This scenario is professionally challenging because it requires the occupational therapist to balance the immediate needs of a client with the stringent requirements of documentation, coding, and regulatory compliance, all while operating within a specific healthcare system’s policies. Failure to adhere to these regulations can have significant consequences, including reimbursement issues, legal repercussions, and compromised client care. Careful judgment is required to ensure that documentation accurately reflects services rendered, supports appropriate billing, and meets all legal and ethical standards. The best professional approach involves meticulously reviewing the client’s progress notes against the established treatment plan and the specific ICD-10-CM and CPT codes that accurately represent the skilled occupational therapy interventions provided. This approach ensures that all documentation is precise, justifiable, and compliant with payer requirements and professional standards. By cross-referencing the notes with the treatment plan and coding guidelines, the therapist validates that the services billed were indeed delivered, medically necessary, and appropriately categorized, thereby safeguarding against fraudulent claims and ensuring proper reimbursement. This aligns with the ethical obligation to provide accurate and truthful billing and the regulatory requirement to maintain comprehensive and accurate client records. An incorrect approach would be to broadly assign a general code for “evaluation” without specific detail, even if the client was seen. This is problematic because it fails to capture the specific skilled interventions performed and the client’s unique needs and progress, potentially leading to under-billing or over-billing depending on the complexity of the session. It also violates the principle of accurate representation of services rendered, which is a cornerstone of regulatory compliance. Another incorrect approach would be to prioritize speed by using pre-filled templates for documentation and coding without tailoring them to the individual client’s session. While templates can be efficient, their indiscriminate use can lead to generic entries that do not reflect the specific skilled services provided or the client’s unique response to therapy. This can result in inaccurate coding, lack of justification for skilled intervention, and potential non-compliance with payer requirements for detailed and individualized documentation. A further incorrect approach would be to assume that because a service was provided, it automatically qualifies for reimbursement without verifying its medical necessity and appropriate coding. This overlooks the critical step of ensuring that the intervention aligns with the client’s diagnosis and treatment goals, and that the chosen code accurately reflects the skilled nature of the service. Regulatory bodies and payers require clear justification for all billed services, and this approach bypasses that essential verification process, increasing the risk of audit findings and repayment demands. Professionals should employ a systematic decision-making process that begins with a thorough understanding of the client’s condition and treatment goals. This should be followed by a detailed review of the session’s activities and the therapist’s clinical reasoning. Next, the therapist must consult current coding manuals (e.g., ICD-10-CM for diagnoses, CPT for procedures) and payer-specific guidelines to select the most accurate and appropriate codes. Finally, all documentation and coding should be cross-referenced against the treatment plan and regulatory requirements to ensure completeness, accuracy, and compliance before submission.

Scenario Analysis: This scenario presents a professional challenge due to the critical need to balance patient safety, evidence-based practice, and the efficient allocation of limited resources within a healthcare setting. The occupational therapist must make a decision that impacts a patient’s functional recovery and the team’s workflow, requiring a deep understanding of anatomy, physiology, and applied biomechanics to inform their judgment. The challenge lies in discerning the most appropriate intervention based on a complex interplay of patient presentation and available evidence, while adhering to professional standards. Correct Approach Analysis: The best professional practice involves a thorough reassessment of the patient’s current functional status, specifically focusing on the affected limb’s range of motion, strength, and pain levels, in conjunction with a review of the latest evidence-based guidelines for post-operative rotator cuff repair rehabilitation. This approach prioritizes individualized care, ensuring interventions are tailored to the patient’s specific physiological response to surgery and the biomechanical demands of the proposed exercises. It aligns with the ethical principle of beneficence, aiming to maximize the patient’s recovery and minimize the risk of re-injury by grounding decisions in current best practices and the patient’s unique presentation. This ensures that the chosen therapeutic activities are both safe and effective, directly addressing the patient’s anatomical and physiological state. Incorrect Approaches