Editor's Note: This text-based course is a transcript of the webinar, Integrating Coaching In Occupational Therapy: Strategies For Patient-Centered Care, presented by Ten'Niquwa Bryan, B.A.S. in Supervision and Management, M.S. in I/O Psychology, Evidence-Based Coaching Certification.
*Please also use the handout with this text course to supplement the material.
Learning Outcomes
- After this course, participants will be able to identify how coaching principles can be integrated into occupational therapy to enhance therapeutic outcomes.
- After this course, participants will be able to recognize specific coaching techniques that can be effectively applied in occupational therapy settings.
- After this course, participants will be able to list various strategies for incorporating coaching into family-centered care within occupational therapy.
Introduction
Hello everyone. I am an industrial organizational psychologist, or more broadly, a psychology practitioner. My work focuses on helping organizations prioritize their people by creating a healthy quality of life and work-life balance. Additionally, I specialize in leadership development, organizational development, and maximizing workplace productivity.
Today’s course centers on the role of coaching within occupational therapy. I am a certified coach, and coaching is my area of expertise. Coaching is generally defined as a helping relationship between a coach and a client, utilizing various behavioral techniques and methods to assist the client in achieving mutually identified goals. The ultimate aim is to enhance professional performance as well as personal satisfaction.
During this course, we’ll explore how coaching strategies can be seamlessly integrated into occupational therapy practices to promote not only better outcomes for patients but also a more inclusive and family-centered approach to care.
Your Commitment
Before we dive into today’s topic, I want to take a moment to express my heartfelt gratitude to each of you. As occupational therapists, the work you do is transformative. You help individuals regain their independence, improve their quality of life, and support families through some of the most challenging times they may face. Your commitment to patient-centered care is truly inspiring, and I feel honored to be here with you today.
This presentation is designed to provide you with practical coaching tools that can further enhance the remarkable work you already do. Thank you for your time, energy, and most importantly, for the compassionate care you provide to your patients.
Introduction to Coaching
Alright, let’s go ahead and get started. Before we delve into the specifics of how coaching can enhance occupational therapy, I want to take a moment to define what coaching truly is. We often hear the term used in various settings, particularly in health and wellness or professional development contexts. But what exactly does coaching entail?
Coaching is about working closely with an individual or group to support their personal development in targeted areas—whether it’s health, wellness, or, as we’re discussing today, within occupational therapy. This is key because coaching isn’t about giving instructions or telling someone exactly what to do. It’s a collaborative process where the focus is on guiding the individual toward achieving their own goals. It’s centered on them, not us.
One of the main distinctions between coaching and counseling is that coaching is inherently future-focused and action-oriented. It emphasizes where the individual is headed rather than where they’ve been. This forward-looking perspective is crucial in helping clients see their potential, zero in on their goals, and work toward tangible, measurable outcomes.
Coaching in OT
Now, let’s look at coaching within the specific context of occupational therapy. Research shows that coaching is inherently client-centered, meaning the patient is always at the core of what we do. This approach is not about the therapist or coach imposing their agenda. Rather, it’s about listening to the patient, understanding their needs, and working alongside them in a supportive role.
One of the foundational elements of coaching is active listening. But what does active listening mean in this setting? It’s not merely about sitting quietly while the patient speaks or superficially acknowledging what they’re saying. True active listening means understanding where the patient is coming from—their desires, fears, motivations, and concerns. It involves picking up on verbal and nonverbal cues and showing the patient that you are fully present and genuinely invested in their entire experience—not just the parts that relate to your professional expertise.
Once you establish this trust through active listening, the next step is collaborative goal setting. Goal setting is not simply asking the patient, “What are your goals?” and writing them down. It requires active engagement, thoughtful discussion, and mutual exploration. This process is about co-creating a plan that reflects their personal objectives, values, and aspirations. It’s about understanding their perspective and shaping a roadmap that aligns with what’s meaningful to them.
