Follow each client from referral and assessment to goals, sessions and the final report.

Occupational therapy is organised around goals. A client wants to dress without help, return to work after an injury, hold a pencil or stay safe at home, and the therapist plans sessions around that goal.

Referrals, outcome measures and funder reports are written by hand or in word processor files, so progress against a goal is hard to show at review time. Session counts approved by a funder are tracked in a separate sheet.

A referral arrives from a physician, a school, an employer, an insurer or a family. The front desk records who referred, what funding applies and what the client hopes to change. A therapist completes an initial assessment, sets goals with the client or the parent, and agrees a plan for the sessions that follow.

Sessions are held in a treatment room, a sensory gym, a school, a workplace or the client’s home. After each one the therapist writes a note against the goals, records any outcome measure and sets the next appointment. Some clients need a custom splint, an adapted utensil or a seating recommendation, and these are ordered or made and fitted at a later visit. Assistants prepare rooms and equipment.

Reports go back to referrers at set points, and funders approve a limited number of sessions at a time. Home and workplace assessments involve travel, photographs and a written recommendation. Therapists who work as contractors are paid by sessions delivered.