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

Abstract

Participation is often the comprehensive objective of treatment but also an indication of the extent to which the process of occupational therapy is client-centred. The purpose of this study was to explore levels of participation during occupational therapy among clients in the area of mental health from the occupational therapists' perspectives. Additionally the authors sought to identify factors that might hinder client participation. Postal questionnaires were sent out to 670 Swedish occupational therapists working with persons with mental illness and learning disabilities. The questionnaire required therapists to rate clients' levels of participation during occupational therapy. Findings indicated that the most common level of participation for the clients was interdependent, meaning that problems, goals, and plans were identified jointly and collaboratively with the occupational therapist. However, more than 20% of the clients were described as being dependent. Almost 90% of the occupational therapists rated client participation in therapy to be very important and nearly 70% claimed that client participation in general needed to be increased. Occupational therapists rated the primary barriers to participation as being clients' inability to participate and organizational and financial problems. Implications of these findings for education in client-centred practice approaches are discussed.

Key words::

• attitudes
• intellectual disabilities
• learning disabilities
• mental illness
• mental health
• occupational therapist
• practice

Acknowledgements

The authors would especially like to thank Karin Sjöberg, RegOT MSc OT, who completed the questionnaire and conducted the first survey, and Kristin Alfredsson Ågren RegOT MSc OT, for continuously support during the process. Thanks are also offered to all the occupational therapists who completed and returned the questionnaires.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.