Article

Despite beneficial effects on communication and process measures,
client-centred practice has been shown to result in poor functional outcomes. To
examine a potential explanation for poor functional outcomes, this paper aims to
assess whether in client-centred therapy more time is spent on diagnostic
consultation and less time on actual treatment compared to usual care. METHOD: A
multicentre cluster randomised controlled trial was performed. Thirteen hospitals
and rehabilitation centres, 29 therapists and 269 outpatients with multiple
sclerosis participated. Measurements included an inventory of diagnostic and
treatment goals, the number of sessions, therapy duration and therapy intensity.
RESULTS: In client-centred therapy, more sessions were used for diagnostic
consultation (10.9% points difference, p = 0.030); the time needed to formulate
the first treatment goal was longer (11.4 days difference, p = 0.041); there was
a tendency towards more goals directed to diagnostic issues (0.69 goals
difference, p = 0.056), spending more hours on indirect issues (1.16 h
difference, p = 0.051) and towards a longer total therapy period (1.56 months
difference, p = 0.058) than in usual care. CONCLUSION: Client-centred therapy
resulted in more intensive diagnostic evaluation and less intensive treatment.
This suggests that client-centred therapy should be adjusted towards a more
proportional distribution of time devoted to diagnostic evaluation versus actual
treatment.

Langue : ANGLAIS