Occupational Therapy Students’ Confidence in Building Rapport with Clients During Level II Fieldwork

Abstract

Background: Occupational therapists regard rapport as a critical element to provide quality client-centered care using an intentional and personal therapist-client relationship. This study aimed to describe OT students’ confidence in client rapport-building skills during level II fieldwork. Knowledge of improvement areas with key components to building rapport would inform OT education.

Methods: A quantitative, descriptive survey was administered to OT students across the South-eastern United States from winter 2024 to spring 2025.

Findings: Results indicate that a variety of factors, including undergraduate background, graduate degree level, and fieldwork experience, influence OT students’ confidence in various areas of rapport building with clients. Of 36 respondents, it was found that, on average, students entering their second level II rotation were 4% more confident in various aspects of client rapport building than students entering their first level II rotation, demonstrating an increase in confidence with continued experience. This 4% difference occurred over a three-month period, on average, indicating early career continued growth in rapport confidence would be substantial. Additionally, rapport building components of empathizing with clients, being on time and prepared, and maintaining professional boundaries with clients were rated highest confidence by respondents.

Conclusion: Gaining confidence as an occupational therapy student is important sequentially from didactic learning to experiential learning. Mastering confidence with rapport building, however, is an ongoing learning process throughout an OT career. Continued research on rapport building is needed and foundational to effective, client-centered occupational therapy practice.