title: Implementing a client-centred approach in rehabilitation: an autoethnography.
abstract: OBJECTIVE
  Client-centred practice is widely considered a key element of rehabilitation. However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalized during a clinical trial of innovative goal-setting techniques.
  
  
  METHODS
  This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data.
  
  
  RESULTS
  The primary way that client-centred practice was operationalized was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilizing mindful listening, allowing time, supporting clients to prioritize what is meaningful and viewing the therapists' role differently.
  
  
  CONCLUSIONS
  While technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services.
authors.affiliation: Health and Rehabilitation Institute, AUT University, Auckland, New Zealand. felicity.bright@aut.ac.nz
authors.forename: Felicity A S
authors.initials: FA
authors.lastname: Bright
authors.forename: Pauline
authors.initials: P
authors.lastname: Boland
authors.forename: Sandy J
authors.initials: SJ
authors.lastname: Rutherford
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Kayes
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: McPherson
mesh_terms: D000884:Anthropology, Cultural; D003142:Communication; D006801:Humans; D010358:Patient Participation; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012046:Rehabilitation; D057566:Self Report