Beliefs about responsibilities, the aims of therapy and the structure of the therapy process: a qualitative study of caseload management issues in child health occupational therapy
Article first published online: 6 MAR 2011
© 2011 Blackwell Publishing Ltd
Child: Care, Health and Development
Volume 38, Issue 1, pages 108–116, January 2012
How to Cite
Kolehmainen, N., Francis, J. J., McKee, L. and Duncan, E. A. S. (2012), Beliefs about responsibilities, the aims of therapy and the structure of the therapy process: a qualitative study of caseload management issues in child health occupational therapy. Child: Care, Health and Development, 38: 108–116. doi: 10.1111/j.1365-2214.2011.01220.x
- Issue published online: 20 DEC 2011
- Article first published online: 6 MAR 2011
- Accepted for publication 2 January 2011
- caseload management;
- child health;
- occupational therapy;
- role and identity;
- therapy process
Background Individual therapists' behaviour contributes to overall caseload management in therapy services. Therapists' caseload management (i.e. actions in relation to assessment, treatment and discharging) is likely to relate to their beliefs about caseload management; it may be possible to change therapists' caseload management by changing their beliefs. This study explored children's occupational therapists' beliefs about caseload management with a view to designing a caseload management intervention.
Methods Twenty-five therapists from six NHS Scotland Health Boards were interviewed using a semi-structured format. Interviews were transcribed verbatim, and the interview transcripts were analysed for emerging themes. A proportion of transcripts were independently read and coded, and the themes were validated through critical discussion.
Results Key issues emerged concerning therapists' beliefs about their responsibilities, the aims of therapy and the structure of the therapy process. Therapists expressed a strong sense of professional duty/responsibility, but the interpretations of what this duty/responsibility was differed between therapists. For example, therapists expressed highly contrasting beliefs about the goals and purpose of therapy and the ways in which therapy processes should be structured. Some therapists promoted an approach structured around clients' goals, while others focused more on relationship building.
Conclusions Therapists' beliefs about caseload management differ considerably; these differences could translate to variation in therapists' intentions and behaviours. Implications for practice, policy and future research were identified, as were implications for the way clinicians' caseload management is theorized.