The use of coaching in Occupational Therapy

In OT, coaching is considered a fundamental skill to enable occupation.

Townsend and Polotajko (2007) describe it as...

“An asset based appreciative approach highly congruent with enabling lasting occupational change… The emphasis is to coach people to take responsibility for self-direction in naming priorities and goals, which are most meaningful to them... The coach may offer feedback on occupational performance in order to support and enhance occupational development.”

(Side note: We think the definition starts off as a bit of a mouthful...but then it's not so bad eh!? We did have to cut it down a touch;)

But coaching in healthcare is not unique to OT. In fact, it’s recognized in the fields of psychology, counselling, education, and more; and it continues to spread in the world of healthcare.

So how exactly do OT’s use coaching and what is the evidence behind this?

Today's Paper
Kessler, D., & Graham, F. (2015). The use of coaching in occupational therapy: An integrative review. Australian occupational therapy journal, 62(3), 160-176.

This study examines how OTs use coaching and aims to clarify the similarities and differences between different OT coaching interventions. It also took a broad look at the evidence base for the use of coaching in OT. 


  • Integrative literature review using the AACPDM Level of Evidence and Conduct Rating Tools

  • Included 24 articles

  • Identified 11 different interventions used by OTs across various populations


Evidence for the use of OT specific coaching looks promising but is pretty limited (mainly due to a small, differentiated pool of OT specific research on the subject to draw from; with only one randomized control trial to boot).

The most commonly included OT-coaching components were:

  1. Goal setting

    • Included increasing knowledge specific to health conditions or impairment, or learning strategies or techniques to increase participation in activity.

  2. Problem solving

    • Included performance analysis, discovery of strategies, reflective questioning to foster insight, and an iterative process of goal setting, analysis, planning, action and evaluation.

    • Interventions mainly differed in the directiveness of the therapist; interventions with a focus on remediation or developing component skills for occupation where more directed by OTs than other areas.

  3. Education

    • Most educational components drew from adult learning theories to build existing knowledge and link information with the learner’s current concerns.

Theoretical underpinnings included occupation-centered practice, client or family centered practice and adult learning theory.

Summary and Takeaway(s)
Preliminary evidence on OT specific coaching suggests goal setting, problem solving, and educational components can lead to increased occupational performance, satisfaction with performance, goal attainment, and improved self-efficacy and self-esteem.

Coaching may be a useful tool in your practice and is probably best used in conjunction with a clear process to monitor and measure outcomes to ensure goals are being met.