Another critical element of coaching in occupational therapy is how we deliver feedback. Effective feedback goes beyond simply affirming successes or pointing out areas for improvement. Instead, it should prompt patients to reflect on their progress, think critically about their actions, and assess how far they’ve come. This reflective feedback encourages a more holistic view of their journey, allowing them to feel empowered to make adjustments and take ownership of their progress.
Through this approach, the patient becomes an active participant in their development, transforming feedback into a tool for growth rather than an evaluation of performance. Ultimately, this fosters a deeper sense of engagement, resilience, and motivation, ensuring the patient feels supported and capable throughout their journey.
Active Listening
Now that we have a clearer picture of what coaching looks like in occupational therapy let’s dive deeper into the three essential components of coaching. First and foremost, we have active listening. While we all understand that listening is important, in coaching it goes beyond simply hearing the words spoken. Active listening is about being fully present with the patient. One of the most valuable lessons I learned early in my coaching journey was the importance of setting aside my own thoughts and distractions so I could truly focus on what the patient was saying. It’s about being entirely tuned in to the moment.
Active listening requires paying close attention not only to what the patient is saying but also to how they’re communicating it. This includes observing their body language, which often reveals more than words alone, as well as noting changes in tone, pace, and emotional cues. We often convey just as much—if not more—through nonverbal communication. When we listen actively, we create an environment where the patient feels genuinely seen and heard, which is a powerful and transformative experience.
This level of presence and validation is critical, particularly in healthcare settings, where patients might not always feel comfortable being completely honest. By actively listening, we foster a therapeutic relationship that encourages patients to be open and forthcoming, knowing that we’re fully engaged and truly invested in their experience.
For example, imagine a patient expressing frustration about their progress. Perhaps they feel they’re not improving as quickly as they’d like, or they’re overwhelmed by the number of exercises they need to complete. In that moment, active listening isn’t just saying, “I hear you.” Instead, you might respond by validating their experience: “I understand that you’re feeling frustrated, and that’s okay. Let’s talk about what’s been particularly challenging and see if we can come up with a way to address it.”
This kind of response goes beyond acknowledging the words spoken; it shows that you care about their emotional experience as much as their physical progress. Engaging in this type of dialogue deepens the therapeutic relationship and opens the door for more meaningful collaboration. Research consistently highlights active listening as the foundation of effective coaching. It’s the first step in building trust and creating a stronger therapeutic alliance, because when patients feel understood, they’re more likely to engage openly and work with you toward solutions. This shared understanding is ultimately the goal of coaching in occupational therapy.
Next, we’ll look at goal setting, another key component of coaching, which builds on the trust established through active listening.
Goal-Setting in Coaching
Traditionally, therapists might set goals based on what they believe the patient needs to achieve. However, in coaching, the process is fundamentally different. It must be collaborative. Rather than dictating goals, we work with the patient to establish achievable and meaningful goals for them.
This collaborative goal-setting approach in occupational therapy is crucial because it taps into the patient’s intrinsic motivation. When patients feel they are active participants in the process, they are more likely to take ownership of their progress. This sense of ownership is where we start to see measurable goals come to life. The goals need to be specific and concrete so that the patient knows exactly what they are working towards and can tangibly track their progress.
For example, instead of a broad objective like "improve mobility," a concrete goal might be, “By the end of the month, I want to be able to walk unassisted for ten minutes.” This way, the patient clearly understands what they’re striving for and can see incremental progress. Just as important is ensuring that the goals we set align with the patient’s values and priorities.
Patients who don’t feel personally invested in their goals are less likely to commit to the process. For instance, if you’re working with someone recovering from a stroke, and you set a goal to improve their handwriting, but their main concern is being able to cook again, then the goal of handwriting will not resonate. Instead, you’ve missed an opportunity to link therapy to something that truly matters to them. Coaching, and by extension collaborative goal setting, is subjective—it’s different for every patient and must be tailored to their unique preferences and aspirations.
