No matter the career paths we choose, we are all ultimately salesmen selling our wares. Even to get hired we play the role of salesmen, selling ourselves to prospective employers.

As therapists, we don't have products, but we do have to sell our services. The first rule of selling is to figure out what drives your clients. No two clients are the same. One client may be delighted to resume playing cards once a week with her bridge club. Another client may be determined to return to an eighty-hour work week in the African rainforest. These two clients will not be inspired by the same incentives.

Some clients come self-motivated; they are known as an "easy sell." These are the clients who make occupational therapy a dream job. They come to the first therapy session knowing what they want to accomplish and work diligently to achieve their goals.

While therapists need to set short-term goals for the plan of care, these clients' personal long-term goals will likely keep them motivated. Passion is to be admired, but overzealous participants can end up with protracted courses of rehabilitation when unfettered eagerness gives way to ill-advised overexertion. Make sure the "easy sell" clients balance their enthusiasm with wisdom.

Then there are clients who find our clinic with the forceful help of loved ones, by happenstance, or even by mistake. These are our challenging clients, the ones who are a "hard sell." These clients may not know why they are in therapy-either because they don't have an understanding of what occupational therapy has to offer, or because they lack direction for their lives in general.

These clients will likely flounder at first. Be so bold as to ask them, "Why are you here? What do you want out of your treatment?" Listen to them. Study them. Educate them. If we help clients uncover their motivation, and then structure their therapy to meet their personal goals, treatment sessions will transform from challenging to rewarding for both client and therapist. These clients are not likely to be motivated by the big-picture, long-range plan. Keep them focused on accomplishing short-term, functional goals. Each new success will spur them to strive for the next level of victory.

Finally, there are clients who just shouldn't be clients. Therapy isn't for everyone. Some clients are a "no sale." The sooner we reconcile that fact, the happier our clinical days will be.

Determining early on that therapy isn't a fit for a particular client is a win-win situation. The discharged client avoids frustration while saving money and time. The therapist is spared needless documentation time and the frustration that accompanies non-compliant clients. A therapy slot is made available for clients who will actually benefit from therapy services.

Once the client's motivation is established, therapy can be presented from that angle. Consider whether clients are motivated by the broad, end-game perspective or a short-term, compartmentalized view. Then, tailor treatment programs to address clients' personal goals. Therapy that is directed by clients' motivation lessens therapist frustration and improves client success rate.

Jane Goude is a freelance writer in Lexington, SC, with 12 years of rehab and management experience. Column consultant Mitzie Derrick, OTR/L, is manager of occupational therapy and speech-language pathology at Spartanburg Regional Medical Center in Spartanburg, SC. You can reach them at otedit@advanceweb.com.