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

Abstract

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.

Purpose: 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.

Method: 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.

Clinical implications: 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.