Paying attention to what is truly meaningful for each patient is the key to creating goals that matter. When we co-create goals aligned with their priorities, we boost their motivation and help them see how therapy is a vital part of achieving their larger life goals. And when patients see even small increments of progress in important areas, they are more likely to stay engaged and motivated.
Celebrating these small wins along the way is also critical. No matter how minor, each step forward is a step in the right direction and should be acknowledged. Recognizing these successes helps build momentum and reinforces the value of their efforts. Focusing on small but meaningful progress is the key to success in occupational therapy, as it keeps patients engaged and hopeful throughout the journey.
Reflective Feedback in Coaching
Finally, we come to reflective feedback. In this context, feedback is not simply about praising or pointing out mistakes. It’s about providing the patient with insights into their progress in a way that fosters self-awareness and deeper understanding. Reflective feedback goes beyond telling someone what they did right or wrong—it’s about helping them see their journey, recognize patterns, and think critically about their experiences.
The goal is to guide the patient in exploring what went well, what didn’t, and what they might consider doing differently next time. Instead of saying, “You didn’t complete this task correctly,” you might reframe it to, “I noticed you struggled with this part. What do you think could help you next time?” This language encourages reflection and empowers the patient to develop solutions independently. It allows them to think critically and problem-solve independently, ultimately building their confidence and self-efficacy.
This approach is especially important in coaching, as it is intended to build a person’s capacity for self-management. Unlike long-term therapy, which may last for years, coaching is often a shorter, more focused process—typically spanning a few months—designed to help individuals develop skills they can use independently. The aim is to empower patients so they no longer need the same level of external guidance and can continue progressing independently.
Reflective feedback also fosters a growth mindset. When patients can reflect on their progress and recognize their growth, it boosts their confidence and motivates them to keep pushing forward. It shifts the focus from perfection—where they feel they must do everything right—to embracing continuous improvement. They begin to see each experience and challenge as an opportunity to learn and refine their approach, understanding that setbacks are not failures but part of the journey toward achieving their goals.
This shift in mindset supports the patient’s short-term progress and helps them develop lifelong skills in problem-solving and self-reflection. By creating a space where patients can think critically about their actions and feel empowered to make adjustments, we’re helping them cultivate a mindset of resilience and adaptability. Ultimately, reflective feedback becomes a powerful tool that enables patients to navigate future challenges independently and with greater confidence—one of the most valuable outcomes of any therapeutic process.
Coaching in OT: Practical Application
Now, let’s move into my favorite part of the conversation—the practical application of coaching techniques. We’ve already discussed the foundational components of coaching, so let’s explore techniques that can be highly effective in an occupational therapy setting.
One of the most powerful tools at your disposal is motivational interviewing. This technique involves asking open-ended questions and encouraging patients to reflect on their motivations, goals, and challenges. It’s especially useful when working with patients who may feel discouraged or uncertain about their progress. Instead of telling them what to do, motivational interviewing invites them to explore their reasons for change, which can help reignite their commitment to the therapy process. For example, rather than saying, “You need to focus on your exercises,” you might ask, “What’s motivating you to keep going even when it feels difficult?” This approach can unlock their internal drive and deepen their engagement.
Another effective method is using strength-based approaches. This model shifts the focus away from deficits and emphasizes the patient’s strengths. Rather than zeroing in on what the patient can’t do, we highlight what they can do and build on that foundation. In coaching, we don’t ignore the areas that need improvement but concentrate on growing the patient’s strengths to the point where their challenges become smaller and more manageable. For instance, if a patient has strong cognitive skills but struggles with physical tasks, we can leverage their cognitive abilities to help them problem-solve and develop strategies for working around their physical limitations. This approach boosts the patient’s confidence and fosters a greater sense of control and ownership over their therapy journey.
Finally, there’s focused coaching, which is about helping patients find answers to their challenges. This method is less about providing solutions and more about guiding the patient toward discovering what works best for them. It involves asking reflective questions and encouraging them to brainstorm strategies, ultimately empowering the patient to see themselves as the expert in their own life. For example, instead of offering a specific adaptation for a difficult task, you might ask, “What has worked for you in similar situations?” This encourages them to lead the problem-solving process, fostering independence and resilience.
