A macro perspective for client-centred practice in curricula: Critique and teaching methods

Abstract

Background: Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients’ goal attainment. Objectives: The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students’ abilities to address the complexities of client-centred practice. Method: This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Findings: Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students’ competencies for empowered client-centred practice are required. Conclusion: Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

Key words:

• Disabilities studies
• empowerment
• occupational therapy education
• professional competence
• social justice

Acknowledgement

I thank Melissa Teresco, University of Scranton Graduate Assistant, for her production assistance.

Dedication

This work is dedicated to my brother Kevin Michael Fleming (1954-1989) and to University of Scranton graduate student Maria Gervasio (1991-2014). While Kevin could not win his battle with Friedreich’s Ataxia, his tenacious fight to live a self-directed life remains my inspiration. His life would have been greatly enriched by working with an occupational therapist such as Maria. ‘got’ the big picture. She is dearly missed by all who loved her and (unbeknownst to them) by those who never had the privilege of having the gift of Maria in their lives.

Declaration of interest: The author reports no conflict of interest. The author alone is responsible for the content and writing of this paper.