Goal setting dynamics that facilitate or impede a client-centered approach.

Area of Science:

• Occupational therapy
• Client-centred practice
• Goal setting

Background:

• Client-centred goal setting is crucial for enabling occupation but faces practical barriers.
• This study investigates facilitators and impediments to client-centred goal formation in a supportive setting.

Purpose of the Study:

• To identify factors that facilitate or impede client-centred goal setting in occupational therapy.
• To understand the dynamics of goal-setting conversations in Occupational Performance Coaching for stroke survivors.

Main Methods:

• Conversational analysis of 12 goal-setting sessions from a pilot trial of Occupational Performance Coaching.
• Transcription and analysis of interactions using established conversation analysis conventions.

Main Results:

• Two interaction types observed: introductory actions (context setting, information sharing) and goal selection actions (exploration, endorsement, or dropping of goals).
• Introductory actions involved clarifying goal requirements and client competencies.
• Goal selection actions revealed how goals were negotiated between therapist and client.

Conclusions:

• Facilitating client-centred goals involves contextualizing them within life changes and lifelong development, and actively listening to clients' narratives.
• Therapists can enhance consistency in adopting client goals by clarifying goal meanings and addressing power dynamics, values, and beliefs regarding risk and attainability.