Analysis: Recommending the continuation of the previously prescribed exercise protocol without reassessment fails to acknowledge the potential for altered biomechanical stress or physiological changes that may have occurred since the last evaluation. This approach risks exacerbating the patient’s pain or delaying recovery by not adapting to their current needs, potentially violating the principle of non-maleficence. Implementing a new, unresearched exercise regimen based solely on anecdotal evidence or personal preference, without a systematic review of its efficacy and safety for this specific condition, is professionally irresponsible. This bypasses the ethical obligation to provide evidence-based care and could lead to adverse outcomes, contravening the principles of competence and due care. Relying solely on the surgeon’s initial directive without considering the patient’s ongoing functional progress or potential complications ignores the collaborative nature of patient care and the occupational therapist’s role in monitoring and adapting treatment plans based on the patient’s evolving physiological and biomechanical status. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a comprehensive assessment of the patient’s current condition, integrating knowledge of anatomy, physiology, and biomechanics. This assessment should then be cross-referenced with current, evidence-based practice guidelines and relevant literature. Collaboration with the interdisciplinary team, including the surgeon, is crucial for a holistic understanding of the patient’s recovery trajectory. Finally, interventions should be individualized, regularly re-evaluated, and adjusted based on the patient’s response, always prioritizing safety and optimal functional outcomes.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate needs of a growing allied health service with the long-term strategic imperative of ensuring sustainable, high-quality patient care. The pressure to expand services quickly can lead to compromises in recruitment, training, and resource allocation, potentially impacting patient safety and regulatory compliance. Careful judgment is required to navigate these competing demands ethically and effectively. Correct Approach Analysis: The best professional practice involves a phased, evidence-based approach to expansion. This means conducting a thorough needs assessment to identify specific service gaps and target populations, followed by a detailed resource plan that includes realistic timelines for recruitment, onboarding, and competency validation of allied health professionals. This approach prioritizes patient safety and quality of care by ensuring that new services are introduced only when adequate staffing, equipment, and supervision are in place. Regulatory frameworks, such as those governing allied health practice and healthcare facility accreditation, mandate that services are delivered by competent practitioners in appropriate settings, which this phased approach directly supports. Ethical considerations, particularly the principle of non-maleficence (do no harm), are upheld by avoiding premature service expansion that could compromise patient well-being. Incorrect Approaches Analysis: One incorrect approach involves immediately launching new services to meet perceived demand without adequate preparation. This fails to comply with regulatory requirements for service provision, which often stipulate minimum staffing ratios, appropriate qualifications, and established referral pathways. Ethically, this approach risks patient harm due to insufficient staffing or unqualified personnel, violating the principle of beneficence and non-maleficence. Another incorrect approach is to prioritize rapid expansion by hiring less experienced staff without robust supervision or a structured professional development plan. This contravenes guidelines from professional bodies and regulatory agencies that emphasize ongoing competency assessment and professional development for allied health practitioners to ensure safe and effective practice. It also neglects the ethical duty to provide adequate support and training to staff, potentially leading to burnout and compromised patient care. A third incorrect approach is to focus solely on financial targets for expansion, overlooking the critical need for infrastructure, equipment, and support services. Regulatory bodies often have specific requirements for the physical environment and necessary equipment for allied health services. Failing to address these can lead to non-compliance and an inability to deliver care safely and effectively, ethically compromising the organization’s commitment to patient well-being. Professional Reasoning: Professionals should employ a strategic decision-making framework that integrates regulatory compliance, ethical principles, and evidence-based practice. This involves: 1) needs assessment and gap analysis; 2) development of a comprehensive strategic plan with clear objectives, timelines, and resource allocation; 3) robust risk assessment and mitigation strategies; 4) stakeholder engagement (including staff, patients, and regulatory bodies); and 5) continuous monitoring and evaluation of service delivery against established quality indicators and regulatory standards.

