Before I became a UX designer, I worked in the mental health industry for about 5 years. I had the opportunity to work with children, youth and adults in daycares, schools and residential homes. This is where I learned the relevance and implications of client-centered care. Although I was first introduced to the term “human-centered design” when I first started studying UX Design, I experienced this concept first-hand while working in the mental health industry. I noticed that certain companies talked about a “client-centered perspective”, so I learned the term without really understanding the gravity of what this phrase meant for both myself and the clients I was working with. As I started to work in various companies, I learned that I preferred to work in organizations who prioritized a client-centered perspective for a number of reasons. These are some of the lessons the mental health industry has taught me about why using a human-centered approach is so important and why I feel so strongly about it today.
Organizations that held a client-centered perspective created homes that were tailored to the unique needs and preferences of their clients. Everything was designed to reinforce habits that would increase their independence and set them up for success. This was evident in safety protocols and precautions, but also in the design of each home. Some homes had a room dedicated to shelves of Disney movies because a client loved to collect VHS tapes and looked forward to viewing them with a bowl of popcorn each night. This helped provide encouragement for him to complete some of the more non-preferred tasks he encountered each day. Some homes had a sensory jungle gym of sorts in the basement of the home, with high tech sensory lamps, fibers, textures and equipment because this helped the clients de-escalate and it was something they truly enjoyed.
The tools and techniques used in each home were different based on each client’s needs. The environment was built to ensure that the client wasn’t over-stimulated and was able to process their surroundings and reinforce good habits. An example of this was the picture communication system laid out in the washrooms with images of the decomposition of steps it takes to complete hygiene-related tasks. With one client, I hung pictures around the classroom of their favorite superhero character found in a series of books that helped reinforce social behavior. I sewed a simple cape he could wear to defeat the bad guys that were telling him to be unkind to others.
This wouldn’t have worked with any other client, but because this character was who he looked up to, it was almost the only thing that helped him get through challenging moments. Creating an environment built around a client’s needs helped to make each client more successful throughout their day.
Observation is Key
As a mental health worker, I was required to carefully observe behaviors and reactions — this was especially important when working with clients who are non-verbal. If I could sense someone was feeling agitated or if I had observed them experiencing a trigger that I knew from past interactions could cause distress, I would pay closer attention to their behaviors and sometimes introduce a more preferred activity. So much of mental health work is anticipating the needs of others, which is impossible to do if you do not carefully observe behaviors, facial expressions, breathing patterns. This is what mental health workers do all the time in order to try and understand their client’s needs so that they can transition to a different activity or be able to somewhat predict a state of agitation before it gets too escalated.
I was required to constantly absorb new information and then use that information to adjust my methods, often trying new things and adjusting my methods incrementally until I discovered something that was successful. This emphasis on careful observation as well as iterating upon existing methods connects with principles of design thinking where we learn that we need to observe, listen, and understand before moving toward creative solutions.
Human-centered design must be employed intentionally
If human needs aren’t prioritized intentionally they often fall to the wayside and other commitments are prioritized. We don’t typically accommodate human needs above all other priorities, instead we try to modify our actions based on the existing structures that are already in place. In order to create human-centered designs for the people we are designing for we must prioritize human needs intentionally from the outset. In mental health, prioritizing client needs meant that before the individual moved into a home, it was intentionally designed with their needs in mind. When there was a question about whether an activity was beneficial to a client we looked to how much this would benefit them and how much it could cause distress. Sometimes what caused some distress in the moment was more beneficial down the road. Mental health workers must constantly re-evaluate priorities in order to tailor each day to serve the client’s needs.
When human needs are not prioritized they aren’t altogether discarded, but they typically become second or third in the hierarchy of priorities in our list of ongoing considerations. In the field of mental health this has immediate consequences for workers as well as for clients. I found that organizations who didn’t state from the beginning that they supported a client-centered perspective were not suddenly supporting an approach that discarded the client’s needs altogether, it’s just that the client’s needs fell second to some other priority. This may not seem like it makes a large impact, but it was quite significant to me because it meant that a client would be going through needless distress in order to accommodate a priority that wasn’t essential and at times, I wasn’t sure who was benefiting in those moments.
Employing a client-centered perspective sets individuals up for success.
Working in environments that lacked a client-centered perspective meant that instead of altering the environment of a classroom to fit the needs of my client, I was asked to constantly try to adjust my client in order to fit better into the environment. This caused stress for my client as well as myself. As a result, I found that I was less effective as a support worker and my client was less successful throughout their day. Each client I worked with always had goals that were meant to help them integrate into society, or a class-setting, but the difference was that in client-centered companies the client’s needs outweighed this goal of integration. This is what made all the difference. Although adjusting behavior to help with integration was always a goal, it wasn’t prioritized over the client’s needs. If human needs are not prioritized, we are essentially setting up these individuals for failure time and time again until they stop feeling like they can succeed. By employing a client-centered perspective we are essentially setting people up for success, creating a much more positive atmosphere.
There is always a hierarchy of values being employed
During my time as a mental health worker, I learned that the values and perspectives a company has on how they conduct their work was more important than I had realized. I learned that I couldn’t work somewhere that did not prioritize human needs above integration and this was when I first realized the importance of human-centered design. Being able to see the difference over these past 5 years has made a huge impact on how I value a human-centered perspective. It was so difficult to watch someone being told to sit in a circle when they would rather stand outside in the sunshine, especially when this wouldn’t have a negative impact on the larger group or class. I remember being told that I couldn’t do an activity with a child because the rest of the group was doing something else and realizing after some discussion that the only reason for this was an over-emphasis on integration and a need to have someone “fit in” better with the rest of the group. I wondered how fitting in with the rest of the group could be more beneficial when it entailed having to put the client in a non-preferred state that would agitate them and cause so much distress. Watching this for long enough created a strong desire to advocate for a client-centered perspective. I realized that even if it’s not being said, a hierarchy of priorities is always being employed.
While taking courses in UX design, I learned that design thinking is a process that begins with listening and discovering human needs in order to create intuitive solutions to problems through iteration and collaboration. Essentially, it’s a re-ordering of priorities in the hierarchy of values we all carry to work with us each day that dictates how we execute tasks. In the case of design thinking, the user’s needs are put at the forefront of everything we do. And although I fully embrace this perspective, it challenges me because it doesn’t always come naturally. It contradicts a large portion of what I have been taught both directly and indirectly throughout my life. I deal with this by remembering how a human-centered approach impacts people in other industries and also in daily life and this has created a holistic appreciation and dedication that goes beyond my work. It reminds me that people thrive best when we acknowledge their differences and cater to their individual needs whenever possible and that this is worth advocating for.