Client-centred occupational therapy: the importance of critical perspectives

Background: The occupational therapy profession has proclaimed itself to be client-centred for over 30 years, but until recently this assertion remained largely unchallenged. Critical thinkers, who have begun to explore client-centred practice in occupational therapy, highlight the necessity for further critical reflection. Aims. This paper aims to define what constitutes "critical" thinking; and to persuade occupational therapists of the importance of employing critical perspectives towards the profession's assumptions and assertions regarding occupational therapy's "client-centred" practices. Major findings. Critical thinking is not solely a process of carefully and thoughtfully weighing various arguments or evidence, but of additionally appraising the ideological and structural contexts in which these positions or evidence have arisen. Critical perspectives towards occupational therapy's client-centred practices identify the ways in which power is exercised by the profession, and culturally specific and disabling ideologies are perpetuated. Practice conclusion. Critical thinking enables occupational therapists to reflect on their own inequitable access to privilege and power, and reduces the potential for the profession to re-inscribe dominant ideologies that devalue disabled people and justify their inequitable opportunities. Because critical thinking demands a readiness to restructure one's thinking, and decreases the risk of acting on faulty assumptions, it is an essential component of client-centred practice.