Appropriate care delivery for patients with severe mental illness (SMI) requires a high level of collaboration quality between primary, mental health, and social care services. Few studies have ...addressed the interpersonal and inter-organizational components of collaboration within one unique study setting and it is unclear how these components contribute to overall collaboration quality. Using a comprehensive model that includes ten key indicators of collaboration in relation to both components, we evaluated how interpersonal and inter-organizational collaboration quality were associated in 19 networks that included 994 services across Belgium. Interpersonal collaboration was significantly higher than inter-organizational collaboration. Despite the internal consistency of the model, analysis showed that respondents perceived a conflict between client-centered care and leadership in the network. Our results reveal two approaches to collaborative service networks, one relying on interpersonal interactions and driven by client needs and another based on formalization and driven by governance procedures. The results reflect a lack of strategy on the part of network leaders for supporting client-centered care and hence, the persistence of the high level of fragmentation that networks were expected to address. Policy-makers should pay more attention to network formalization and governance mechanisms with a view to achieving effective client-centered outcomes.
This study explored the impact of an Australian regional university's Clients-as-Tutors Program (CTP) on speech-language pathology students' perception and understanding of client-centred practice.
...Two focus group interviews comprising three final-year students and four newly graduated speech-language pathologists who had completed the CTP. An inductive thematic analysis was undertaken to identify salient themes.
Three themes were identified: (a) learning from theory, (b) learning from others, and (c) learning from yourself. These themes represented all participants' experiences in the CTP, yet there were unique, individual journeys that each participant experienced.
Findings from this study have the capacity to affect change in how client-centred practice is taught at universities across speech-language pathology and other health courses, to disrupt the traditional power structure between client and clinician, and to provide an evidence base for the role of experiential learning in this area.
Despite universal healthcare, immigrants often face unique challenges accessing healthcare. Employing an interpretative phenomenological analysis approach, four focus groups were conducted with 29 ...women and eight men from 15 different countries attending English language classes hosted at a non-governmental organization in Regina, Saskatchewan, Canada in 2016 and 2017. Personal factors such as language barrier, lack of transportation, childcare and others interacted with systemic factors such as lack of appointment, long wait times, etc. delaying access at each point of contact with the healthcare system. Participants expressed dissatisfaction with the potency of medications, time spent in appointments and the way healthcare professionals communicated health information. The referral process and wait times were viewed as barriers to accessing specialist, diagnostic and acute care services. Participants were concerned that appropriate healthcare will be unavailable when needed. Strategies addressing systemic and person-specific barriers are needed to provide equitable client-centered care.
Despite a range of interventions available to treat mental health symptoms experienced by youth with a history of child sexual abuse (CSA), limited empirical work has examined practitioner delivery ...of these interventions in real-world practice.
This paper aimed to qualitatively explore the delivery of trauma-based interventions in community settings in Ontario, Canada.
Using qualitative description, a purposeful sample of service providers (N = 51; 92 % female) were recruited from nine community-based organizations located in Southern Ontario, Canada providing psychotherapeutic trauma-based interventions to youth with a history of child sexual abuse.
Semi-structured one-on-one (n = 17), joint (n = 3) and focus group (n = 5) interviews elicited provider descriptions of their strategies and approaches for addressing trauma-related symptoms in this population. Data were interpreted using conventional content analyses.
Eclectic delivery of interventions and multifactorial decision-making processes were identified as core elements of treatment planning and intervention delivery among providers. Eclectic treatment was described to involve the consideration of four core elements (provider judgement; youth voice; youth characteristics; and clinical team discussion) of intervention and three key principles (meeting youth needs; providing client-centered care; addressing safety and stability).
Research capable of characterizing the efficacy of client-centered, eclectic approaches to treat symptoms experienced by youth with a history of CSA is needed.
Returning to the community after being incarcerated brings many challenges. In Victoria, Australia, a government-funded contract with non-government organisations (NGOs) allocates reintegration ...workers to assist with the post-release social integration process. In 2020, we interviewed reintegration workers to explore how they performed their roles before and during the COVID-19 restrictions. The key finding was that building rapport to tailor support was the most crucial aspect of practice, which workers could not adequately do without meeting face-to-face. Strengths-based practices, consisting of holistic, trauma-informed interactions, should become enshrined in reintegration job roles and the key performance indicators (KPIs) that measure success of the government contract.
