Person-Centered Care and Speech and Language Therapy

ABSTRACT

Person-centered care (PCC) has become the foundation for practice in many areas of health care provision. Research has suggested that providing PCC may improve therapy outcomes, client satisfaction, and perceived quality of care, as well as address aspects of evidence-based practice. As members of the health care provider community, speech-language pathologists (SLPs) will be expected to provide PCC as part of their therapeutic interactions. Some research, however, has indicated that SLPs have a tendency to provide more structured, task-oriented therapies. In this article, a working definition of PCC is described, along with a pilot study designed to investigate the use of PCC by student SLP clinicians. Results from this study indicated no increase in the use of PCC as student clinicians gained clinical experience and suggested that current approaches to clinical supervision and grading may play a role in reducing the amount of PCC provided by student clinicians.

Person-centered care - client-centered care - clinical supervision - therapeutic interaction

REFERENCES

• 1 Bowers B J, Fibich B, Jacobsen N. Care-as-service, care-as-relating, care-as-comfort: understanding nursing home residents' definitions of quality.  Gerontologist. 2001;  41 539-545
• 2 Grosch K, Medvene L, Wolcott H. Person-centered caregiving instruction for geriatric nursing assistant students.  J Gerontol Nurs. 2008;  34 23-31
• 3 O'Connell E. Therapeutic relationships in critical care nursing: a reflection on practice.  Nurs Crit Care. 2008;  13 138-143
• 4 Maitland R E, Fine M J, Tracy D B. The effects of an interpersonally based problem-solving process on consultation outcomes.  J Sch Psychol. 1985;  23 337-345
• 5 Jamieson M, Krupa T, O'Riordan A et al.. Developing empathy as a foundation of client centered practice: evaluation of a university curriculum initiative.  Can J Occup Ther. 2006;  73 76-85
• 6 Sumsion T, Law M. A review of evidence on the conceptual elements informing client-centred practice.  Can J Occup Ther. 2006;  73 153-162
• 7 DiLollo A, Neimeyer R A, Manning W H. A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment.  J Fluency Disord. 2002;  27 19-42
• 8 Luterman D M. Counseling Persons with Communication Disorders and Their Families. 4th ed. Austin, TX; Pro-Ed 2001
• 9 Scheuerle J. Counseling in Speech-Language Pathology and Audiology. New York, NY; Macmillan 1992
• 10 Shames G H. Counseling the Communicatively Disables and Their Families. Needham Heights, MA; Allyn & Bacon 2000
• 11 Rogers C R. Counseling and Psychotherapy. Boston, MA; Houghton Mifflin 1942
• 12 Rogers C R. Client-Centered Therapy: Its Current Practice, Implications, and Theory. Boston, MA; Houghton Mifflin 1951
• 13 Bohart A C. Person-centered psychotherapy and related experiential approaches. In: Gurman AS, Messer SB Essential Psychotherapies: Theory and Practice. 2nd ed. New York, NY; Guilford Press 2003: 107-148
• 14 Bosman R, Bours G, Engels J, de Witte L P. Client-centered care perceived by clients of two Dutch homecare agencies: a questionnaire survey.  Int J Nurs Stud. 2008;  45 518-525
• 15 White D L, Newton-Curtis L, Lyon K S. Development and initial testing of a measure of person-directed care.  Gerontologist. 2008;  48 114-123
• 16 Wolf D M, Lehman L, Quinlin R, Zullo T, Hoffman L. Effect of patient-centered care on patient satisfaction and quality of care.  J Nurs Care Qual. 2008;  23 316-321
• 17 Donabedian A. Exploration in Quality Assessment and Monitoring: The Definitions of Quality and Approaches to Its Assessment. Ann Arbor, MI; Health Administration Press 1980
• 18 Davies A R, Ware J E. Involving consumers in quality of care assessment.  Health Aff. 1988;  7 33-48
• 19 Leahy M M, Walsh I P. Talk in interaction in the speech-language pathology clinic: bringing theory to practice through discourse.  Top Lang Disord. 2008;  28 229-241
• 20 Sackett D L, Strauss S E, Richardson W S, Rosenberg W, Haynes R B. Evidence-Based Medicine. Edinburgh, United Kingdom; Churchill Livingstone 2000
• 21 Ratner N B. Evidence-based practice: an examination of its ramifications for the practice of speech-language pathology.  Lang Speech Hear Serv Sch. 2006;  37 257-267
• 22 Wampold B E. The Great Psychotherapy Debate: Models, Methods, and Findings. Mahwah, NJ; Lawrence Erlbaum 2001
• 23 Brown G S. Common factors and therapeutic effects in therapy outcomes. Paper presented at Annual Meeting of the American Speech-Language-Hearing Association November 2004 Philadelphia, PA;
• 24 Bachelor A, Horvath A. The therapeutic relationship. In: Hubble MA, Duncan BL, Miller SD The Heart and Soul of Change: What Works in Therapy. Washington, DC; American Psychological Association 1999: 133-178
• 25 Burns D D, Nolen-Hoeksema S. Therapeutic empathy and recovery from depression in cognitive-behavioral therapy: a structural equation model.  J Consult Clin Psychol. 1992;  60 441-449
• 26 Connors G J, Carroll K M, DiClemente C C, Longabaugh R, Donovan D M. The therapeutic alliance and its relationship to alcoholism treatment participation and outcome.  J Consult Clin Psychol. 1997;  65 588-598
• 27 Horvath A O, Symonds B D. Relation between working alliance and outcome in psychotherapy: a meta-analysis.  J Couns Psychol. 1991;  38 139-149
• 28 Martin D J, Garske J P, Davis M K. Relation of the therapeutic alliance with outcome and other variables: a metanalytic review.  J Consult Clin Psychol. 2000;  68 438-450
• 29 Manning W H. Clinical Decision Making in Fluency Disorders. 3rd ed. Clifton Park, NY; Delmar 2010
• 30 Damico J S. The lack of efficacy in language therapy.  Lang Speech Hear Serv Sch. 1988;  19 51-66
• 31 Leahy M M. Therapy talk: analyzing therapeutic discourse.  Lang Speech Hear Serv Sch. 2004;  35 70-81
• 32 Panagos J M, Bliss L S. Presuppositions for speech therapy lessons.  Journal of Childhood Communication Disorders. 1990;  13 19-28
• 33 Panagos J M, Bobkoff K, Scott C. Discourse analysis of language intervention.  Child Lang Teach Ther. 1986;  2 211-229
• 34 Geller E, Foley G M. Broadening the “ports of entry” for speech-language pathologists: a relational and reflective model for clinical supervision.  Am J Speech Lang Pathol. 2009;  18 22-41