213 -15 Principles of Client Centered Care
Counselor Toolbox

 
 
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15 Principles of Client Centered Care
Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery
Definition and Benefits
~ Client Centered Care empowers the client to actively participate in his/her care and develop an understanding of the interaction between his/her environment and self.
~ Improves treatment compliance
~ Leads to more rapid and enduring improvements
~ Starts with caring
Characterize caring
~ Listening to and empathizing with clients’ points of views
~ Recognizing clients as unique individuals
~ Never allowing your values to interfere with clients’ right to receive care

Client Centered Care
~ An approach in which
~ Clients are viewed as whole persons
~ It is not merely about delivering services where the client is located
~ It involves advocacy, empowerment, and respecting the client’s autonomy, voice, self-determination, and participation in decision-making.
Empowerment
~ Empowerment is “the participation of individuals and communities in a social action process that targets both individual and community change outcomes.” A concept that is crucial is that community workers and professionals must “start where the people are”
~ Initial and ongoing assessment of clients’ values, feelings, actions are integral to any community work.
Humanistic Approach
~ Based on knowing the client and the client’s perspective through continuous dialogue.
~ Views the client as a whole, and recognizes the interconnectedness and interrelationship between the client and the environment.
~ Focuses on restoring health, harmony and enhanced quality of life.
Participatory Management
~ Participatory Management is the extent to which managers involve staff in decisions regarding their work and aspects of the work environment,
~ Characterized by
~ the manager seeking staff input and feedback about the work environment
~ involving staff in decision making about their own work
~ providing recognition and support and taking action on the input
Reflective Practice
~ An ongoing process that the counselor utilizes in order to examine his/her own nursing practice, evaluate strengths, and identify ways of continually improving practice to meet client needs.
~ Questions useful in framing the reflective process include:
~ “What have I learned?”
~ “What has been most useful?”
~ “ What else do I need?”
Respect
~ Respect clients’ wishes, concerns, values, priorities, perspectives, and strengths.
Clients Are Experts for Their Own Lives
~ Clients know themselves the best or they would not be in this situation.
~ You should follow your client’s lead with respect to information giving, decision making, care in general and involvement of others.
~ Clients define the goals that coordinate the practices of the health care team.
Identifying Concerns/Needs
~ Initiate discussion or strategies (i.e. Focus groups and surveys) in order to understand the client’s perspective regarding his/her health and quality of life.
~ Seek to clarify the hopes, wishes, preferences, strengths, needs, and concerns of the client, from his/her perspective.
~ Seek to build the client’s capacity (ability to reach independence) based on the client’s goals.
~

~ Represent the client’s/community’s perspective of health, goals in life, as well as their concerns when making recommendations to others
~ Follow the client’s lead when providing information or teaching what the client wants with respect to his/her health/illness situation
~ Document the client’s/community’s perspective with regard to health and quality of life, goals, wishes, choices regarding information, and concerns

Making Decisions
~ Identify priorities for change or action.
~ Identify options from client’s/community’s perspective.
~ Act as a resource for clients in deciding care strategies. Clarify and provide information or teaching that clients want and say they need, with respect to their health/illness situation or possible health strategies.
~ Act as advocate for the client’s/community’s values and decisions
Caring and Service
~ Involve clients throughout the caring and service process.
~ Respect and honour client choices and decisions though they may not be related to the illness/ disease process or health services and regardless of the counselor’s own values.
~ Use trust-building strategies to develop the counselor-client relationship.
~

~ Demonstrate respect and value for clients by listening with openness.
~ Use positive language to discuss clients. Use the client’s own words to describe situations
~ Involve family/significant others as per client wishes.
~ Ensure that the client’s goals are central to the coordination, continuity, and consistency of care

Evaluating Outcomes
~ Engage the client in evaluating care delivery and health related outcomes.
~ Support the client if or when goals cannot be met.
~ Demonstrate an attitude of openness and a willingness to change in order to improve the quality of care from the client’s perspective.
~ Change care plans and practice approaches in order to improve quality from the client’s perspective
Successful implementation of client centered care requirements
~ Organizational and managerial support.
~ Organizational champions
~ Education and training for counselors and counselors
~ Care delivery that ensures continuity of care and continuity of caregiver.
~ Organizational and unit policies congruent with client centered care
~ Positive work-life environment
~ Outcomes evaluation
Key elements of a client centered system include all of the following
~ Do clients feel they are respected?
~ Do they feel caregivers value their personal expertise?
~ Do clients say they are listened to?
~ Is there evidence of the client’s/community’s view in the plan of care/program plan?
Humanizing the physical environment, routines, and the language of care giving
~ Creating a more humane and home-like environment with personal items and pictures demystifying routines and language
~ Providing freedom to choose
Values and Beliefs of Client Centered Care
~ Respect
~ Human dignity
~ Clients are experts for their own lives
~ Clients as leaders
~ Continuity and consistency of care and caregiver
~ Timeliness
~ Responsiveness and universal access
Core Processes of Client Centered Care
~ Identifying Concerns/Needs
~ Allowing the client to Make Decisions
~ Involve the client in caring and Service
Decision coaching
~ Monitoring decisional conflict (uncertainty about the course of action and related modifiable deficits in knowledge, values clarity and support);
~ Tailoring decision support to needs (e.g. Facilitating access to evidence-based information, verifying understanding, clarifying values, building skills in deliberation, communication, and accessing support; and
~ Monitoring progress in decision making and decision quality. The goal is to help clients improve the decision making process and decision quality
Patient Decision Aids
~ Evidence-based tools designed to prepare clients to participate in making specific and deliberative choices among healthcare options in ways they prefer.
~ Provide evidence-based information about a health condition, the options, associated benefits, harms, probabilities, and scientific uncertainties;
~ Help clients recognize the values-sensitive nature of the decision and clarify the value they place on the benefits, harms, and scientific uncertainties.

~ Strategies include: describing the options in enough detail that clients can imagine what it is like to experience the physical, emotional, and social effects; and guiding clients to consider which benefits and harms are most important to them
~ Provide structured guidance in the steps of decision making and communication of their informed values with others involved in the decision (e.g. Clinician, family, friends).

Summary: Key Concepts in Client Centered Care
~ Identifying concerns and needs for individualized, culturally sensitive, trauma informed care.
~ Seek to clarify the hopes, wishes, preferences, strengths, needs, and concerns of the client, from his/her perspective.
~ Seek to build the client’s capacity to reach independence based on the client’s goals
~ Clarify the client’s wishes and follow his/her lead in determining the involvement of others in their health care.
~ Represent the client’s/community’s perspective of health, goals in life, as well as their concerns when making recommendations to others
~ Follow the client’s lead when providing information or teaching that the client wants with respect to his/her health/illness situation. Teach the client in a way that is relevant to his/her personal reality
Summary: Key Concepts cont…
~ Document the client’s/community’s perspective with regard to health and quality of life, goals, wishes, choices regarding information, and concerns
~ Make the client the key decision-maker in planning care and services.
~ Identify priorities for change or action
~ Clarify and provide information or teaching that clients want and say they need, with respect to their health/illness situation or possible health strategies.
~ Acknowledge the client’s expertise and encourage clients/communities to share their knowledge and skills.
~ Demonstrate respect and value for clients by listening with openness
~ Use strengths-based, positive language and the client's own words to describe situations
Summary: Key Concepts cont…
~ Engage the client in evaluating care delivery and health related outcomes by using specific processes/evaluations that provide continuous feedback from the client’s perspective about the quality of care
~ Demonstrate an attitude of openness and a willingness to change in order to improve the quality of care from the client’s perspective