The problem of this study was a descriptive analysis of the process of client-centered play therapy. The purposes of this study were (l) to investigate and describe the patterns of play activities, nonverbal expressions, and verbal comments during the process of client-centered play therapy; (2) to determine whether phases of emotional and/or social development do exist during the process of client-centered play therapy; and, (3) to describe any identified phases of emotional and/or social development that exist during the process of client-centered play therapy.

Using a participatory ergonomic approach, this research explored if the self-identified needs and concerns of computer users are reflected in a typical occupational therapy office ergonomic educational presentation. While the study confirmed that generally the needs of computer users are met, the topics that the participants found to be most relevant were workstation layout and equipment adjustment. This study also revealed that knowledge transfer/translation is an important factor and that clinicians should consider involving clients at the initial development phase of client educational information. The study participants preferred ergonomic information to be communicated in a brief manner, emphasizing action-oriented information and avoiding medical references. They wanted client information to employ humour, colour and lots of “pizzazz.” The manner in which clinical information is communicated to clients is vital for effective client education.

This study addressed two questions: (a) how do the various discourses that are at work in everyday practice of occupational therapists inhibit or enhance a collaborative therapist-client therapeutic relationship and (b) what are the ways of strategizing a more client-centred collaborative approach in the midst of the tensions and disjunctures of everyday clinical practice? These questions were addressed by analyzing narratives from the everyday practice of occupational therapy. These narratives were constructed from my own practice in order to provide an insider’s view from the clinician’s perspective, a view that is missing from the extensive literature on client-centred practice in occupational therapy. Guided by an emancipatory interest, the study focused primarily on the tensions between dominant health care discourses that position the therapist as expert and a collaborative, egalitarian therapeutic relationship, which I called “participatory consciousness” after Heshusius (1994). The methodology of critical reflexivity had two parts. The first was the assemblage and interpretations of a collage for the purpose of critically examining my values, beliefs and theoretical predispositions; and the second was the critical reading and rereading of the practice narratives using as analytical tools the concepts of discourse and of occupational therapy clinical reasoning. Discourse refers to ways of thinking, feeling and acting that constitute social and cultural reality. Clinical reasoning refers to how clinicians think in the midst of practice and was the key to identifying how the clinician consciously and/or consciously negotiated or resisted the discourses shaping the clinician-client relationship. The study demonstrated what was entailed in the move to participatory consciousness and offered recommendations to the profession for supporting therapists to move toward a deeper sense of collaboration within client-centred practice.

Thesis (Ph.D.) -- University of Western Sydney, 2002. / A thesis submitted in fulfillment of he requirements for the degree of Doctor of Philosophy at the University of Western Sydney, School of Social Ecology and Lifelong Learning, College of Arts, Education and Social Sciences, Oct. 2002. Bibliography : p. 303-321.

Aim: The purpose of this study is to investigate and describe professional occupational therapists' experiences of what characterizes a good therapeutic relationship between the occupational therapist and the client. Method: The study was designed based on an qualitative approach where data is obtained via semi-structured interviews. The selection was made through strategic selection. Results: The following four main categories emerged: Flexible approach, Client-centered approach, Creating a safe relationship and Confident as an occupational therapist. The category Flexible approach reflects the occupational therapist's ability to adapt to person and situation. The category Client-centered approach means seeing the uniqueness of each client and working based on the client. The category Create a safe relationship reflects various aspects needed to create security in the relationship. The category Confident as an occupational therapist means being confident in the professional role of occupational therapist and also making preparations that provide security for the occupational therapist. Conclusion: These results increase the understanding that there are important aspects that form the basis for a good relationship between occupational therapist and client and how it promotes participation. Additional aspects based on the study are the time perspective required to promote a good relationship, but also the confidens of one's own professional role. The experience of occupational therapists shows that there is an awareness of what constitutes the basis for the good therapeutic relationship and its significance. The study also show that the occupational therapist works actively with the therapeutic relationship in their daily work. The relationship is affected by the occupational therapist's ability to be flexible, confident in himself/herself and his/her own professional role, the ability to work client-centered and the ability to make the client feel safe. Without these aspects, it becomes more difficult to create a good relationship and thus more difficult to promote participation. The relationship requires commitment from the occupational therapist, both to build and maintain it. Further research in the subject could be security in one's own professional role and how it affects the creation of relationships with the client. Other research that may be of value is the time perspective needed to establish a therapeutic relationship in relation to the cost-effectiveness of care

