Preparation addresses each client's individual deficits. Examples include exercises to open the hand while reaching, scanning strategies for visual neglect, learning what the parts of a memory notebook are for, and learning how to stop negative self-talk.
Many people have the same shoulds. We all should get dressed so we can leave the house, do laundry so we have clean clothes, write legibly so we can sign credit card slips, and have good memory strategies so we get to appointments on time. OTs call "I shoulds" functional outcomes. Insurance companies will not pay for therapy if clients do not show some functional gains.
3. The I Want Tos.
"I want to" is personal, like petting a beloved cat. Valued activities occur outside of therapy so clients may not see how they are connected to OT. OTs need to make linking statements so clients understand the full value of OT. A linking statement might be "don a bra so I will not be embarrassed when I eat lunch with friends." I live alone so donning my bra enhances my social life. If a client wants to feel the sun on his or her face, pointing while saying "leg brace - patio" can make a client's face light up.
Preparation and functional training are essential but they do not sustain our commitment to action when we recover slowly. Practicing a tip pinch so I can zip my coat needs to be followed by "because I want to..........." Valued activities help us maintain the physical, cognitive, language, and social skills we work so hard to regain. Living life to the fullest does not mean going to Paris. It means satisfying deep human needs like feeling needed and having fun. It means turning
"I should" into "I want to."