Occupational Therapist Interview Questions

I usually start from the patient's perspective rather than a textbook definition. I explain that occupational therapy is about helping people do the everyday things that matter to them: whether that is getting dressed independently after a stroke, managing anxiety well enough to return to work, or adapting someone's home so they can stay living safely on their own. The word "occupation" in occupational therapy refers to any meaningful activity, not just paid work. Interviewers and patients both need to understand that OT is not just about physical function: we work across physical health, mental health, learning disabilities, and community care settings. I find that grounding the explanation in a specific example, like helping someone return to cooking after a brain injury, makes it much more memorable than describing frameworks or models.

I start by building rapport with the client and understanding what they want to be able to do, not just what they currently struggle with. The occupational profile comes first: I explore their roles, routines, values, and priorities through structured and unstructured conversation. Then I carry out a performance analysis, observing the client doing tasks that are meaningful to them rather than relying solely on standardised tools, although I do use validated assessments such as the COPM, AMPS, or functional task assessments depending on the setting and the client's needs. I consider environmental factors: the home, the workplace, the community. I document my findings clearly, share my interpretation with the client, and set goals collaboratively. I am clear from the beginning that the client is the expert on their own life and that my role is to support them to achieve what they have identified as important.

I triage by a combination of clinical urgency and risk. Patients who are medically unwell, at immediate risk in their home, or blocking acute hospital discharge take priority. I am transparent with colleagues and managers when caseload pressures affect turnaround times, and I keep a visible record of my caseload so I can escalate concerns with evidence rather than approximation. For clients who are progressing but not urgent, I review the frequency of contact against their goals: someone working toward a long-term goal may need fortnightly rather than weekly sessions. I use waiting time as an opportunity to involve clients in self-directed activity or peer support where that is appropriate and safe. When something has to wait, I communicate that to the client and agree on a safety plan where needed. Caseload management is a skill I treat as seriously as any clinical skill.

I start by trying to understand what is underneath the apparent lack of motivation. In my experience it is rarely simple disinterest: it is more often fear of failure, past experiences of not being listened to, a mismatch between what the referrer expects and what the client actually wants, or a mental health issue affecting engagement. I use motivational interviewing techniques to explore ambivalence rather than pushing toward a goal the client has not chosen. I ask what a good day looks like for them, what small things they used to enjoy, and what getting better would mean for their life. I set very small initial goals that are achievable and generate a sense of success, then build on those. I also acknowledge openly that it can take time to build trust, especially if someone has had poor experiences with services before. If motivation remains low after several sessions, I review whether the intervention model is appropriate or whether a referral to another service would serve the client better.

I was working with an older adult who had been discharged from hospital following a hip replacement. The clinical team recommended a ground-floor bedroom for safety, but the client was very clear that sleeping downstairs felt demeaning to her and that returning to her bedroom upstairs was central to her recovery goals. Rather than overriding her choice, I did a thorough risk assessment of the staircase and observed her practising the stairs with appropriate technique and a rail. I worked with the team to develop a stair management plan that included practice sessions, a monitoring schedule, and clear criteria for reviewing the arrangement if her strength or balance changed. I documented her informed decision-making capacity and her understanding of the risks. She returned to her bedroom upstairs, managed well, and told me later that the ability to do so had significantly motivated the rest of her recovery.

During a home visit to an elderly client I noticed several things that concerned me: the home was cold despite it being winter, there was very little food visible in the kitchen, and the client seemed anxious when I asked about who was looking after her finances. She had previously mentioned a family member who helped with her shopping and bills, but she became visibly uncomfortable when I mentioned this person by name. I did not press her directly in that moment, as I was aware she might feel unsafe doing so. I completed the visit, documented everything I had observed factually, and reported my concerns to my manager and the safeguarding team that day. I followed the agreed referral process and ensured a safeguarding investigation was opened. I did not disclose my concerns to the family member. The outcome was that the client received additional support from adult social care and a financial review was initiated.

I was working with a young adult with autism spectrum disorder who was struggling with the transition from school to adult services. The standard social skills group was not a good fit: the noise level, unpredictable social dynamics, and large group size were creating significant distress rather than building confidence. I reviewed his sensory profile and spoke with him and his family about what environments felt manageable. We redesigned the intervention as a one-to-one vocational exploration programme, starting with low-sensory activities that matched his interests in technology. Over six weeks he identified a volunteering opportunity at a local library, which provided the structure and predictability he needed. He progressed to a supported employment pathway from there. The adaptation required me to document my clinical reasoning carefully and discuss it with the team, but the outcome was significantly better than the standard group would have been.

I start by gathering information before the visit: the patient's medical history, functional status in hospital, what level of support they have at home, and any specific risks identified by the ward team. I confirm the purpose of the visit with the patient beforehand and explain what I will be assessing. During the visit I look at every area the patient needs to access: bedroom, bathroom, kitchen, and entry and exit to the property. I observe the patient performing the key tasks they will need to manage independently or with their support network: transferring in and out of bed, using the toilet and shower, managing stairs if relevant. I assess the need for any equipment or adaptations such as grab rails, a perch stool, or a raised toilet seat. I check that any equipment already in the home is safe and correctly installed. I document the outcome clearly and communicate it to the ward and to the patient's GP. Where major adaptations are needed, I initiate the referral to the relevant housing or social care authority.

Activity analysis is one of the core OT skills I use every day. When I am working with a client on a specific task, I break it down into its component parts: the physical demands, the cognitive demands, the sensory requirements, the social elements, and the environmental context. This lets me identify exactly where a client is struggling and why. For example, if someone cannot make a cup of tea independently, I use activity analysis to determine whether the problem is grip strength, sequencing, fatigue, visual processing, or anxiety in the kitchen environment. Each cause requires a different intervention: adapted equipment for grip, cognitive strategy for sequencing, energy conservation for fatigue. Activity analysis also guides how I grade tasks: I can make an activity easier or harder along multiple dimensions depending on where the client is in their recovery. I use it both informally in practice and formally when writing up clinical reasoning for complex cases.

The underlying OT framework is the same: I am always focused on enabling someone to do the occupations that give their life meaning. But the practical emphasis shifts considerably. In physical rehabilitation the work is often more concrete: helping someone regain a functional skill, prescribing equipment, carrying out a home assessment. In mental health OT, the barriers are more often cognitive, emotional, or social, and the pace of change tends to be slower. Building a therapeutic relationship is more explicitly part of the clinical process: without trust, very little else is possible. I use approaches like occupational mapping to understand how someone's mental health has changed what they can do, and I work on habits and routines as well as specific tasks. Risk assessment is also more present throughout, particularly around self-harm and safeguarding, and I need to hold that alongside the therapeutic relationship rather than letting it dominate the work.