Client-centred occupational therapy in Canada: Refocusing on core values / Recentrer l’ergothérapie au Canada sur les valeurs fondamentales de la pratique centrée sur le client

Abstract

Background.

The Canadian occupational therapy profession has proclaimed its allegiance to client-centred practice for three decades. However, official definitions of client-centred practice have been inconsistent, and its defining features, underlying assumptions, and power relations have been subjected to little critical reflection.

Purpose.

The aim was to reflect critically on Canadian conceptions of client-centred practice and its core values.

Key issues.

Definitions of client-centred practice have evolved and changed, suggesting that the occupational therapy profession in Canada may have abandoned those values that originally underpinned its vision of client-centred practice by electing to focus on the enabling skills of therapists. However, evidence suggests that clients value those qualities of client-centred practice that underpinned the profession’s original vision.

Implications.

This paper proposes a renewed focus on respect—respect for clients; respect for clients’ strengths, experience, and knowledge; respect for clients’ moral right to make choices concerning their lives—and on fostering respectful, supportive relationships with clients.

Description.

Pendant trois décennies, la profession de l’ergothérapie au Canada a proclamé son allégeance à la pratique centrée sur le client. Toutefois, les définitions officielles de la pratique centrée sur le client ont été inconstantes, et les caractéristiques, suppositions sous-jacentes et relations de pouvoir qui la définissent ont fait l’objet de peu de réflexion critique.

But.

Faire une réflexion critique face aux conceptions canadiennes sur la pratique centrée sur le client et ses valeurs fondamentales.

Questions clés.

Les définitions de la pratique centrée sur le client ont évolué et changé au fil du temps, ce qui suggère que la profession de l’ergothérapie au Canada a peut-être abandonné les valeurs qui sous-tendaient initialement sa vision de la pratique centrée sur le client, en choisissant de mettre l’accent sur les compétences en habilitation des ergothérapeutes. Cependant, des données probantes indiquent que les clients valorisent les caractéristiques de la pratique centrée sur le client qui sous-tendent la vision originale de la profession.

Conséquences.

Cet article propose de recentrer la pratique sur le respect; le respect des clients, le respect des forces, de l’expérience et des connaissances des clients, le respect du droit moral des clients de faire des choix face à leur vie; et de favoriser les relations respectueuses et de soutien avec les clients.

Keywords

Autonomy Critical thinking Culture Models Power autonomie culture modèles pensée critique pouvoir

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