Syfte: Syftet med denna studie var att beskriva arbetsterapeuters erfarenheter inom specialiserad palliativ vård. Metod: En kvalitativ studie genomfördes. Deltagarna bestod av elva arbetsterapeuter yrkesverksamma inom specialiserad palliativ vård. Datainsamlingen skedde med semistrukturerade intervjuer per telefon och datan analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i ett övergripande tema; Att möjliggöra aktivitet och delaktighet till livets slut med tre kategorier; Flexibilitet och följsamhet, Interventioner med livskvalité som mål och Teamet fyller flera funktioner. Resultatet visar att arbetsterapeuternas erfarenheter är att samtal och följsamhet utgör grunden för den terapeutiska relation som behövs för att stödja klienten i sin process och genomföra interventioner som bygger på klientens egna behov och önskemål. Resultatet visar att det krävs framförhållning och flexibilitet eftersom det sker snabba förändringar hos klienterna. Interventioner som utförs syftar till att klienten skall uppleva livskvalité till livets slut vilket bland annat görs med kompensatoriska åtgärder, handledning, anpassning av aktiviteter och miljö samt symtomlindring. Att arbeta i ett multiprofessionellt team utgör grunden för att möta klientens fysiska, psykiska, sociala och existentiella behov där teamet även utgör ett emotionellt och kunskapsmässigt stöd för arbetsterapeuten. Slutsats: Resultatet kan bidra med förståelse och kunskap för det förhållningssätt och arbetssätt som arbetsterapeuten använder sig av inom palliativ vård för att möta klientens behov och möjliggöra aktivitet och delaktighet till livets slut. Studien kan även bidra till en förståelse för betydelsen av ett fungerande teamarbete, samt varför arbetsterapeuten som profession inom de palliativa teamen behövs. Ytterligare forskning behövs för att beskriva arbetsterapeutens unika kompetens i den palliativa vården samt hur den kompetensen förvärvas. Vidare behövs forskning om arbetsterapi inom olika palliativa vårdformer för att belysa och tydliggöra arbetsterapi inom palliativ vård och skapa en gemensam teoretisk grund. / Aim: The aim of this study was to describe occupational therapists’ experiences of specialized palliative care. Method: A qualitative study was conducted. The participants consisted of eleven occupational therapists working in specialized palliative care. The data collection was conducted with semi-structured interviews using telephone and the data was analyzed with a qualitative content analysis. Result: The analysis resulted in an overall theme; To enable occupation and participation until the end of life with three categories; Flexibility and compliance, The goal of interventions is quality of life, The multifunctional team. The result shows that the occupational therapists experiences is that conversation and compliance form the basis of the therapeutic relationship required to support clients in their process and implement interventions based on the clients individual needs and requests. The result shows that it takes foresight and flexibility to meet the clients rapid changes. The aim with interventions is that clients shall experience quality of life till the end of life. This is for instance made with compensatory interventions, guidance, adapting activities and environment and symptomatic relief. Working in a multi-professional team is the basis for meeting the client's physical, mental, social and existential needs, where the team also stands for knowledge exchange and as an emotional support. Conclusion: The result can contribute with understanding and knowledge of the approach and working method used by the occupational therapist in palliative care to meet the client's needs and enable activity and participation towards the end of life. The study can also contribute to an understanding of the importance of teamwork in palliative care and why the occupational therapist is needed in the palliative care teams. Further research is needed on the occupational therapists unique competence and how it is acquired. Further research is needed on occupational therapy in various palliative care forms to clarify occupational therapy in palliative care and to create a common theoretical basis.

