lThe Delphi technique is one type of research methodology that is growing in popularity. This paper introduces this technique to therapists searching for a user-friendly method of conducting research. The Delphi process is explained and several issues that the researcher must consider are presented. These issues include the identification of participants and the number of questionnaires or rounds that are required to reach consensus.A discussion of the advantages and disadvantages of the technique concludes that the argument is weighted equally on both sides. Applications to research in rehabilitation are reviewed and brief case scenarios related to the application of the technique to management issues are presented for further consideration. The Delphi technique is not a perfect tool for all situations but it can be adapted to address a variety of issues in a range of working environments.
The paper concludes with a discussion of practice implications through the presentation of questions for therapists to consider as a quick reference tool and suggestions for further research and dialogue concerning client-centred practice.
This research sought to determine which therapist barriers prevent client-centred practice the most, and which methods are perceived as being most effective in resolving therapist barriers. A list of barriers that therapists bring to client-centred practice and methods to resolve these was identified from the literature and formed the basis of a questionnaire sent to 60 occupational therapists in the United Kingdom. The results showed that the therapist and client having different goals was the barrier which most prevented client-centred practice. The high ratings of other statements suggested that the values, beliefs and attitudes of therapists and of the employment culture make client-centred practice uncomfortable to use and hence prevent its implementation. Case examples showing how to practice in a client-centred fashion were rated as the most effective method of barrier removal.
Most occupational therapists, like the founders of the profession, believe that engagement in meaningful occupation is fundamental in helping to overcome the effects of disability. This paper describes the method and one of the resulting themes of a study that investigated the value, related to personal meaning, of occupation from the perspective of people with enduring mental health problems. Qualitative research methods were used in two mental health day service settings: a workshop, where woodwork was provided as a medium for creative therapy, and a drop-in facility. Clients were asked about their motivation, their occupational experiences and any benefits that engagement in occupation might have had for them. Participant observation was undertaken over 10 sessions and six in-depth interviews were conducted. The findings emerged through content and inductive analysis, as well as analytical triangulation of the data. Occupation was identified as a means for generating intrinsic motivation. By providing a sense of purpose and a structuring of time, within an empowering environment, engagement in occupation was seen to be of value and had personal meaning for the clients. However, more research needs to be undertaken to augment the findings. Such evidence will support increased provision of occupation for people whose lives have been severely disrupted by mental health problems.
This paper reports on the second phase of a research project to determine a British occupational therapy definition of client-centred practice. Sixty-seven occupational therapists participated in nine focus groups, structured according to the nominal group technique. These groups involved therapists working in social services, mental health, learning disabilities, paediatrics, neurology, a wheelchair service and with elderly clients and there were two groups in general medicine. A hundred and sixty-five components of client-centred practice were generated and subsequently analysed to form seven themes. Frequencies and medians of the components ranked in the top five were also calculated. In addition, three questions were asked to solicit opinions on the definition that was created in the first phase of this study and frequencies were also determined from these responses. All these data were used to inform revisions to the definition created in phase one. This revised definition was then reviewed by members of the Council of the College of Occupational Therapists as the final validating group. The resulting final definition will enable therapists to determine whether or not they are using a client-centred approach.
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