When you consider these three techniques—motivational interviewing, strength-based approaches, and focused coaching—they all emphasize empowerment and collaboration between you and the patient. These are the core principles of coaching in occupational therapy.
You’ll see summaries of these techniques on the next few slides, but I encourage you to take notes, as I’ll share additional insights that aren’t captured on the slides. These will include practical activities you can use in your work, whether independently or in collaboration with colleagues, patients, or even your family. Make sure to have something handy to write on so you can capture these takeaways for future practice!
Motivational Interviewing
So, we’ve discussed motivational interviewing in theory, but let’s explore it through a role-playing exercise that I think will help deepen your understanding. I appreciate role-playing activities because they allow you to explore different approaches to handling a situation, even if you haven’t encountered it in practice yet. It’s a great way to build skills and confidence.
For this exercise, partner up with a colleague. One of you will play the therapist, and the other will take on the role of the patient. As the therapist, your objective is to ask open-ended questions to help patients identify their goals and motivations. The key is encouraging patients to reflect on what’s important to them, using questions similar to those shown on the screen.
For example, you could ask, “What changes would you like to see in your day-to-day life?” or “What would success look like for you?” These questions are specifically designed to help the patient think about their reasons for engaging in therapy. Remember, the goal is not to provide advice or solutions. Instead, your role is to guide the patient in exploring their motivations.
These questions prompt the patient to think critically and deeply about why they want to engage in therapy. This technique is particularly effective when a patient feels stuck or unmotivated. When a patient can connect the therapy process to something that matters to them personally, it increases the likelihood that they’ll engage more meaningfully and stay committed to the goals they’ve set for themselves.
Try this role-play activity when you have time. It’s a valuable way to practice framing your questions and fine-tuning your approach to motivational interviewing, which can make a significant difference in fostering patient engagement and adherence.
Strength-Based Approach
Next, I’ll outline a short case study for the strength-based approach activity for you to consider.
Imagine that you’re working with a patient who has limited upper body mobility due to a spinal cord injury. However, this patient possesses exceptionally strong cognitive skills and a remarkable knack for problem-solving. Rather than focusing on their physical limitations, we want to leverage these cognitive abilities to help them navigate and overcome the challenges they face.
In this scenario, you might incorporate problem-solving exercises that engage their cognitive strengths. For instance, you could work together to strategize ways to adapt daily tasks such as cooking, baking, dressing, or sweeping the floor. This might involve brainstorming techniques for using adaptive equipment or creating new methods for performing tasks with available resources. You could also actively involve the patient in selecting or designing custom equipment to further engage their problem-solving strengths and creativity.
The key here is to build on what the patient can do rather than dwelling on what they can’t. By centering the intervention around their cognitive strengths, you help boost their confidence and keep them motivated, which, in turn, empowers them to feel more in control of their recovery.
When you revisit this case study later, consider how you would approach a similar situation in your practice. Perhaps you’ve worked with a patient with significant physical limitations but strong cognitive abilities. How would you adjust your intervention plan to harness those strengths?
Solution Focused Coaching
Finally, let’s explore solution-focused coaching, another valuable technique in the coaching toolbox. This approach works best when applied in a collaborative group setting, so you can utilize it with colleagues in the workplace. This activity aims to brainstorm solutions using the patient’s resources and abilities rather than providing them with external strategies.
In this scenario, imagine you’re working with a young adult struggling to balance school commitments with occupational therapy sessions. They’re extremely overwhelmed and unsure of how to manage their time effectively. In a traditional therapy setting, the instinct might be to step in and suggest various time management strategies. However, for this activity, we’ll use the solution-focused coaching technique to guide the patient in identifying what works best for them.
