ABSTRACT
Rehabilitation facilities increasingly advocate a best practice care philosophy known as “client-centered care” (CCC) (Armstrong 2008; Cott 2004; Maitra and Erway 2006), which is predicated on client autonomy and choice in goal-setting, optimizing clientpractitioner partnership, and breaking down status hierarchies between patients and staff (Law et al. 1995). Despite the proven benefits of CCC (Law et al. 1995; Pegg et al. 2005; Restall et al. 2003; Stewart et al. 2000), barriers to its systematic implementation into practice persist (Sumsion and Smyth 2000; van den Broek 2005; Wilkins et al. 2001). Efforts to understand what facilitates and/or impedes CCC within the rehabilitative context have for the most part focused on the processes and influences within practice contexts, such as a hierarchical model of care that reinforces sick role behavior of clients
Introduction ...................................................................... 117 Therapeutic Landscape .................................................... 119 The Built Environment of Rehabilitation ......................120 The Ideological Landscape of Rehabilitation ................120 The Personal Landscape of Traumatic Brain Injury .... 121 Discussion .........................................................................128 Acknowledgments ............................................................ 131 References .......................................................................... 131
(Cott 2004; Maitra and Erway 2006), and the reluctance of therapists to share the power of decision making with clients (Rebeiro 2000), favoring instead therapist-driven therapeutic activities (Mortenson and Dyck 2006). The interfaces between physical spaces, social roles, and rehabilitation treatment practices within inpatient rehabilitation settings, and their interactive roles in determining CCC, have been largely unaddressed. To this end, insights of critical health geography (Andrews 2004; Andrews and Moon 2005; Curtis et al. 2007; Evans et al. 2009; Gesler 1992; Kearns and Moon 2002; Watson et al. 2007)—specifically the notion of “therapeutic landscape” theory-have much to offer explorations of CCC in rehabilitation settings.
