Bridging that gap : occupational therapist experiences of client-centred practice
Bibliographic record
Abstract
Although client-centred practice has become an essential part of Canadian occupational therapy practice in the last twenty years (Law, 1998; Sumsion & Smyth, 2000), many authors have indicated that therapists do not practice in a client-centred manner (Law, Baptiste & Mills, 1995; Toomey, Nicholson & Carswell, 1995; Hammell, 1998a). Some authors have focused on how therapists are responsible for problems implementing client-centred practice, because they are unwilling to give up power (Sumsion, 1999c; Gage, 1999; Hammell, 1998a; Law, Polatajko, Pollock, McColl, Carswell, & Baptiste, 1994). As power has been identified as an important construct in the literature on client-centred practice, I have conducted an exploratory, qualitative study of occupational therapists' experiences of client-centred practice using standpoint theory and Foucault's work on power to frame the study. Based on a thematic analysis of in-depth ethnographic interviews of nine therapists from acute care and homecare settings three main themes were identified. "Bridging that gap: ideal versus real conceptions of client-centred practice" reveals the tensions that therapists experience between the discourse and practice of occupational therapy. "Related to the service environment: the importance of setting" focuses on how institutional factors shape practice. The final theme "a bit of tension: problems with the client-therapist relationship" describes the client-therapist interaction, which is influenced by discursive and institutional factors. The thesis concludes with a discussion of the theoretical implications, practical applications, limitations and significance of these research findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.044 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.028 | 0.037 |
| Scholarly communication | 0.017 | 0.014 |
| Open science | 0.005 | 0.028 |
| Research integrity | 0.007 | 0.011 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".