The evaluation methodology shows that understanding the purpose and eligibility for Critical Occupational Therapy Leadership Board Certification is paramount for advancing the profession and ensuring high standards of practice. This scenario is professionally challenging because it requires a leader to navigate the complex landscape of professional development, organizational needs, and individual career aspirations while adhering to the specific requirements of a prestigious certification. Misinterpreting the purpose or eligibility criteria can lead to wasted resources, demotivation, and a failure to meet the intended objectives of the certification. The best approach involves a thorough review of the official certification body’s documentation to ascertain the precise purpose and eligibility criteria. This includes understanding the intended impact of the certification on leadership practice, the specific qualifications (e.g., years of experience, educational background, leadership roles, professional contributions) required for application, and the process for demonstrating competency. Adhering to these documented requirements ensures that the leader is pursuing a path that aligns with the certification’s goals and that their application will be considered fairly. This approach is correct because it is grounded in the explicit guidelines set forth by the certifying body, which are the ultimate arbiters of who qualifies and for what purpose the certification is intended. Ethical practice demands adherence to established standards and transparent processes. An approach that focuses solely on the perceived prestige of the certification without verifying specific eligibility criteria is professionally unacceptable. This fails to acknowledge the structured nature of board certification, which is designed to validate specific competencies and experiences, not just general leadership aspirations. It risks misrepresenting an individual’s qualifications and undermines the integrity of the certification process. Another professionally unacceptable approach is to assume that any leadership role automatically fulfills the experience requirements. Board certifications often have nuanced definitions of “leadership experience,” which may include specific types of responsibilities, supervisory roles, or demonstrable impact on practice or policy. Failing to investigate these specifics can lead to an inaccurate assessment of eligibility. Finally, an approach that prioritizes personal ambition over the stated purpose of the certification is also problematic. The Critical Occupational Therapy Leadership Board Certification is intended to elevate the profession through demonstrated leadership excellence. If an individual pursues it solely for personal advancement without a genuine commitment to contributing to the broader field as defined by the certification’s purpose, it deviates from ethical professional development. Professionals should employ a decision-making framework that begins with clearly defining the objective (e.g., obtaining board certification). This should be followed by diligent information gathering, specifically consulting the official guidelines of the certifying body. Next, an honest self-assessment against these criteria is necessary. If gaps exist, a strategic plan for meeting them should be developed. Throughout this process, maintaining integrity and transparency regarding one’s qualifications and motivations is crucial.

This scenario is professionally challenging because it requires a candidate to balance the demands of their current occupational therapy practice with the significant time commitment and focused preparation needed for a rigorous board certification. The pressure to perform well on the exam, coupled with potential workplace responsibilities and personal commitments, necessitates a strategic and well-planned approach to candidate preparation. Careful judgment is required to select a preparation strategy that is both effective and sustainable. The best approach involves a structured, multi-faceted preparation plan that integrates study with practical application and seeks guidance from established resources. This strategy acknowledges the depth of knowledge required for board certification and the importance of ongoing professional development. It prioritizes consistent engagement with relevant materials, including official study guides and practice assessments, while also incorporating reflective practice and peer discussion. This method aligns with ethical professional conduct by ensuring thorough preparation and a commitment to maintaining high standards of practice, as expected of board-certified occupational therapists. It also implicitly supports the principles of lifelong learning and evidence-based practice, which are foundational to the profession. An approach that relies solely on reviewing past notes and informal discussions with colleagues is professionally deficient. This method fails to address the comprehensive and specific knowledge domains tested by the Critical Occupational Therapy Leadership Board Certification. It lacks the systematic review of current best practices, leadership theories, and regulatory frameworks that are essential for demonstrating advanced competency. Ethically, this approach risks presenting oneself as qualified without having undergone the rigorous preparation expected, potentially undermining the integrity of the certification process and the public’s trust in certified professionals. Another inadequate approach is to cram extensively in the weeks immediately preceding the examination. This method is unlikely to foster deep understanding or long-term retention of complex leadership concepts and their application in occupational therapy. The intense, short-term focus can lead to superficial learning and increased anxiety, hindering optimal performance. Professionally, this demonstrates a lack of foresight and commitment to thorough preparation, which is contrary to the dedication expected of leaders in the field. It also fails to integrate learning with practical experience, a key component of effective leadership development. Finally, an approach that exclusively focuses on memorizing leadership theories without considering their practical application in diverse occupational therapy settings is also flawed. While theoretical knowledge is important, board certification assesses the ability to apply these theories to real-world leadership challenges. This method neglects the critical skill of translating abstract concepts into actionable strategies for improving service delivery, managing teams, and advocating for the profession. Professionally, this represents a gap in competency, as effective leadership requires both theoretical grounding and practical acumen. Professionals should adopt a decision-making framework that prioritizes a comprehensive understanding of the certification requirements, realistic self-assessment of knowledge gaps, and the development of a personalized study plan. This plan should incorporate diverse learning methods, allocate sufficient time for review and practice, and seek out credible preparation resources. Regular self-evaluation and adaptation of the study plan based on progress are also crucial for success.