Despite high levels of need, racial and ethnic minoritized (REM) youth are much less likely than their White peers to engage in mental health treatment. Concerns about treatment relevance and ...acceptability and poor therapeutic alliance have been shown to impact treatment engagement, particularly retention, among REM youth and families. Measurement-based care (MBC) is a client-centered practice of collecting and using client-reported progress data throughout treatment to inform shared decision-making. MBC has been associated with increased client involvement in treatment, improved client-provider communication, and increased satisfaction with treatment services. Despite its promise as a treatment engagement strategy, MBC has not been studied in this capacity with REM youth or systematically modified to address the needs of culturally-diverse populations. In this article, we propose a culturally-modified version of MBC, Strategic Treatment Assessment with Youth (STAY), to improve treatment engagement among REM youth and families. Specifically, STAY is designed to target perceptual barriers to treatment to improve treatment retention and ultimately, client outcomes. The four STAY components (i.e., Introduce, Collect, Share, and Act) are based on an existing MBC practice framework and modified to address perceptual barriers to treatment among REM youth. The clinical application of this model is presented via a case example. Finally, future research directions to explore the use of MBC as a treatment retention strategy with REM client populations are provided.
Impact Statement
Youth who identify as racial or ethnic minorities are more likely to leave mental health treatment early than youth who identify as White. This article describes a way that therapists can prevent this by building a positive relationship with the youth and their primary caregiver and making sure that therapy is relevant and personalized to the issues youth are most concerned about. We describe a mental health treatment practice that involves the youth, caregiver, and therapist working together to select personalized ways to track the youth's progress and use progress updates from the youth and caregiver to make decisions together about next steps in treatment.
Medical readiness is a major source of overall military readiness, and Army occupational therapy practitioners are uniquely qualified professionals to enhance readiness within the Army. The ...literature lacks a theoretical paradigm that guides occupational therapy practitioners with improving readiness in the Army and a unifying model that provides consistent terminology of the internal mechanisms of change for Army occupational therapy practitioners. This article uses two case studies to propose the implementation of the Person, Environment, Occupational Performance (PEOP) model to promote client-centered care and holistic health and fitness performance strategy development provided in the military context.
Background. The active participation of clients is an important aspect of rehabilitation quality as conceptualized in client-centred practice (CCP). A recommended outcome measure for enhancing CCP is ...the Canadian Occupational Performance Measure (COPM). However, the relationship between COPM use and CCP enhancement has not been documented. Aim. The aim of this study was to examine whether the use of the COPM enhanced CCP. Methods. We performed a scoping review in five steps: (1) identifying a search strategy with inclusion and exclusion criteria; (2) screening relevant databases for published and unpublished studies by using selected keywords and by manually scrutinizing reference lists; (3) agreeing on eligible papers between authors in terms of inclusion and exclusion criteria; (4) charting included data; and (5) analysing data using qualitative content analysis. Results. Twelve studies were included in the review. The results indicated enhanced CCP in two themes when using the COPM. These themes appeared to influence each other; therefore, the first theme, Conditions for enhancing CCP when using the COPM, represented the circumstances needed for the second theme, Enhancing CCP when using the COPM, to be fulfilled. Conclusion. The use of the COPM seems to enhance CCP if certain conditions are present.
Introduction
Evidence-based practice skills and habits begin during undergraduate education and continue through professional life. It is important novices learn the skills in their education ...programme that are required in practice. This study explores strategies experienced occupational therapy supervisors use to encourage novices to be evidence based, and how these might be enhanced.
Method
Qualitative descriptive methodology was used to explore the views and experiences of 15 experienced supervisors from a range of practice areas and geographical locations, interviewed in four focus groups.
Results
Evidence-based practice is an element of professional reasoning not isolated from client-centred practice or from reflective practice. Five sources of evidence to inform competence in professional decision-making were identified: (a) research evidence from literature; (b) local environment, resources and culture; (c) client’s expertise and perspective; (d) expertise of others; and (e) practitioners’ own knowledge and experience.
Conclusion
Intentional use of all five sources of evidence to inform professional decision-making contributes to habits of evidence-based thinking and practice. Experienced therapists and educators can support evidence-based practice in novices by prompting questioning and developing systems supportive of scanning for evidence in each area. Collaboration in this endeavour will enhance integration of academic and practice education.
This article assesses the reliability and validity of the Self-Efficacy in Client-Centredness questionnaire (SECCQ). SECCQ assesses social worker students' subjective belief in their ability to ...provide client-centered care in their daily interaction with children or families. Self-efficacy is defined as an individual's judgments concerning their capability to perform certain skills necessary to attain a desired outcome of behavior. Client-centeredness, on the other hand, relates to how social workers treat clients, not only from a clinical perspective, but also from an emotional, mental, and social perspective. Overall findings demonstrate that this questionnaire has satisfying psychometric properties and high reliability. Hence, the SECCQ may be a valuable tool for raising students' awareness of their self-efficacy and the evaluation of student learning outcomes.
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