Client-Therapist Relationships: Experiences of Occupational Therapy Clients in Rehabilitation

Abstract

The relationship between a therapist and his or her client has been recognised to be an important determinant of the success or failure of occupational therapy. The purpose of this qualitative study was to explore clients' perceptions of the relationship that they formed with their occupational therapist in the context of rehabilitation. Twenty clients with varied health problems were interviewed.The analysis of data revealed three main categories, therapist role, power and connection, as pertaining to the characteristics of the client-therapist relationship. From these categories, seven different relationship dimensions were identified and arranged hierarchically. The dimensions were described as concern, direction, fellowship, guidance, coalition, detachment and rejection. Relationships were generally experienced as positive; however, there were also examples of negative and detrimental experiences.The findings are discussed in relation to the definition of the therapeutic relationship and to client-centred practice. Occupational therapists are encouraged to consider their own attitudes, needs and boundaries when it comes to establishing close connections and to share power with their clients. Furthermore, therapists must explore which form of relationship and participation each client prefers in order to establish an effective collaborative relationship.

The myth of participation in occupational therapy: reconceptualizing a client-centred approach

“…The present study explores this focus on participation. Participation as a means is reflected in clientcentred approaches, which are fundamental in occupational therapy practice today (2,4,(7)(8)(9)(10)(11).…”

“…The importance of client participation is also highlighted in the Swedish Code of Ethics for Occupational Therapists (19). Studies with clients as respondents indicate that occupational therapists should be more aware of clients' desire for participation and involve them more in the planning and process of therapy (10,13,20,21). Of interest, is that all of these findings are based on information gathered from respondents with physical disabilities.…”

Therapeutic Use of Self in Academic Education: A Mixed-Methods Study

“…Clients in an array of service settings have expressed consistent desires relative to their relationships with professional care providers, including sincere interest, respect, empathy, rapport, acceptance of the client's frame of reference and individuality, and collaboration (Asay & Lambert, 1999;Blank, 2004;Corring & Cook, 1999;Palmadottir, 2006). In clinical psychology, the quality of the therapeutic relationship has been found to account for 30% of the therapeutic effect of therapy, regardless of the therapeutic techniques being used or the severity of the client's presenting problems and motivation (Lambert, 1992).…”

Deconstructing hierarchies: Service users as co-teachers in occupational therapy education

“…Following this, major occupational therapy leaders called for a return to the holistic, humanistic foundation of the profession [4,5], which translated into the development of client-centered approaches as best practice, and reclaimed the biopsychosocial model as the basis for occupational therapy practice [1]. While presently, occupational therapy tends to see itself as operating based on a client-centered approach which reflects the notion of collaboration with the service user [10], research often reflects a discrepancy between rhetoric and actual practice favoring the medical model, as viewed by service users and reflected in occupational therapy clients' narratives [3,6,7].…”