Syftet med litteraturöversikten var att beskriva kunskapsläget vad gäller arbetsterapeutiskt hemrehabilitering vid stroke med fokus på klientcentrering. Metoden som använts under litteraturöversiktens gång bygger på 10 artiklar hämtade från fyra databaser inriktade på arbetsterapi och rehabilitering; PubMed, CINAHL, AMED och PsycINFO. Författarna har granskat de valda artiklarna, identifierat likheter och skillnader i resultatet som resulterade i tre kategorier. Resultatets kategorier blev; Hemmiljöns betydelse för den klientcentrerade rehabiliteringen, klientens delaktighet under den klientcentrerade hemrehabiliteringen och det sociala nätverkets påverkan på den klientcentrerade hemrehabiliteringen. Resultatet visar på att hemmiljön vid rehabilitering efter stroke har stor betydelse för klienten och den fortsatta rehabiliteringen i hemmet. Klientens delaktighet vid rehabiliteringen är viktig för att rehabiliteringen ska bli så bra som möjligt och för att få effektiva resultat. Anhöriga och andra personer runt klienten är viktiga för rehabiliteringen efter stroke. Slutsatsen som författarna kom fram till var att det behövs rutiner för att trygga klienter vid hemrehabilitering. Utbildning och information till anhöriga måste säkerställas. Klienters känsla av delaktighet i rehabiliteringen behöver stärkas. Ytterligare forskning på hemrehabilitering och klientcentrering i samband med stroke behövs.

The aim of this study was to make changes to how occupational therapists in a transitional care unit setting provide education about Cognitive Performance Test (CPT) scores to caregivers of those patients with dementia or suspected dementia. Caregiver education for this population is important, as the incidence of persons living with Alzheimer's disease and other dementias is expected to grow dramatically in the coming two decades. This study used a Participatory Action Research (PAR) approach to gather input from occupational therapists and caregivers of patients evaluated with the CPT. Interviews of caregivers indicated that they were unhappy with the education they received from therapists. Caregivers wanted a more collaborative relationship with therapists, and were sensitive to the experience of their loved one in occupational therapy in general, as well as to the approach to the education and the tone and language used to convey information about CPT scores. Therapists, with the caregiver input, worked together to develop education that reflected the needs of the caregivers, creating a new process, new tools and more opportunities for therapist- caregiver interactions. Interviews with a second group of caregivers who experienced the new education process revealed that they had a different, more positive experience overall with the new caregiver education process. This finding suggests that PAR as a methodology is well suited to facilitate changes to support development of client centered occupational therapy practice.

"Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Occupational Therapy Department, College of Allied Health and Nursing, Nova Southeastern University." The author explored the current state of practice and the essential elements in the wheelchair assessment and procurement process. Obtaining the correct wheelchair is a complex process, involving the client, family, practitioners, suppliers, manufacturers, policy makers and insurers. This study utilized a qualitative research approach using Participatory Action Research (PAR) and a Delphi consensus approach to garner input from 155 individuals who have experience in the field of wheelchair assessments. While wheelchair users account for 1% of the United States population over the age of 6, they experience oppression, unemployment, and activity limitations. The findings of this study suggest that the wheelchair assessment process be theoretically based on empowerment and reflect a client-centered process.

Culturally diverse clients often face barriers to accessing and using health and education services, which may affect the clients’ performance outcomes and impact the quality of services. These barriers include practitioners’ insufficient cultural competence and humility and an ineffective health care system. The Cultural Humility program aims to train and educate occupational therapy practitioners to gain confidence and improve their cultural humility and practical communication skills to maintain, establish, and manage therapeutic relationships. The program duration will be twelve 2-hour biweekly sessions over 6 months, in person at clinical settings or on a virtual platform. The program includes learning modules, such as lectures, simulation or video modeling, and discussion sessions with brain-based learning for occupational therapy practitioners. The program will provide meaningful opportunities for practitioners to reflect on their practice attitudes, gain confidence, change their mindsets, and learn practical communication skills for use with clients from various cultural backgrounds. The aim of the Cultural Humility program is to apply these practical techniques related to cultural humility, bringing synergy and authenticity to practitioners’ daily practice, and improving their clients’ performance and outcomes.