• Joanna Caton

Simple Conversations To Help With Expectations

Updated: Mar 9

Over the years I’ve noticed the topic of “coping with client expectations” crop up over and over during mentoring sessions with allied health professionals. Often, discussions surround the discomfort the worker is experiencing. The health professional may feel unsure about how to address certain client interactions or be uncomfortable with being asked to carry out tasks which are outside their role. Difficulty knowing how to address these issues without ruining the therapy relationship can lead to some resentment, worry or anxiety on the part of the therapist which is less than ideal for good outcomes.


It is VERY easy to see how these situations crop up within care giving professions. For example;

  • Some of our professional training schools may focus more on teaching the skills involved in "technique" rather than on what it takes to build PARTNERSHIPS;

  • As health professionals we enter the workforce with a mission to be “helpful”. However, in our bid to be helpful, we often forget that being helpful is not about saying “Yes” to everything or about being “liked”;

  • Sometimes we get confusing messages from our workplaces and employers where we are encouraged to go “over and above” without clear guidance on what is beyond our scope. Conversely, our workplace may also put super strict limitations on our ability to make decisions about how we can and can’t work with clients which also puts us at a disadvantage.


In any case a more productive relationship between health professionals and clients can usually be achieved through clear COMMUNICATION of FAIR EXPECTATIONS combined with EMPATHY for the client needs. This needs to be explained effectively right from the beginning and also in an ongoing manner.


But what do clients think of this?


"In my experience I appreciate the therapist taking the time to listen to me but also to set the scene about how it all works".

"It just makes sense to know what is expected upfront. That way I know if the therapist is the right fit for us."

Information about expectations and boundaries could include;

  • What your role is and is not.

  • Ways to communicate with each other.

  • What your service actually does.

  • Fees and time frames.

  • What the client’s role is within the process.

  • What you will do if you cannot be of help.

  • Anything else that impacts on your ability to work together.

This kind of information is often best provided via multiple types of media…. on your website, in written form, during verbal discussions and through emails. However, it is often the VERBAL discussions, had at the right time in the right manner which provide the most effective form of communication and the best opportunity to develop a partnership.


Here are a few examples of conversation starters which could help to position you for a great partnership with your client.

  • “As an occupational therapist my role is to help with…..”

  • “I'm not able to help with that. Let me have a think about who would be better suited and I will let you know…”

  • “ Tell me how you like communication to take place. I can offer text messages, emails or written progress notes that you take home after your session…”

  • “I really value clear communication so feel free to email me any questions. Just be aware that I only answer them on my work days and that if I feel your questions are better answered in a consultation I will let you know…”

  • “ I only work during school hours so let me know if you need ideas on someone who works after hours or if you are able to work with that….”

  • “Our service is only funded to provide 5 sessions. Let’s talk about how that can be most helpful for you and what we can do when they finish up…”

  • “To get a good outcome we recommend that you carry out some daily home practice. What are your thoughts on that?...”

  • “ It’s really important you let us know the day before if you cant attend. That gives us a chance to call someone who is waiting on our cancellation list who needs to see us…”

  • “I just want to give you the “heads up” that if you need to cancel you wont be charged a cancellation fee if you remember to do it at least 2 days before hand.”

  • “When you begin to work with us our process is …”

Journal Prompts.

Take some time to journal on how you are communicating expectations with clients. Is this an area which needs some work? Have you made assumptions that your clients know expectations even though you have never discussed it? Have you got some other conversation starters to share? How can you make sure you keep following up on the message in a clear but "not annoying" way?


Remember: You can support a productive partnership with your client by combining EMPATHY for their needs with CLEAR COMMUNICATION regarding your BOUNDARIES AND EXPECTATIONS. Don’t forget to keep on communicating this in an ONGOING way.


Occupational therapist having a conversation with a client
Communication with empathy


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