To facilitate this process, you’ll want to ask open-ended questions that prompt the patient to reflect on their past experiences and resources. For instance, you might ask, “What has worked for you in the past when you’ve had to juggle multiple priorities?” or “When you’re at your best, how do you typically manage the demands of your schedule?”
These types of questions are designed to help the patient tap into their strengths and strategies that they’ve successfully used before. The idea is to help them generate authentic and achievable solutions rather than imposing external advice. As you work through this scenario, focus on how you can guide the patient toward discovering their strategies, keeping in mind that the goal is to promote their independence and build confidence in their problem-solving ability.
This technique is particularly powerful because it encourages patients to recognize and utilize their internal resources. You reinforce their autonomy and self-efficacy by facilitating a process where they discover solutions independently. This approach helps shift the focus from feeling overwhelmed by challenges to feeling empowered by their ability to navigate them.
Case Study: Coaching in OT- Child with Developmental Delays
Now, I want to share a real-world example of how coaching can be integrated into occupational therapy, specifically when working with children. This story is personal, as it involves my son when he was around two years old. If you look at the photos, you can see that he started his life in the NICU (Figure 1).
Figure 1. Author's son in the NICU.
He was born at 28 weeks gestation, weighing exactly three pounds. As a preemie parent, I knew we would face challenges and developmental delays in various areas.
Fortunately, my son primarily needed speech and occupational therapy. That doesn’t mean the journey was easy, though. For the first year, a therapist came to the house every week to work with him. She used various techniques, like having him hold shapes and engage in activities designed to build his fine motor skills. However, what stood out was what she did after each session. She would sit down with me and coach me on how to replicate what she did with him, asking me about my goals for him and what I hoped to see in his progress.
It wasn’t just about a list of exercises to check off. She involved me in the process, making sure I was equipped to support him throughout the week. If she met with him on Monday and Wednesday, I would spend the time until the next session practicing whatever new techniques she had taught us. This allowed us to work on his development as a family, not just during the therapy sessions, which made a tremendous difference.
Imagine if she had just worked with him and left without involving me. That would have been the extent of his care, and I would have had little understanding of how to support him through the different milestones and changes. But because she took the time to coach me, show me the techniques, and work through my concerns, I felt more confident and empowered as a parent. She transformed a potentially passive experience into an active and collaborative one, setting the stage for my son’s progress.
After a year, my son had made such great progress that he transitioned out of home-based therapy and started attending a facility where he received both speech and occupational therapy. I remained very involved in his development, as minimizing his challenges as a preemie was crucial. The setting at the facility was different from one-on-one sessions—he was working with a group of people, sometimes two therapists at a time—but the team continued to use the same coaching approach.
They applied motivational interviewing to understand my goals for him and kept me involved throughout the process. They didn’t just work with him and move on; they taught me what I needed to do so that I could, in turn, teach my family members and ensure a consistent approach at home. I felt supported throughout this journey, even though I wasn’t the direct patient. Research supports this approach, showing that using motivational interviewing strengthens the patient’s outcomes and enhances the family’s support system.
When families are part of the journey, everyone feels more invested in the patient’s progress. We continued occupational therapy until my son was about three years old. Along the way, I enrolled him in preschool at around two and a half years old because he was an only child, and I felt he needed additional social support. I noticed a significant difference when he began engaging more with other children during his OT sessions, and it reinforced the importance of social interaction in his development.
Later, I transitioned him from preschool to a preparatory school, which also had a positive impact. All these decisions were guided by goals that I set collaboratively with his OT and speech pathologist. As you can see from the photos in Figure 2, he became fascinated with writing—something that had initially been very difficult for him due to challenges with holding objects and coordinating his movements. But with persistence and support, he began writing, throwing basketballs, and actively using his hands in ways that initially seemed impossible.
Figure 2. The author's son doing activities.
At one point, he even took an interest in typing on the computer and picking up tasks that required fine motor precision—activities he once struggled with. This entire transformation was a direct result of having a cohesive plan and being coached along the way as a family. Everyone, from the therapists to the school staff, was aligned on his goals, and this shared approach made a world of difference.
