Power and Client-Centred Practice: An Insider Exploration of Occupational Therapists' Experiences

Background. Although problems with power sharing are frequently described in discussions about client-centred practice, little research has explored occupational therapists' experiences with this model of service delivery. To critically examine this aspect of occupational therapy, an insider study was conducted. Purpose. The objectives of the study were to explore therapists' experiences with client-centred practice and to reveal how power works within this practice and in the health service environment. Method. Semi-structured interviews with 9 therapists were conducted and a thematic analysis of these transcripts was completed. A variety of institutional documents were reviewed and analysed. Results. Three main themes were identified: the different interpretations of occupational therapy discourse, the power of context and the continuum of client-therapist interactions. Clinical Implications. It is important to consider the various competing discourses and institutional practices that frame the therapeutic relationship when evaluating methods to improve client-centred practice.