Client-centred rehabilitation: client perspectives

Purpose: The purpose of this research is to understand the important components of client-centred rehabilitation from the perspective of adult clients with long-term physical disabilities. Method: Focus groups were conducted with adult clients who had completed at least one course of rehabilitation in the publicly-funded rehabilitation system in Ontario. Data were analysed using an iterative inductive approach. Results: The major theme underlying all of the participants' comments was the need for better transitions between rehabilitation programs and the community. Participants felt ill-prepared for community living and the emotional challenges of living with a long-term condition and, once discharged from rehabilitation, felt isolated and had difficulty finding out about and accessing community services. Conclusions: The findings demonstrate that client-centred rehabilitation encompasses much more than goal-setting and decision-making between individual clients and professionals. It refers to a philosophy or approach to the delivery of rehabilitation services that reflects the needs of individuals and groups of clients. This entails a shift from an acute-illness, curative model to one that acknowledges the long-term nature of the career of chronic illness or disability. Definitions of evidence that is deemed credible need to be broadened beyond expert, 'scientific' evidence to include multiple dimensions of evidence including the expertise of the client.