Today, my son is almost twelve and nearly as tall as I am—and I’m 5’11”! His journey from those early NICU days to where he is now is truly remarkable. The outcome could have been completely different without occupational therapy and our established collaborative relationships. The consistent use of coaching strategies supported his development and empowered me as a parent to play an active role in his success.
I wanted to share this story as a tangible example of what coaching looks like when fully integrated into occupational therapy and how transformative it can be when the entire family is involved. By seeing the child and the family as a unit and by coaching all of us, those early therapists laid the foundation for the progress we see today.
Integrating Family-Centered Care in OT
To understand family-centered care and its importance in occupational therapy, we must recognize that we can’t treat patients in isolation from their support system. When incorporating coaching into therapy, one of the first things you want to determine is who is part of the patient’s support network. This is especially critical when working with children or individuals with complex needs.
For example, if a patient can’t yet walk without assistance, including their support system is vital. Their success will depend not only on what happens during the therapy sessions but also on their family and caregivers' active involvement and support. Integrating coaching into a family-centered care model encourages the family to participate meaningfully in decision-making, goal-setting, and the overall therapy process.
This approach is not about simply providing advice or instructions to the family. Instead, it’s about empowering them to understand the patient’s needs and equipping them with the skills and confidence to work with the patient to set and achieve goals. Research consistently shows that using coaching strategies helps strengthen the patient’s independence and the family’s capacity to support them effectively.
A robust support system around the patient leads to improved outcomes. When patients feel supported inside and outside of therapy, they are more likely to stay motivated and engaged in their rehabilitation journey. This sense of holistic support boosts their confidence and increases their likelihood of achieving their goals. As OTPs, our role extends beyond direct patient care to include building up the network around the patient to ensure sustainable and long-lasting success.
Strategies for Incorporating
So, how do we incorporate coaching into family-centered care within occupational therapy? First and foremost, it starts with setting collaborative goals. It’s essential to involve the family members in the goal-setting process to ensure everyone—the patient, the therapist, and the family—is on the same page and working toward shared outcomes. This approach helps the family better understand how they can support the patient in reaching those goals.
Next, we have strength-based family engagement. This means focusing on what the family is already doing well. For example, they might be great at providing emotional support or have already developed a consistent routine for assisting the patient with daily tasks. Recognizing and building on these strengths boosts the family’s confidence and encourages them to stay engaged throughout the therapeutic process.
Open communication and reflective listening are also critical components. It’s important to create a space where family members feel comfortable expressing their concerns and ideas about how they can best support the patient. Listening actively and validating their input reinforces the value of their role in the patient’s therapy and strengthens the overall support system.
Another key element is education and empowerment. Families need to be coached on specific therapy techniques, much like the experience I shared about working with my son. This coaching should be tailored to integrate seamlessly into their daily routines. When family members feel equipped with the right tools and strategies, they gain the confidence to contribute actively to the patient’s progress.
In addition, motivational interviewing can be highly effective when working with families. This technique helps address any doubts or concerns and keeps them motivated to stay committed to the therapy plan that has been collaboratively developed. It’s about guiding them to reflect on their role and how their support can make a meaningful difference.
Regular feedback and progress updates are also essential. When families see the tangible results of their involvement, it reinforces their commitment and makes the entire process feel more rewarding. This consistent communication is key to maintaining momentum and ensuring all parties feel engaged and valued.
These strategies benefit the patient and help the entire family feel supported, empowered, and engaged in the journey toward recovery. By fostering a sense of shared purpose and collaboration, coaching within a family-centered approach can enhance the patient’s progress and the overall well-being of the family unit.
Common Challenges in Coaching Within OT
As with any approach, integrating coaching into occupational therapy will have challenges. Some patients, or even their family members, may resist the coaching model, especially if they are accustomed to a more traditional, therapist-led approach. In these cases, the shift towards collaboration and shared decision-making can feel unfamiliar or even uncomfortable. There may also be instances where cultural dynamics come into play, making some family members view the therapist as the sole expert whose instructions should be followed rather than seeing themselves as active participants.