This scenario presents a professional challenge because it requires an occupational therapist to navigate the complexities of a certification board’s policies regarding exam performance and future attempts, while also upholding ethical obligations to their profession and potential future clients. The critical judgment needed lies in understanding the nuances of the board’s blueprint weighting, scoring, and retake policies, and how these interact with professional development and career progression. The best approach involves a thorough and proactive review of the official Critical Occupational Therapy Leadership Board Certification (COTLBC) candidate handbook. This handbook is the definitive source for all policies, including the detailed breakdown of the blueprint weighting for each domain, the specific scoring methodology used, and the precise conditions and limitations surrounding retake attempts. Understanding these elements allows for a strategic approach to preparation and a clear comprehension of the consequences of exam performance. This aligns with the ethical imperative for occupational therapists to maintain professional competence and adhere to the standards set by certifying bodies, ensuring that their credentials accurately reflect their knowledge and skills. It also supports transparency and informed decision-making regarding professional development pathways. An incorrect approach would be to rely on informal discussions or anecdotal evidence from colleagues regarding the exam’s difficulty or retake procedures. This fails to acknowledge the official nature of the COTLBC’s policies and risks acting on misinformation. Such a reliance bypasses the established channels for accurate information, potentially leading to misinterpretations of scoring or eligibility for retakes, which could have significant professional repercussions. Ethically, this demonstrates a lack of diligence in seeking authoritative guidance. Another incorrect approach would be to assume that a single failed attempt automatically disqualifies an individual from future certification without consulting the specific retake policy. This can lead to premature discouragement and abandonment of professional goals. The COTLBC’s policies likely outline specific waiting periods, additional educational requirements, or a limited number of retake opportunities, all of which need to be understood before making assumptions about future eligibility. This approach lacks the necessary due diligence and can hinder professional growth. A further incorrect approach would be to focus solely on the perceived difficulty of the exam content without understanding how the blueprint weighting influences the scoring. The blueprint dictates the proportion of questions from each domain, meaning that mastery of certain areas might be more critical for achieving a passing score than others. Ignoring this weighting can lead to inefficient study habits and a misunderstanding of how performance in different sections contributes to the overall score. This demonstrates a failure to engage with the structured assessment methodology established by the board. The professional reasoning framework for situations like this involves a commitment to evidence-based practice, which extends to understanding the rules and regulations governing professional credentials. This means prioritizing official documentation, seeking clarification from the certifying body when necessary, and making decisions based on accurate information rather than assumptions or hearsay. It requires a proactive and systematic approach to professional development and certification processes.

The efficiency study reveals a significant backlog in diagnostic imaging referrals for patients presenting with suspected neurological conditions. This scenario is professionally challenging because it directly impacts patient care timelines, potentially delaying crucial interventions and affecting prognoses. Leaders must balance resource allocation, staff workload, and the ethical imperative to provide timely and effective care, all while adhering to professional standards and regulatory guidelines. The correct approach involves a multi-faceted strategy that prioritizes patient safety and evidence-based practice. This includes a thorough review of current referral pathways to identify bottlenecks, an assessment of available imaging modalities and their appropriate utilization based on clinical presentation, and a proactive engagement with referring physicians to ensure accurate and complete diagnostic information is provided with each referral. Furthermore, it necessitates an evaluation of staff competency and training in the interpretation of imaging findings and the application of diagnostic principles. This approach aligns with the ethical duty of care and the professional responsibility to ensure that diagnostic processes are efficient, accurate, and patient-centered, reflecting best practices in occupational therapy leadership and diagnostic fundamentals. An incorrect approach would be to simply increase the volume of imaging requests without a corresponding review of the appropriateness of each request or the diagnostic rationale. This could lead to unnecessary resource expenditure, potential patient exposure to radiation or other risks associated with imaging, and could overwhelm the diagnostic services, further exacerbating delays. This fails to uphold the principle of judicious use of diagnostic tools and could be seen as a breach of professional responsibility to ensure patient well-being. Another incorrect approach would be to implement a blanket policy of reducing imaging referrals for certain suspected conditions without consulting with relevant medical specialists or reviewing current diagnostic guidelines. This could lead to missed diagnoses or delayed diagnoses, directly compromising patient care and potentially violating ethical obligations to provide appropriate diagnostic services. It demonstrates a lack of understanding of the nuances of diagnostic decision-making and the importance of interdisciplinary collaboration. A further incorrect approach would be to focus solely on the speed of image acquisition without considering the quality of the images or the accuracy of their interpretation. Diagnostic imaging is only valuable if it provides reliable information that can inform clinical decisions. Neglecting the quality control aspects of instrumentation and interpretation undermines the entire diagnostic process and fails to meet professional standards for diagnostic accuracy. Professionals should employ a systematic decision-making process that begins with understanding the problem’s scope and impact. This involves gathering data, consulting relevant professional guidelines and ethical codes, engaging with stakeholders (including patients, referring physicians, and imaging specialists), and evaluating potential solutions based on their adherence to best practices, patient safety, and resource efficiency. Continuous evaluation and adaptation of strategies are also crucial.

