15 Principles of Client Centered Care

15 Principles of Client

Centered CareDr. Dawn-Elise Snipes, PhD

Executive Director: AllCEUs.com

Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery

AllCEus Unlimited CEUs $59 | Addiction Counselor Certification Training $149 | Webinars $4 1

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 requirementsOrganizational 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

CareIdentifying 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 realityAllCEus Unlimited CEUs $59 | Addiction Counselor Certification Training $149 | Webinars $4 25

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


15 Principles of Client Centered Care

Healthcare