Another major challenge is time constraints. We all know that therapy sessions are often limited, and incorporating coaching techniques involving more dialogue, reflection time, and collaboration can make it difficult to fit into these short windows. It can feel time-consuming from both the therapist’s and the patient’s standpoint. However, it’s essential to remember that the quality of the interaction often outweighs the quantity. A well-structured, meaningful discussion, even if brief, can significantly enhance the patient’s engagement and overall progress.
Lastly, there’s the issue of goal misalignment between the patient’s priorities and the OTP’s clinical objectives. Sometimes, patients or families may want to focus on goals that, as a therapist, you don’t view as a priority. This can lead to tension or frustration, especially if other areas require more immediate attention. In these cases, it’s important to revisit the principles of active listening and collaborative goal-setting. Finding a way to honor the patient’s goals while incorporating critical therapeutic objectives can help bridge this gap, ensuring that the patient feels heard and respected while working toward essential outcomes.
Navigating these challenges requires flexibility, patience, and a willingness to adapt your approach to meet the needs of each unique situation. Ultimately, the investment in building these collaborative relationships can lead to more sustainable and meaningful outcomes for both patients and their families.
Solutions to Common Challenges
So, how do we overcome these challenges? To address resistance, the key is building rapport from the very beginning. Take the time to establish trust and clearly explain the benefits of a coaching approach. When patients and families feel heard and understood, they are much more likely to engage in the process. For example, you might say, “I understand that this is a different way of doing things, but I believe that when we work together, we can achieve even better outcomes.” By framing it as a partnership, you invite them into the process rather than imposing it on them.
For time-constraint issues, the solution lies in setting small, manageable goals. We don’t need to solve every problem in one session. Instead, break things down into achievable steps, which helps keep the process focused and efficient. Small wins build momentum over time and can significantly impact even brief sessions. This approach ensures that each session feels productive and aligns with the patient’s progress.
To tackle goal misalignment, involve the patient and their family in the goal-setting process right from the start. This is crucial to ensuring everyone feels heard, and their perspectives are incorporated. When the patient’s values and priorities are reflected in the therapy plan, the process becomes collaborative rather than directive, reducing the likelihood of frustration or disagreement later.
To wrap up, I’ll share a couple of scenarios that illustrate these challenges and how these solutions can look in practice. These examples will highlight how addressing resistance, managing time constraints, and aligning goals can transform the therapeutic process into a more collaborative and successful experience for everyone involved.
Scenarios
In the first scenario, imagine you’re working with the mother of a young child in OT. She’s hesitant about the coaching approach because she’s accustomed to the traditional therapy model and doesn’t see why she should be involved in goal-setting or decision-making. Her perspective is that you, as the OTP, should handle those responsibilities. In this situation, take the time to build rapport by explaining the value of her involvement. For example, you might say, “Your input is incredibly valuable in helping us understand what’s best for your child. When we work together, we can ensure that therapy meets your child’s needs and aligns with your family’s goals.” By addressing her concerns and validating her role, you encourage her to become a more active participant, shifting from a passive role to one where she feels empowered and engaged.
In the second scenario, imagine a patient coming into therapy with a long list of goals, all very ambitious. They want to improve mobility, strength, coordination, and much more—all at once. This can quickly lead to frustration when there isn’t enough time in a session to address every area, and they don’t see immediate progress. To prevent this sense of overwhelm, the strategy here would be to help the patient prioritize their goals and set smaller, more achievable steps for each session. This might require taking a step back and having a focused conversation to narrow down what’s most important to them.
You could say, “I see how dedicated you are to improving in every area, and that’s a great mindset. But to ensure steady progress, let’s choose one or two key areas to focus on for now. We can build on those as you start seeing gains.” By breaking down the goals into smaller, manageable steps, the patient will begin to see progress without feeling overwhelmed or frustrated by the enormity of their initial expectations.
