Strategies occupational therapists use to engage children and parents in therapy sessions.

Unlabelled: Occupational therapists implicitly rely on tacit knowledge to inform the strategies they use to engage children and parents in a therapy session.

Objective: To identify strategies occupational therapists use in a therapy session to engage children and parents.

Methods: A qualitative approach was employed using interpretive description methodology. This involved seven therapy session observations with six occupational therapists (involving child, parent and therapist) and a key informant interview with the therapist after each session. Thematic analysis was undertaken.

Results: Two themes emerged. (a) 'Engaging the child' included 'building a connection', 'attending to feelings', 'thoughts and behaviours', 'structuring or designing the session', 'giving choice and respecting their choice', 'use of self', 'helping the child feel success' and 'helping the child understand and explore'. (b) 'Engaging the parent' included 'connecting', 'listening', 'explaining', 'demonstrating anddiscussing', 'including the parent and valuing their input' and 'collaborating'.

Conclusions: The strategies therapists used to engage children and families can be mapped with autonomy, relatedness- and competence-supportive strategies of Self-Determination Theory. Therapist attunement and responsiveness to the child as well as collaboration with the parent were strategies that represented all aspects of SDT.