Family-centred occupational therapy: What do therapists and low-socio-economic families value?

Introduction: Family-centred practice is considered best practice for occupational therapists (OTs) working with children and families. However, low-income families, despite their increased need for allied health services, are less likely to experience therapy practices consistent with family-centred principles. This gap in service delivery may hinder optimal outcomes for these families. Objectives: This study explores the relationship between OTs and parents from low-income backgrounds, examining how their values, expectations, and experiences align or differ and the impact on the therapeutic process. Methods: Using constructivist grounded theory, semi-structured interviews were conducted with nine OTs and eight parents, supplemented by secondary interviews and an online focus group. Data analysis involved systematic coding and theory development to construct a theory grounded in participants’ experiences. Results: The study found significant differences in the values held by OTs and parents. While both groups valued safety, OTs prioritised independence, whereas parents emphasised interdependence. Both groups expected relationship development, communication, and collabo-ration, but parents reported inconsistencies in how well these expectations were met. OTs recognised the resilience and strengths of low-income families but found it challenging to fully account for the complex contextual factors affecting these families when building relationships, maintaining consistency, and implementing strategies. Conclusion: These findings highlight the challenges OTs face in fully implementing family-centred practices with low-income families, likely due to differing values and expectations. Addressing these gaps requires a critical examination of the assumptions underlying OT theory and practice. Future research should focus on strategies to bridge these differences for more equitable service delivery.