Spotlight on Lived Experience and Person-Centred Assessment

Person-centred practice is a foundational principle of occupational therapy and is particularly important within assistance animal practice because assistance animal partnerships are deeply personal, long-term and integrated into everyday life.

An assistance animal is not simply a clinical intervention delivered to a person. It becomes part of the person’s routines, identity, relationships, home environment and community participation.

Therefore, effective assessment requires understanding not only what a person is unable to do, but also:

  • who they are;
  • what matters to them;
  • what occupations give their life meaning;
  • what barriers they experience;
  • what outcomes they hope to achieve.

A diagnosis, functional assessment score or referral question can provide important information, but it cannot fully describe a person’s lived experience.

Occupational therapists must understand the person’s story before determining whether an assistance animal may be an appropriate intervention.

The Importance of Lived Experience in Occupational Therapy

Occupational therapy recognises that people are experts in their own lives.

Clinical assessments provide professional knowledge about:

  • function;
  • participation;
  • environments;
  • intervention options.

However, the individual provides essential knowledge about:

  • their priorities;
  • their experiences;
  • their values;
  • their challenges;
  • what success means to them.

This combination of professional expertise and lived experience forms the basis of shared decision-making.

Within assistance animal practice, this is particularly important because the person is not simply receiving a service.

They are entering into a long-term partnership with another living being.

Moving Beyond Deficit-Based Assessment

Historically, disability assessments have often focused on limitations and problems.

While identifying barriers is necessary, an occupational therapy approach must also identify:

  • strengths;
  • abilities;
  • existing strategies;
  • resilience;
  • supports;
  • personal resources.

A deficit-only approach may create a picture of a person defined entirely by what they cannot do.

A strengths-based approach asks:

“What is this person already doing successfully, and how can intervention support further participation?”

For example:

A person may experience difficulty attending community environments.

A deficit-focused assessment may document:

“The person cannot tolerate public spaces.”

A strengths-based occupational assessment may explore:

  • what environments they already access successfully;
  • what strategies help;
  • what supports enable participation;
  • whether an assistance animal could build on existing strengths.

Understanding Personal Meaning and Occupational Identity

Occupations are not simply activities.

They are activities that hold meaning within a person’s life.

Two people may perform the same activity but experience it differently depending on:

  • identity;
  • values;
  • relationships;
  • culture;
  • personal goals.

For example:

Attending university may represent:

  • independence;
  • career development;
  • social connection;
  • personal achievement.

Going shopping may represent:

  • autonomy;
  • family participation;
  • community connection.

An assistance animal recommendation should therefore be connected to meaningful occupational outcomes rather than isolated tasks.

The question is not:

“What can the animal do?”

The question is:

“What meaningful part of this person’s life may this partnership support?”

The Importance of Listening to the Person’s Goals

People may seek assistance animals for many reasons, including:

  • wanting greater independence;
  • participating more in the community;
  • reducing barriers;
  • feeling safer;
  • managing daily routines;
  • reconnecting with valued roles.

The occupational therapist must explore what these goals mean.

For example:

A person may state:

“I want an assistance dog because I want to leave the house.”

The occupational therapist explores:

  • Why is leaving the house difficult?
  • What occupations are affected?
  • What situations create barriers?
  • What changes would improve participation?
  • What role could an assistance animal realistically play?

The goal is not to accept or reject the request immediately.

The goal is to understand the occupational meaning behind the request.

The Difference Between Respecting Choice and Providing Uncritical Approval

Person-centred practice does not mean automatically agreeing with every requested intervention.

True person-centred practice involves:

  • listening;
  • understanding;
  • informing;
  • collaborating;
  • supporting informed decisions.

A person may strongly believe an assistance animal is the right solution.

The occupational therapist respects that perspective while also considering:

  • evidence;
  • alternatives;
  • risks;
  • sustainability;
  • animal welfare.

Shared decision-making means decisions are made together, not that professional reasoning is removed.

Understanding Cultural, Family and Personal Context

Lived experience is shaped by context.

Assistance animal assessment should consider:

  • culture;
  • family relationships;
  • beliefs about animals;
  • previous experiences;
  • housing;
  • community;
  • social supports.

For some people, animals may have:

  • strong cultural significance;
  • emotional importance;
  • previous therapeutic meaning.

For others, animals may create:

  • sensory challenges;
  • practical difficulties;
  • cultural concerns.

There is no universal relationship between people and animals.

The occupational therapist must understand the individual’s context.

The Role of Trauma-Informed Practice

Many people considering assistance animals have experienced trauma, discrimination or previous negative interactions with systems.

Trauma-informed assessment requires consideration of:

  • psychological safety;
  • autonomy;
  • choice;
  • trust;
  • control.

The assessment process itself should avoid recreating experiences where the person feels:

  • judged;
  • disbelieved;
  • powerless;
  • reduced to a diagnosis.

A trauma-informed approach does not mean accepting every request without assessment.

It means conducting assessment respectfully and collaboratively.

Supporting Autonomy While Maintaining Professional Responsibility

Assistance animal decisions involve balancing two important principles:

Respect for Autonomy

The person has the right to:

  • participate in decisions;
  • express preferences;
  • identify meaningful goals.

Professional Responsibility

The occupational therapist has a responsibility to:

  • provide evidence-informed recommendations;
  • consider alternatives;
  • protect animal welfare;
  • avoid unsupported claims.

The strongest recommendations occur when both are considered together.

Applying Person-Centred Assessment to Assistance Animal Practice

A person-centred occupational profile should explore:

Who is this person?

Including:

  • identity;
  • roles;
  • relationships;
  • strengths;
  • values.

What matters to them?

Including:

  • meaningful occupations;
  • personal goals;
  • desired changes.

What barriers affect participation?

Including:

  • disability impacts;
  • environmental barriers;
  • social barriers.

Could an assistance animal contribute meaningfully?

Considering:

  • appropriate role;
  • realistic outcomes;
  • sustainability.

Key Practice Principles

1. The Person Is More Than Their Diagnosis

Assessment must understand the whole person, not just their condition.

2. Lived Experience Is Essential Clinical Information

The person’s perspective contributes knowledge that cannot be obtained through clinical measures alone.

3. Start With Meaningful Occupations

Recommendations should connect to what matters in the person’s life.

4. Person-Centred Does Not Mean Request-Driven

Respecting choice must occur alongside professional reasoning.

5. Strengths Matter Alongside Challenges

Assessment should identify abilities, supports and successful strategies.

6. Context Shapes Occupational Participation

Family, culture, environment and previous experiences influence suitability.

7. Assistance Animal Partnerships Must Be Individualised

There is no universal assistance animal solution because every person–animal partnership is unique.

Person-centred assessment ensures assistance animal practice remains grounded in occupational therapy principles. By understanding the person’s lived experience, goals, strengths and context, occupational therapists can determine whether an assistance animal represents a meaningful and sustainable support rather than simply responding to a diagnosis or request.

Spotlight 7 – Occupational Identity and Meaningful Participation
Placement: Topic 1.2 – Occupational Profile.