Setting Intentional OT Goals for the New Year: A Reflective Practice Approach

Written By Abi Smith

Why OT Goal-Setting Often Fails — And What Actually Works

After supervising OTs for more than 30 years, I’ve noticed a predictable pattern:

Most therapists set goals based on pressure, comparison, or unrealistic expectations — not genuine professional needs.

New graduates often think they need to “know everything.”
Mid-career clinicians worry about falling behind.
Experienced clinicians feel responsible for outcomes outside their control.

But effective professional growth does not begin with:

  • a new course

  • a new framework

  • a new technique

It begins with reflection.

This is supported by the work of:

  • Donald Schön (Reflective Practice)

  • Sameroff (Transactional Theory)

  • Bronfenbrenner (systems influence on practice)

  • Porges (regulation affects reasoning)

  • Perry and Siegel (experience-dependent learning)

When reflection comes first, goals become meaningful, achievable, and sustainable.

The Three Foundations of Intentional Goal Setting

1. Identity Before Skill

Skill development is easy when your clinical identity is secure.
Identity work is the foundation.

Reflect on:

  • What values guide my work?

  • What emotional patterns show up in my sessions?

  • What kind of therapist do I want to be known as?

  • What is my natural clinical lens? Sensory? Relational? Developmental? Coaching-based?

The OTPF-4 highlights professional identity as a core factor shaping ethical practice.

When identity is clear:

  • your decisions become easier

  • your boundaries strengthen

  • your interventions align with your values

Identity → clarity → confidence.

2. Depth Before Breadth

New graduates often ask:
“How do I learn everything?”

You don’t.

Experienced clinicians know that mastery comes from depth, not volume.

Choose one focus area for 2025–2026, such as:

  • sensory-emotional pattern interpretation

  • parent coaching and communication

  • therapeutic use of self

  • developmental trauma-informed practice

  • DIR/Floortime foundations

  • interoception awareness

  • case formulation and clinical reasoning

  • visual supports and environmental adaptations

One well-developed skill has more impact than ten half-understood strategies.

This reflects the neuroscience of experience-dependent learning
(Perry, Siegel, Schore) — the brain changes through repetition and depth.

3. Reflection Before Action

Goals without self-reflection become abandoned by February.

Reflection helps you identify:

  • your patterns

  • your triggers

  • your growth edges

  • your strengths

  • your current developmental stage

Use questions like:

  • What moments challenged me most this year? Why?

  • What made me feel unsure or emotionally activated?

  • Where did I rely on outside reassurance?

  • What situations brought out my best therapeutic self?

  • What themes keep appearing in my caseload?

This is how you move from reactive practice to intentional, strategic practice.

A Simple, Evidence-Informed 3-Step OT Goal Method

Step 1: Notice the Patterns

Review:

  • session notes

  • family conversations

  • supervision discussions

  • your regulation state during sessions

From a sensory-emotional lens (Ayres + Polyvagal Theory):

  • When do you feel regulated?

  • When do you become overwhelmed?

  • Which presentations bring out your clinical strengths?

Patterns reveal what truly needs development.

Step 2: Choose One Primary Focus for the Year

Examples of deeply meaningful OT goals:

  • strengthen co-regulation coaching with parents

  • refine your sensory-emotional case formulation

  • improve confidence when working with distressed families

  • develop your therapeutic presence

  • deepen your understanding of interoception

  • gain fluency in using visuals and environmental supports

  • practise advanced observation (micro-cues, relational patterns)

Focus creates transformation.
Scattered goals do not.

Step 3: Build Micro-Habits, Not Overwhelming Plans

Micro-habits create long-term change.

Try:

  • five minutes of reflection per day

  • one journal article per month

  • one parent communication script to practise each week

  • one case brought to supervision each fortnight

  • one new environmental adaptation trialled each week

Micro-habits align with the neuroscience of incremental learning (Schore, Perry).

External Links

Reflective Practice (Donald Schön)
 https://infed.org/mobi/donald-schon-learning-reflection-change/

Polyvagal Theory Overview (Stephen Porges)
 https://www.stephenporges.com/polyvagal-theory

DIR/Floortime Model
 https://www.icdl.com/dir

Sensory Integration Theory (Ayres)
 https://www.spdstar.org/basic/understanding-sensory-integration

Harvard Center on the Developing Child: Co-regulation
 https://developingchild.harvard.edu/resources/what-is-co-regulation/

Interoception Overview (Kelly Mahler)
 https://www.kelly-mahler.com/what-is-interoception/

OT Practice Framework (OTPF-4)
 https://ajot.aota.org/article.aspx?articleid=2763042

References

Ayres, A. J. (1972). Sensory Integration and Learning Disorders.
Bronfenbrenner, U. (1979). The Ecology of Human Development.
Dunn, W. (1997). The Sensory Profile.
Greenspan, S., & Wieder, S. (2006). Engaging Autism.
Mahler, K. Interoception Resources. (??)
Perry, B. & Winfrey, O. (2021). What Happened To You?
Porges, S. W. (2011). The Polyvagal Theory.
Sameroff, A. (2009). The Transactional Model of Development.
Schön, D. A. (1983). The Reflective Practitioner.
Schore, A. N. (2003). Affect Dysregulation and Disorders of the Self.

Abi Smith https://www.togglestudio.com.au
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