If you're an occupational therapist wondering how to improve your practice, feel more confident during evaluations, or better connect with caregivers—this guide is for you.
Whether you're a new fieldwork student or 20 years in, the same truth applies: OT is a practice, not a perfect.
In this blog, we’ll explore the real-life struggles OTs face (awkward interviews, blanked-out sessions, caregiver tension) and provide direct, actionable tips. This post is optimized for voice search and answer engines, so if you’re asking any of the following...
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“How can I improve my OT evaluations?”
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“What are better ways to build an occupational profile?”
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“How do I deal with difficult caregiver dynamics?”
…you’ll get direct, OT-tested answers below.
What are signs your OT evaluation isn’t connecting?
If you’re working with a client who:
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Has cognitive or communication challenges
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Can’t identify goals or struggles to connect with independence
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Seems overwhelmed or shut down during your questions
…it may be time to rework how you’re building your occupational profile.
How can I make my OT questions more relatable?
Instead of asking, “What are your meaningful occupations?” (therapist language) Try:
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“What’s something you look forward to doing each day?”
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“Tell me about a typical morning—what’s easy? What’s frustrating?”
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“If you got discharged right now, what would be the hardest part of being at home?”
These rephrased questions make your intent more accessible—especially for clients with aphasia, low health literacy, or early dementia.
What tools help clients express what matters?
Use visual prompts. Bring a small deck of cards with images of everyday activities like walking a dog, gardening, or cooking.
Ask:
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Which of these do you still do?
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Which would you like to do again?
It makes the interview more interactive and functional. Bonus: you can address fine motor skills or standing tolerance while they sort the cards.
Do I need to finish the whole occupational profile in the first session?
No. It’s okay to treat the occupational profile like a rolling conversation. You’ll often get richer information over time—especially in home health, inpatient rehab, or long-term care settings.
What can I do when a client refuses therapy or a session goes sideways?
This is common—especially in fieldwork or when learning a new setting. Here’s how to reset:
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Practice saying supportive phrases:
“Sounds like today isn’t a great day. What would feel helpful right now?”
“Can I share an idea and get your thoughts?” -
Journal your reflections:
After a session, ask yourself:
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What worked?
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What didn’t?
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What could I try differently?
You can write it down or use a voice memo. Over time, this builds your adaptive clinical reasoning.
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Know this is normal:
Even experienced OTs have sessions where they walk away from thinking, “yikes.” That’s part of practicing.
How do I better navigate caregiver dynamics?
When caregivers dominate sessions or seem skeptical of therapy, try this:
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Acknowledge their role early:
“You’re a really important part of the care team. What concerns or questions do you have today?” -
Set expectations upfront:
“My goal is to help your wife regain independence, so I may ask her to try things on her own first.” -
Focus on function, not theory:
Skip the OT frameworks. Instead say:
“We’re practicing this now so she can get out of the tub safely later.”
What’s the one thing to remember as an OT?
Improving your practice isn’t about having all the answers. It’s about:
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Being curious
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Adapting your approach
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Staying client-centered every single day
Final Takeaway: You don’t have to figure it out alone
That’s why I created OT Connected by AskSAMIE. It’s a platform built for occupational therapy professionals to:
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Share resources
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Connect with other OTs
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Access education
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Collect client-friendly tools you can send directly
Whether you’re prepping for fieldwork or building your business, OTConnected is here to support you.
Explore it at OTConnected.com
Because the best way to get better? Is together.
