Objectives. Recent clinical reasoning literature has identified a collaborative model of treatment – one that responds to clients’ perceptions of their illness and disability experiences – as central to occupational therapy practice. Assessing clients’ priorities on admission is essential to that model.

Method. Surveys from of a convenience sample of 269 occupational therapy directors in adult physical rehabilitation facilities throughout the United States (70.2% response rate) were analyzed to see whether occupational therapists in those settings are assessing clients’ priorities on admission, and if so, how.

Results. The majority of occupational therapists are using informal interview to determine clients’ priorities on admission. Client goals obtained from these interviews are vague and do not specify meaningful occupations; this finding suggests that therapists are setting treatment goals without specific input from clients about their valued activities.

Conclusion. Occupational therapists have not yet successfully translated their values about client–therapist collaboration into a formal set of procedures for practice.

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