Doing Therapy With Clients, Not To Them: Rethinking Support in Disability Services
In disability support, it’s easy to talk about choice, control, and person-centred care. But the real question is: how often do we actually give people the lead?
One phrase that keeps coming up in therapy and support work is the idea of doing things with someone, not to them. It sounds simple, but it pushes back against habits that still linger in how services are delivered: rushing, assuming, deciding for someone instead of with them.
From passive recipient to active participant
Historically, many support models positioned the practitioner as the “expert” and the person receiving support as the passive recipient. But that dynamic rarely leads to meaningful, lasting change. In fact, research across occupational therapy, psychology, and disability studies points to the exact opposite:
When people are actively involved in identifying their own goals and choosing how they want to pursue them, outcomes improve. Motivation increases. Engagement deepens. Satisfaction rises.
This isn’t just theory, it plays out every day in practice. Whether it’s someone navigating a return to work, building independent living skills, or simply wanting more social connection, the key is starting from their vision of a meaningful life and not ours.
Collaboration is a skill, not a slogan
Saying you’re person-centred is easy. Actually doing person-centred work takes a different mindset. It’s not just about ticking boxes, but a fundamental shift in how we approach every interaction and every support plan.
This means we need to co-design supports with clients from the start.
Our our role involves:
Guiding, not dictating: We walk alongside people, helping them explore what matters and make informed choices.
Respecting lived experience: The person receiving support often knows more about their life than any professional ever could.
Encouraging clients to participate in their care decisions.
- Adapting over time: Support plans need to meet the client’s needs and preferences, and adjust as they grow with you.
In a diverse city like Perth, this kind of co-designed, relational practice is important, particularly when working with Aboriginal and Torres Strait Islander communities or people from migrant backgrounds, where culturally safe approaches are essential.
Doing things with someone might take longer. It might feel less certain.
But over time, it gives clients control, builds confidence and the kind of progress that lasts, specially in a place like Perth, where the diversity of people, communities, and goals means one-size-fits-all support just doesn’t work.