Welcome to guest blogger, OT and Director of the Just for OT Practitioner to Coach Program, Jaclyn Schwartz, PhD, OTR/L
We practice a home exercise program, walk a parent through sensory strategies, or teach a caregiver a different way to approach a daily routine. We explain the recommendations, provide a handout, and move on.
We’ve explained the recommendation and practiced it together. But we may not yet know what the person plans to do with it.
Imagine a parent leaving a session with a visual schedule you developed together. They practiced using it and saw how it could help. As they pack up, you ask how they feel about trying it at home.
“This makes sense,” they say, “but I don’t know how I’ll add it while getting both kids ready and myself out the door.”
That answer changes the conversation. You now have something to explore beyond whether the instructions were clear.
A home program, handout, or recommendation can be appropriate and well explained while still needing a conversation about choice and fit.
Here, we’ll look at:
• The difference between understanding a recommendation and choosing to try it.
• How a coaching approach can support shared planning.
• One conversation to have before the visit ends.
Understanding is important. So is deciding.
Clear education matters. Asking someone to explain or demonstrate a recommendation in their own words helps us check whether we taught it clearly. That is the purpose of techniques like teach-back.
There is another question worth asking: What has the person decided to try?
A parent may understand how to use a visual schedule without having decided to introduce it tomorrow. A client may demonstrate an exercise correctly while wondering where it could fit around work and caregiving.
Even “okay” can leave us uncertain. It might mean “I understand,” “I’m willing to try,” or “I’m not sure what else to say.”
We do not have to guess. We can make room for the person to tell us
Bringing a coaching approach to the recommendation
Our OT expertise helps us assess needs, develop and adapt recommendations, teach skills, and address safety. A coaching approach helps us explore what the person wants to take on and how it could work in their life.
Collaboration already belongs within client-centered OT practice. Coaching skills give us ways to make that collaboration more explicit when we discuss changes between
For the parent facing a hectic morning, you bring knowledge about the strategy and how to adapt it. They bring knowledge about their household, competing responsibilities, and what feels possible.
Both perspectives belong in the plan.
Let one question guide the next part of the conversation
You do not need to add five questions to every visit. Start with the part you do not yet understand.
“Of what we discussed, what, if anything, would you like to try before we meet again?”
Then let the answer guide you.
If the parent says, “I want to try the schedule, but the whole morning feels like too much,” you might ask:
“Which part of the morning would you want to start with?”
Perhaps they choose getting dressed. You can then explore where the schedule would go, when they would introduce it, and whether another adult needs to know the plan.
If they say, “I’m not sure a schedule is what we need,” the next conversation is different. You might ask what concerns them or what they had hoped the strategy would help with. There may be something to clarify, adapt, or reconsider together.
If they want to try it but doubt they can manage it, explore what would make it more doable. They may need practice, a smaller starting point, or practical support.
These are possible directions, not a script. The point is to discover which conversation is needed.
Check the plan you built together
Once there is a next step, ask:
“Can you walk me through what you’ve decided to do?”
Listen for what the person has chosen and how they see it fitting into their day. Clarify anything that remains uncertain, including safety considerations and support they need.
You can also agree on what to revisit next time. What worked? What got in the way? What needs adjusting?
A plan does not have to work perfectly to give you useful information. But it helps to begin with a shared understanding of what the person intends to try.
Keep the handout. Add the conversation.
The exercise sheet, visual schedule, or caregiver handout may still be useful. The opportunity is to connect it with the person’s choices and daily life. At your next visit, notice what happens after you explain a recommendation. What have they told you about whether and how they want to use it?
One question may reveal that you already share a clear plan. It may also uncover a concern that changes your next step.
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Download the companion checklist, Before They Leave below
