1. How can a therapist be client-centred with a client such as Doug, who wants to be independent; however, refuses to learn skills that can facilitate independence? How can a therapist 'sell' the importance of learning specific skills? Is it client-centred to 'sell' a perspective? What types of reasoning are particularly important here and why?

2. How do you feel about taking on the role of a therapist intervening with a client with respect to sexuality? Should this be the role of an OT? Why?

3. What is the role of peer support in the rehabilitation process of a person with an SCI? Does this detract or contribute to the outcome of OT with respect to a client? In what ways?

4. Think of bowel and bladder care and function in a person with an SCI. Consider the roles of various professionals in assisting a person in learning to manage loss of bladder and bowel function. Compare and contrast the roles of these professionals, and discuss the role of OT in assessing and intervening with respect to this issue.

5. Review the different types of clinical reasoning discussed throughout this course, then revisit aspects of this module and identify when each of these types of reasoning were used in your analysis of this case study.

6. Suppose that Doug was granted extra time to stay in hospital and work on ambulation. As a team, watch the following video featuring Doug engaged in this process. The video also features other SCI survivors, and their experiences. Discuss three aspects of the video:

a) What is the role of transformative learning in the recovery of traumatic illness? How have the lives of the men in the video changed following their injury? What is the role of spirituality, if any?

b) In the case study, Doug will be receiving an accident settlement that he can use to make his home accessible, regardless of where he lives. Consider how a client must adapt in a circumstance in which modifications are not possible financially. How can you, as a therapist, work with a client to increase his or her level of independence without making costly changes to their dwelling?

c) Discuss how the expectations of a therapist could impact on the recovery of a client. How may have this have impacted on Doug's recovery prior to the hospital's decision to extend his stay and after? What would have been the outcome if Doug stayed in hospital for a longer period of time with no change to his functional status (psychoemotionally, physically, socioculturally, etc.)?