Sometimes the most meaningful part of a therapy session starts with a simple conversation.
As occupational therapists, we spend so much of our time focusing on helping our patients improve their strength, balance, endurance, cognition, and independence with daily activities. We're constantly thinking about treatment plans, functional goals, documentation, and how to make the most of each session. But sometimes, one of the most meaningful things we can do for our patients has nothing to do with an exercise or an intervention.
Sometimes, it's as simple as asking about the picture on their wall.
Whether you're providing therapy in someone's home, an assisted living community, or a skilled nursing facility, take a moment to look around. Maybe there's a wedding photo sitting on their nightstand. A family portrait hanging above their couch. A picture of a beloved pet. Or a photograph from a vacation taken decades ago. Instead of walking right past it, ask about it. You might be surprised by the story that follows.
1. Remember, There's a Person Behind Every Patient
Before your patient became your patient, they lived an entire life. They had careers, raised families, traveled, developed hobbies, experienced hardships, celebrated accomplishments, and created memories. They were teachers, farmers, nurses, business owners, parents, grandparents, athletes, artists, and so much more. And while we might know them as the patient recovering from a hip replacement or the older adult experiencing difficulty with daily activities, their identity extends far beyond their diagnosis.
One of the things I love most about working with older adults is hearing their stories. Every person has lived a life filled with experiences that have shaped who they are today. And sometimes, those stories are sitting right in front of us, framed on the wall.
2. Building Rapport Starts With Genuine Curiosity
Building rapport is an important part of establishing a positive therapeutic relationship. But rapport doesn't always develop through formal introductions or conversations about therapy goals.
Sometimes, it starts with a simple question:
"Who's in this picture?"
"Where was this photo taken?"
"Is that your family?"
"What kind of work did you used to do?"
"Have you always enjoyed gardening?"
"Tell me about this beautiful picture!"
These questions may seem small, but they create opportunities for genuine connection. When we take an interest in our patients' lives, we're showing them that we care about who they are as individuals, not just what we're there to treat. And that can make a meaningful difference in the therapeutic relationship.
3. Trust Is Built Through Connection
Think about the healthcare professionals you've interacted with throughout your life. Chances are, the ones who made you feel comfortable weren't necessarily the ones who knew the most medical terminology or had the most impressive credentials. They were the ones who listened. The ones who remembered little details about your life. The ones who made you feel like a person rather than another appointment on their schedule. Our patients deserve that same experience. As occupational therapists, we often ask patients to do things that may feel challenging, uncomfortable, or even intimidating. We're asking them to trust us as we work on transfers, mobility, self-care tasks, and activities they may be afraid of attempting.
Building trust helps create an environment where patients feel more comfortable expressing their concerns, asking questions, and participating in therapy. And sometimes, that trust begins long before the first exercise. It begins when we take the time to listen.
4. Their Story Can Help You Become a Better Occupational Therapist
Here's where something as simple as asking about a picture becomes especially meaningful from an OT perspective. Learning about someone's life can help us provide more individualized, occupation-based care. Occupational therapy is rooted in understanding what matters to the person. Their interests, routines, roles, values, and past experiences can all help guide our treatment approach.
For example:
You notice a picture of your patient working in a garden. You ask about it and discover they spent decades growing vegetables and flowers. Now you know gardening is meaningful to them. Perhaps you can incorporate planting, watering, reaching, or other gardening-related activities into treatment when appropriate.
You notice a family picture with several grandchildren. Your patient shares how much they love spending time with their grandchildren but have difficulty getting down on the floor to play with them. Suddenly, you have a meaningful functional goal to explore together.
You notice a photograph of your patient fishing. They tell you fishing was one of their favorite hobbies, but they haven't participated since experiencing a decline in strength and endurance. Now you have an opportunity to explore the physical demands of fishing, activity modifications, energy conservation, and adaptive equipment.
These conversations can help us understand what motivates our patients and what independence truly means to them. Because improving someone's ability to complete an activity is important. But helping them return to something they love? That's what makes occupational therapy so meaningful!
5. Therapeutic Use of Self Is a Powerful Part of OT
As occupational therapists, one of the tools we bring into every treatment session is ourselves. Therapeutic use of self involves intentionally using our communication, empathy, personality, and interpersonal skills to support the therapeutic relationship. It's recognizing when someone needs encouragement, when they need reassurance, and when they simply need someone to listen. And while our treatment sessions should remain purposeful, we shouldn't underestimate the value of genuine human interaction. Taking a moment to ask about a photograph doesn't mean we're ignoring our clinical responsibilities. It means we're recognizing the human being in front of us. Of course, not every patient will want to share personal stories. Some photographs may bring up grief or difficult memories. Respecting their boundaries and allowing them to guide the conversation is just as important as asking the question. Connection should always be an invitation, never an expectation.
6. Sometimes the Smallest Moments Leave the Biggest Impact
Working in healthcare can be busy. We have productivity expectations, documentation to complete, schedules to manage, and patients who need our attention. It's easy to get caught up in checking everything off our to-do lists. But I think it's important to remember that the moments we consider small may mean much more to someone else. A patient might not remember every exercise you completed together. They might not remember how many repetitions they performed or exactly what you worked on during a particular session. But they may remember that you asked about their late spouse. That you listened to the story of how they met. That you remembered their dog's name. Or that you took a genuine interest in something that brought them joy. We may never fully know the impact those moments have. But that doesn't make them any less valuable.
7. Everyone Has a Story to Share
One of my favorite things about working with older adults is the opportunity to learn from people who have experienced so much life. Every patient has a unique story. Some stories are filled with adventure. Others are filled with love, loss, resilience, accomplishments, and lessons learned along the way. And we have the privilege of hearing them.
So, the next time you walk into a patient's room or home, take a moment to look around. Notice the photographs. Notice the hobbies. Notice the little pieces of their personality that make their space their own. And don't be afraid to ask a question. You might discover a meaningful activity to incorporate into therapy. You might learn something new. You might build a stronger therapeutic relationship. Or you might simply give someone an opportunity to share a memory that means the world to them. Because at the end of the day, we're not just treating patients. We're caring for people. And everyone has a story worth hearing.
The Golden OT | Empowering occupational therapists to provide meaningful, client-centered care.
