When Your Clients Know What to Do But Aren't Doing It: Why Occupational Therapy Practitioners Need Coaching Skills

You've done everything right.

You've educated your client about their diabetes management. You've adapted their kitchen for easier meal prep. You've recommended the evidence-based interventions. You've provided detailed instructions and adaptive equipment.

And yet, three months later, they're still not checking their blood sugar. Still skipping medications. Still struggling with the same lifestyle factors that are keeping them from their occupational goals.

Sound familiar?

If you're an occupational therapy practitioner working with clients who have chronic conditions, you've probably experienced this frustration more times than you can count. You know your client understands what they need to do. The problem isn't knowledge. The problem is the gap between knowing and doing.

The Intervention That's Missing From Your Toolkit

Traditional occupational therapy interventions are incredible at addressing physical barriers, environmental adaptations, and skill development. But when the barrier isn't physical or cognitive, when it's behavioral or emotional, we need different tools.

This is where coaching skills come in.

Coaching isn't about replacing your occupational therapy practice. It's about adding evidence-based intervention skills that address the health behaviors driving chronic disease. When a client with heart disease knows they should reduce stress but can't seem to make it happen, that's a coaching conversation. When your client with arthritis understands anti-inflammatory eating but feels overwhelmed by changing decades of habits, that's where coaching creates lasting change.

The Paradigm Shift From Prescribing to Partnering

Here's what makes coaching different: instead of telling clients what to do, you're partnering with them to discover what will actually work in their life.

Research shows that coaching interventions demonstrate strong evidence for improving occupational performance, goal attainment, and self-efficacy across diverse populations with chronic conditions. The key is the collaborative partnership and autonomy-supportive approach, which aligns perfectly with occupational therapy's client-centered philosophy.

When you integrate coaching skills into your practice, you're no longer fighting against the follow-through problem. You're working with your clients to understand their real barriers, leverage their strengths, and create sustainable behavior change that sticks.

What Coaching Skills Look Like in Occupational Therapy Practice

Imagine working with a client who has type 2 diabetes. Traditional intervention might focus on meal prep adaptations and medication management routines. Adding coaching skills, you might:

• Use motivational interviewing to explore their ambivalence about dietary changes

• Apply goal-setting frameworks that honor their values and readiness

• Support them in identifying and reframing limiting beliefs about their ability to change

• Help them build self-efficacy through achievable steps they design themselves

• Partner with them to problem-solve real barriers in their actual life context

Same client. Same chronic condition. Completely different approach to creating lasting change.

Expanding What's Possible in Your Practice

Here's what occupational therapy practitioners tell me after integrating coaching skills into their work:

Their clients achieve goals they previously thought were impossible. The frustration of non-compliance transforms into collaborative problem-solving. And perhaps most importantly, they've expanded their professional scope in ways that create both better client outcomes and new career opportunities.

Whether you're working in outpatient rehab, home health, wellness settings, or private practice, coaching skills give you tools to address the nutrition, stress, and lifestyle factors that impact every chronic disease. You're already seeing these factors affect your clients' occupational performance. Now you can effectively intervene.

Where to Start

If you're ready to move beyond the frustration of clients who know but aren't doing, coaching skills offer an evidence-based path forward. This isn't about becoming a different professional. It's about enhancing your occupational therapy practice with tools that address the whole picture of chronic disease management.

Over the coming weeks, I'll be sharing practical coaching techniques you can start using immediately, research on coaching effectiveness in occupational therapy, and real stories from practitioners who've successfully integrated these skills into their work.

Ready to expand what's possible in your practice? Join my email list at healthcoachot.com for weekly evidence-based coaching tips, early access to courses and resources, and strategies for addressing chronic disease through the lens of occupational therapy.

Because your clients deserve more than knowing what to do. They deserve a practitioner who can help them actually do it.