Scenario Analysis: This scenario is professionally challenging because it requires the occupational therapist to balance the immediate need for a client’s functional improvement with the critical imperative of ensuring the safety and efficacy of a complex therapeutic intervention. The therapist must navigate potential conflicts between client expectations, the limitations of available equipment, and the established protocols for specialized procedures. Accurate calibration and technical proficiency are paramount to prevent harm and achieve desired outcomes, making judgment calls under pressure essential. Correct Approach Analysis: The best professional practice involves a systematic and evidence-based approach. This includes a thorough review of the client’s current functional status and specific needs related to the orthotic device. It necessitates consulting the manufacturer’s guidelines and any relevant professional standards for the calibration and fitting of the specific orthotic. If the therapist identifies a discrepancy between the device’s current calibration and the client’s needs, or if the calibration appears outside the manufacturer’s recommended parameters, the correct approach is to pause the intervention, re-evaluate the calibration, and consult with a senior clinician or specialist if uncertainty persists. This ensures that the intervention is safe, effective, and aligned with best practices, prioritizing client well-being and adherence to professional accountability. Incorrect Approaches Analysis: One incorrect approach involves proceeding with the intervention despite recognizing a potential calibration issue. This disregards the fundamental principle of client safety and the ethical obligation to provide competent care. Failing to address a calibration discrepancy could lead to an ineffective orthotic, exacerbation of the client’s condition, or even direct harm, violating professional standards of practice. Another incorrect approach is to assume the device is correctly calibrated without verification, especially if there are subtle indicators of a problem. This demonstrates a lack of due diligence and can result in suboptimal outcomes and potential risks. Finally, attempting to recalibrate the device without adequate knowledge, training, or consultation, especially if it deviates significantly from standard procedures, poses a risk of further compromising the device’s functionality and safety. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes client safety and evidence-based practice. This involves a continuous cycle of assessment, planning, intervention, and evaluation. When faced with technical challenges, such as orthotic calibration, professionals should: 1) Assess the situation thoroughly, identifying any potential risks or deviations from expected norms. 2) Consult relevant resources, including manufacturer guidelines, peer expertise, and professional literature. 3) Plan the next steps, which may involve further assessment, recalibration, or seeking supervision. 4) Intervene cautiously, ensuring all actions are justified and documented. 5) Evaluate the outcomes and adjust the plan as needed. This systematic approach fosters accountability and promotes the highest standard of care.

