool and suggestions for further research and dialogue concerning client-centred practice.

Barriers to Client-Centredness and Their Resolution:

This research sought to determine which therapist barriers prevent client-centred practice the most, and which methods are perceived as being most effective in resolving therapist barriers. A list of barriers that therapists bring to client-centred practice and methods to resolve these was identified from the literature and formed the basis of a questionnaire sent to 60 occupational therapists in the United Kingdom. The results showed that the therapist and client having different goals was the barrier which most prevented client-centred practice. The high ratings of other statements suggested that the values, beliefs and attitudes of therapists and of the employment culture make client-centred practice uncomfortable to use and hence prevent its implementation. Case examples showing how to practice in a client-centred fashion were rated as the most effective method of barrier removal.

Client-Centred Practice: The True Impact

1993 marks the tenth anniversary of the release of the Guidelines for the Client-Centred Practice of Occupational Therapy which are now central to many clinical programmes and evaluation tools. This discussion paper presents some questions about how the model of client-centred practice is being applied by occupational therapists, and asks whether or not therapists clearly understand the implications of the model. The advantages of this model, such as the ability for the diverse definition of the term “client”, its applicability to community practice, and the presentation of therapeutic challenges, are discussed. The author also provides her opinion about how the truly client-centred process should be applied.

Motivation for continuing involvement in a leisure‐based choir: The lived experiences of university choir members

This study explored the lived experience of participating in a non‐competitive choir as a leisure activity. Semi‐structured in‐depth interviewing was used to collect data from nine university choir members. Analysis, informed by Giorgi (1985), revealed four major themes: that choir members had previous musical experience, experienced a sense of community and social bonding, desired personal and group accomplishment, and felt that being in a choir offered stress relief and improved mood. Some aspects of the experience of choir were unique to small groups or individual participants leading to the discrimination of 11 additional themes. The study suggests that choir participation is a personal experience with varying effects on individuals’ feelings and motivation to engage in choir.

Balancing Challenges and Facilitating Factors when Implementing Client-Centred Collaboration in a Mental Health Setting:

This study undertook a replication of the work conducted by Sumsion in 2004 in the United Kingdom regarding the application of a definition of client-centred practice. Twelve occupational therapists employed by a local mental health facility and working with adult outpatients participated in semi-structured interviews. Template analysis and open coding were used to analyse the data. The resulting concept map indicated that collaboration and meaningful goals were at the centre of client-centred practice and formed the two main categories of data. The therapist and the client were the protagonists in these categories, but the family, team and system also played major roles. A table within this paper outlines all the categories and themes that arose from the data. However, space limitations required a focus on only the category of collaboration and the therapist and client facilitators and challenges within this category. The therapists used both attitudes and actions to facilitate the client-centred process and the clients brought strengths to this relationship. Nevertheless, both groups faced many challenges that had to be overcome to enable the successful implementation of client-centred practice.

Critical elements of spirituality as identified by adolescent mental health clients.

Background. Client spirituality has been recognized as a central component of Canadian occupational therapy, but little research has been conducted in this area. Purpose. This exploratory study attempted to gain insight into the relevant elements of spirituality and its importance to inpatient adolescent mental health clients. Method. An adolescent spirituality questionnaire was developed from definitions of spirituality in the literature, modified by a focus group consisting of members of the target population, and administered to 11 respondents. Results. Elements related to the individual and lifelong pursuits of the individual were most closely associated with spirituality while those items traditionally connected with spirituality and with external pursuits, activities, and relationships are considered less relevant by this population. Results suggest that spirituality is important to a majority of inpatient adolescent mental health clients. Practice Implications. It is suggested that more studies drawing information on spirituality directly from specific client populations are essential for the occupational therapy community to improve its comprehension of, and to better its ability to address in practice, the critical area of client spirituality.

Client satisfaction of hand therapy intervention: An evaluation of the effectiveness of therapy for clients recovered from complex regional pain syndrome.

Complex regional pain syndrome (CRPS) is a neuropathic pain condition that may develop following trauma to an extremity. Clients treated for CRPS at St Josephs Health Care London - Hand and Upper Limb Centre, London, Ontario, were asked to evaluate their level of satisfaction with the treatment they had received by comparing their pain, functional status and emotional status before and after receiving therapy. The results indicated a high level of satisfaction among clients, attributable to the unique nature of the therapy program in use at this facility, where the occupational therapist works in close collaboration with the surgeon and pain specialists, and the therapy regimen is designed for each client individually according to his or her needs. The unique contribution of the present study to the body of clinical literature on CRPS is that it introduces a focus on client functionality and on client satisfaction with therapy received.

Client Satisfaction of Hand Therapy Intervention: An Evaluation of the Effectiveness of Therapy for Clients Recovered from Complex Regional Pain Syndrome

1School of Occupational Therapy,The University of Western Ontario; 2St Joseph’s Health Care London – Hand and Upper Limb Centre, London, Ontario Correspondence and reprints: Shrikant J Chinchalkar, Hand Therapy Division/Hand and Upper Limb Centre, St Joseph’s Health Care London, 268 Grosvenor Street, London, Ontario N6A 4L6. Telephone 519646-6001 ext 64807, fax 519646-6317, e-mail Shrikant.Chinchalkar@sjhc.london.on.ca N Zagzoog, SJ Chinchalkar, T Sumsion. Client satisfaction of hand therapy intervention: An evaluation of the effectiveness of therapy for clients recovered from complex regional pain syndrome. Can J Plast Surg 2008;16(1):27-35.

Book Mark: Ethical and Legal Dilemmas in Occupational Therapy, Second Edition (2003)Ethical and Legal Dilemmas in Occupational Therapy, Second edition (2003)BaileyDiana M.SchwartzbergSharan L.F. A. Davis Company/Publishers 1915 Arch Street Philadelphia, PA, 19103 224 pages;

This book is a practical resource guide offering a method of treatment for clients with mild to moderate depression that is based on cognitive behavioural therapy. It is also suitable for use with groups and offers suggestions on how to adapt the material to a more depressed inpatient population. The guide is designed for use by clinicians with minimal experience treating depressed clients and little previous knowledge of cognitive behavioural therapy. The resource book is a well written, easy to read, spiral-bound guide that is divided into three parts. Part 1 provides basic information about depression, cognitive behaviour therapy and other models of depression. This section includes principles of cognitive behaviour therapy, the cognitive model of depression, using cognitive therapy with depressed individuals and reasons for failure. Part 2 is especially well thought out. It describes the ten therapeutic steps used in the treatment in a way that can be utilized by both therapists for whom this approach is new as well as therapists experienced in using cognitive behavioural therapy. The authors include information on how to structure each section, suggest time frames for each portion of the session and provide handouts for each step that could be photocopied. Part 3 offers information on such topics as improving medication adherence, management of suicide and management of self-harm, again in a useful, practical format. Reading this book was a pleasurable experience. It was easy to follow, well laid out and the sections flowed well together. It would Theoretical Basis of Occupational Therapy, Second edition (2003)

29.95 US ISBN:0-8036-1101-3

Barbara VV Posthuma, Allyn and Bacon, Needham Heights, /V\A 02194 261 pages,