Occupational Therapy: Goal Writing, Interpersonal Communication, Interviewing, and Teaching Techniques

Vocabulary practice flashcards covering COAST goal writing, the Intentional Relationship Model (IRM), therapeutic communication, clinical interviewing techniques, and motor learning teaching strategies.

Problem Statement

A clinical documentation statement that links an affected area of occupation (including level of assistance) with a contributing factor that limits engagement and can be addressed through occupational therapy.

Contributing Factor

A factor that limits engagement in a desired occupation, focusing on elements addressable through occupational therapy—such as contexts, performance patterns, performance skills, and client factors—rather than medical diagnoses.

Long Term Goal (LTG)

An overarching, functional goal defining what the client hopes to achieve by discharge ($\text{d/c}$), typically written as one goal per problem identified during evaluation.

Short Term Goal (STG)

Incremental sub-steps met while progressing toward a long-term goal or discharge, setting the ongoing course of therapeutic treatment.

COAST Format

An occupational therapy goal-writing acronym standing for Client, Occupation, Assist Level, Specific Condition, and Timeline.

C (COAST Goal Component)

The client or caregiver designated to perform or complete the target activity using an active verb (e.g., 'Client will', 'Child will', 'Caregiver will'), rather than what the therapist will do.

O (COAST Goal Component)

The specific functional occupation being performed that directly relates back to the problem statement identified in the intervention plan.

A (COAST Goal Component)

The quantifiable physical assistance level, verbal cues, tactile cues, or visual cues that the client utilizes to accomplish the task.

S (COAST Goal Component)

The specific conditions or criteria under which performance occurs, including modified techniques, adaptive equipment, positioning, or environmental location.

T (COAST Goal Component)

The realistic timeline or expected timeframe within which the goal is to be accomplished, such as a number of sessions, weeks, or target discharge date.

Therapeutic Relationship

A professional alliance characterized by unconditional positive regard where only one person (the client) benefits, distinct from a friendship.

Therapeutic Use of Self

A therapist's conscious and planned use of their personality, insights, perceptions, and judgments to motivate and facilitate the client's therapeutic goals.

Intentional Relationship Model (IRM)

A conceptual model defining four main attributes of the therapeutic process: the client, the practitioner, the interpersonal events that inevitably occur during therapy, and occupation.

Advocating Mode

A therapeutic mode focused on facilitating environmental access, negotiating barriers, reinforcing positive identity, and securing resources for occupational participation.

Collaborating Mode

A therapeutic mode that promotes client autonomy, fosters active partnership, and honors client preferences in decision-making.

Empathizing Mode

A therapeutic mode involving active listening, understanding client thoughts and feelings, and nonjudgmentally validating emotional experiences.

Encouraging Mode

A therapeutic mode that motivates the client by instilling hope, providing positive reinforcement, and incorporating fun and humor.

Instructing Mode

A therapeutic mode emphasizing direct teaching of skills and strategies, setting structure and limits, and providing step-by-step instructions.

Problem-Solving Mode

A therapeutic mode that facilitates reasoning through strategic questioning, guiding the client to analyze challenges and identify workable solutions.

Voice Modulation

The deliberate management of pitch, pace, and pause during verbal communication to convey clarity, meaning, and confidence.

Active Listening

Listening without judgment, comprising restatement of content, reflection of feelings, and clarification through targeted questioning.

Minimal Response

Brief verbal acknowledgments ('mm-hmm', 'go on', 'I see') or therapeutic silences that encourage continued sharing without interrupting.

Therapeutic Self-Disclosure

A practitioner's brief, purposeful sharing of personal experiences to build rapport, normalize client feelings, model behaviors, or enhance empathy within a client-centered framework.

Establishing Rapport

The introductory interview phase where the clinician introduces themselves, defines occupational therapy, asks for preferred naming/pronouns, and addresses immediate practical needs.

Summarize and Clarify

The concluding step of an interview where the therapist reviews key points discussed, verifies mutual understanding, outlines next steps, and thanks the client.

Just-Right Challenge

The optimal balance between task demands and learner capacity necessary to establish motivation and facilitate effective learning.

Talk Back

A teaching strategy where the client verbally repeats instructions or explains how to perform a taught strategy.

Teach Back

A teaching strategy where the client demonstrates mastery by teaching an activity or strategy back to the therapist.

Scaffolding

Providing structured support (verbal, visual, tactile, or physical assistance) to bridge current ability and target task demands, gradually fading help as independence increases.

Forward Chaining

A procedural teaching technique where the learner performs the initial step independently while remaining steps are prompted, sequentially adding independent steps until the entire routine is mastered.

Backward Chaining

A procedural teaching technique where the therapist completes earlier task steps and the client executes the final step to gain immediate positive reinforcement, progressing sequentially from end to start.

Massed Practice

A practice schedule characterized by minimal or no rest periods between repetitions, resulting in more time spent performing than resting.

Distributed Practice

A practice schedule featuring longer rest intervals between practice bouts, with more time allocated to rest than active performance.

Blocked Practice

Repetitive drilling of a single task repeatedly before advancing to another task.

Random Practice

Practicing multiple different tasks in varied, alternating sequence across a single session, facilitating superior long-term motor skill retention.

Closed Task

An activity performed within a stable, stationary, and predictable environment with fixed task demands (e.g., throwing a bowling ball down a lane).

Open Task

An activity requiring dynamic adaptation to an unpredictable, constantly changing environment (e.g., walking through a crowded hospital hallway).

Mental Practice

The cognitive rehearsal and visualization of a motor task prior to physical execution.

Tactile Cueing

A physical touch or non-forceful nudge used to prompt initiation or continuation of a movement without taking over the action.

Physical Assistance

Hands-on guidance where the therapist directly guides or supports the client's body through the physical steps of a task.

Visual Cueing

The provision of pictorial or graphic sequences that demonstrate the steps required to complete an activity.

Explicit Instruction and Explanation

Direct verbal explanation detailing performance standards, key movements, and specific technical parameters of a task.

Think-Aloud Modeling

Demonstrating an activity while verbalizing internal cognitive decision-making, problem identification, and error-correction strategies.