In both scenarios, the key is to acknowledge the patient or family member’s perspective, provide clear explanations, and guide them in a way that respects their autonomy while still ensuring that therapy remains productive and meaningful.
Final Thoughts
To wrap things up, I want to leave you with key takeaways. First, OT coaching is much more than just a set of techniques. At its core, it’s about creating an environment where patients feel truly heard and understood. This builds trust, which is the foundation of any effective therapeutic relationship.
Remember, goal setting is not something you do for the patient—it’s something you do with them. When goals are developed collaboratively, and patients feel they have ownership over their progress, they’re more motivated and invested in achieving them, which can make a substantial difference in outcomes.
Reflective feedback is equally crucial. It’s not about telling patients what they did right or wrong; it’s about guiding them to reflect on their actions, encouraging them to think critically, and helping them develop the skills needed to problem-solve independently.
Techniques like motivational interviewing allow patients to set their own goals, making the process more personal and engaging. Strength-based approaches emphasize what patients can do, which boosts their confidence and helps them progress from a place of strength. Solution-focused coaching encourages patients to take charge of their journey, promoting independence and self-efficacy.
And lastly, don’t underestimate the value of family-centered care. By involving families in the therapeutic process, we build a stronger support system around the patient, which is especially impactful for individuals with complex needs. This, in turn, leads to better outcomes and a more cohesive recovery journey.
Thank you again for your time and attention during this presentation. I hope you’ve gained valuable tools and techniques to add to your toolkit, and I look forward to seeing how you implement these strategies to enhance your practice.
Exam Poll
1)What does coaching in OT focus on?
The correct answer is B, collaboration and empowerment.
2)What is a key component of coaching?
Coaching involves all of these components.
3)Which is NOT a component of coaching in setting goals?
The answer is B. It lets the client know that the OT is in charge of setting in all goals.
4)Which is an example of a practical application of coaching in OT?
All of these are practical applications of coaching in OT.
5)Which is a TRUE statement about incorporating coaching into family-centered care?
Coaching is a collaborative approach, so C is the correct answer.
Questions and Answers
Do you have a class that will give me a coaching certificate?
I have several resources available to help guide you in the right direction. Feel free to email me (in the handout), and I’ll be happy to point you toward some options that can provide a coaching certificate.
How do you approach difficult family members?
Handling difficult family members is as unique as managing each patient. It depends on the type of challenge they present. Motivational interviewing techniques can be very helpful if the family member wants to be involved but is overbearing or overwhelmed. It allows you to structure the conversation to respect their enthusiasm while gently setting boundaries.
Coaching aims to empower patients and their families to participate in the process, but it’s equally important to establish your role as a professional. You need to clearly communicate that you’re the one directing the therapy, and the therapist's role is to support you and the patient. Framing it as a partnership, where everyone’s contributions are valuable, can help manage these situations.
If the family member is more disruptive or consistently negative, you may need to have a direct conversation with your patient, especially if it’s affecting their progress. For example, you could say, “I’ve noticed that this person’s behavior might be hindering your progress—how do you feel about this?” This type of dialogue is crucial because your patient is your primary focus at the end of the day, and their input should guide how you handle the situation.
In cases where a family member’s involvement is not adding value or obstructing progress, it’s okay to have a respectful conversation about setting limits. Let them know their presence might not be beneficial now and explore other ways they can support from a distance, if appropriate.
Can you recommend a good book on coaching?
I recommend Jenny Rogers's "Coaching Skills: The Definitive Guide to Being a Coach." This comprehensive resource offers practical strategies and insights for those looking to deepen their coaching skills. We’ve also shared a link to it in the chat for easy access.
References
Please see the attached handout.
Citation
Bryan, T. (2024). Integrating coaching in occupational therapy: Strategies for patient-centered care. OccupationalTherapy.com, Article 5749. Available at https://OccupationalTherapy.com
