title: A macro perspective for client-centred practice in curricula: Critique and teaching methods.
abstract: BACKGROUND
  Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment.
  
  
  OBJECTIVE
  The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice.
  
  
  METHODS
  This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography.
  
  
  RESULTS
  Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required.
  
  
  CONCLUSIONS
  Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.
authors.affiliation: The University of Scranton , Scranton, PA , USA.
authors.forename: Rita P
authors.initials: RP
authors.lastname: Fleming-Castaldy
mesh_terms: D003479:Curriculum; D006233:Persons with Disabilities / Q000534:rehabilitation; D006801:Humans; D009788:Occupational Therapy / Q000193:education*; D018802:Patient-Centered Care; D011209:Power, Psychological; D012935:Social Justice; D013663:Teaching / Q000379:methods
keywords: Disabilities studies; empowerment; occupational therapy education; professional competence; social justice