Scenario Analysis: This scenario is professionally challenging because it requires the occupational therapy leader to balance the immediate need for efficient data utilization with the ethical and regulatory obligations to protect patient privacy and ensure data accuracy. Misinterpreting or misusing data can lead to suboptimal clinical decisions, potentially harming patients, and can also result in regulatory non-compliance and erosion of trust. The leader must navigate the complexities of data interpretation while upholding professional standards and legal requirements. Correct Approach Analysis: The best approach involves a systematic review of the aggregated data, cross-referencing it with established clinical guidelines and evidence-based practices, and then using this synthesized information to inform the development of targeted interventions. This approach is correct because it prioritizes a comprehensive understanding of the data within its clinical context, ensuring that decisions are grounded in both empirical evidence and professional expertise. Regulatory frameworks, such as those governing health information privacy and professional conduct, mandate that clinical decisions be evidence-based and patient-centered. This method directly aligns with these requirements by ensuring that data interpretation leads to informed, ethical, and effective clinical strategies. Incorrect Approaches Analysis: One incorrect approach involves immediately implementing changes based solely on the most frequently observed patterns in the data without further validation or consideration of individual patient variability. This fails to account for potential biases in data collection or the nuances of individual clinical presentations, which could lead to interventions that are not appropriate for all patients. Ethically, this approach neglects the principle of individualized care. Another incorrect approach is to dismiss the aggregated data as unreliable without a thorough investigation into potential data integrity issues or the limitations of the data collection methods. This overlooks the potential value of the data for identifying systemic trends and opportunities for improvement. Professionally, it represents a failure to engage with available information that could enhance service delivery and patient outcomes. A third incorrect approach is to share the raw, uninterpreted data with all clinical staff without providing context or guidance on its analysis. This poses significant privacy risks if patient identifiers are not properly anonymized and can lead to misinterpretation and inconsistent application of findings, potentially undermining evidence-based practice and patient safety. It also fails to leverage the leadership role in synthesizing information for effective decision-making. Professional Reasoning: Professionals should adopt a data-informed decision-making process that involves: 1) understanding the source and limitations of the data; 2) critically analyzing the data in conjunction with clinical expertise and established guidelines; 3) synthesizing findings to identify trends and areas for intervention; 4) developing and implementing evidence-based strategies; and 5) continuously evaluating the effectiveness of interventions and refining approaches based on ongoing data analysis and feedback. This iterative process ensures that data is used responsibly and effectively to enhance patient care and organizational performance.

Scenario Analysis: This scenario presents a professional challenge rooted in the critical competency of ethical practice and professional responsibility. The occupational therapist is faced with a situation where a client’s expressed wishes conflict with the therapist’s professional judgment regarding safety and potential harm. Navigating this requires a delicate balance between respecting client autonomy and upholding the duty of care, all within the established ethical and regulatory frameworks governing occupational therapy practice. The challenge lies in making a decision that is both legally sound and ethically defensible, ensuring the client’s well-being without compromising their rights. Correct Approach Analysis: The best professional approach involves a thorough, documented assessment of the client’s capacity to make informed decisions regarding their safety. This includes exploring the client’s understanding of the risks associated with their desired activity, their reasoning behind their choices, and their ability to comprehend the potential consequences. If the assessment indicates the client has the capacity to understand and weigh the risks, their decision should be respected, with appropriate safety strategies and compensatory measures collaboratively developed. This aligns with the fundamental ethical principles of autonomy and beneficence, as well as regulatory requirements that mandate client-centered care and informed consent. The occupational therapist’s role is to facilitate informed decision-making, not to unilaterally impose their will. Incorrect Approaches Analysis: One incorrect approach involves immediately overriding the client’s wishes and refusing to support their desired activity based solely on the therapist’s perception of risk. This fails to acknowledge the client’s right to self-determination and may constitute a breach of ethical principles related to autonomy and respect for persons. It also bypasses the crucial step of assessing the client’s decision-making capacity, which is a regulatory and ethical imperative. Another incorrect approach is to proceed with the client’s desired activity without a comprehensive assessment of their capacity or without exploring alternative, safer methods. This could lead to an unsafe situation for the client and potentially expose the therapist to professional liability for failing to exercise due diligence and uphold their duty of care. It neglects the ethical obligation to promote well-being and prevent harm. A third incorrect approach is to delegate the decision-making entirely to a family member or caregiver without a formal assessment of the client’s capacity or without involving the client in the discussion. While family involvement can be valuable, the primary responsibility for assessing capacity and respecting client wishes rests with the occupational therapist, especially when the client is an adult. This approach may violate privacy and autonomy principles. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes client-centered care and ethical considerations. This typically involves: 1) Gathering comprehensive information about the client’s situation, including their goals, values, and environmental context. 2) Assessing the client’s capacity to make decisions relevant to their care, using standardized tools or structured interviews where appropriate. 3) Collaboratively exploring options with the client, discussing risks and benefits of each. 4) Documenting all assessments, discussions, and decisions thoroughly. 5) Seeking supervision or consultation when faced with complex ethical dilemmas. This systematic approach ensures that decisions are informed, ethical, and legally defensible, promoting the best interests of the client while respecting their rights.