JMIR Publications

ABSTRACT

Background:

Telerehabilitation expanded rapidly during the COVID-19 pandemic and is increasingly used alongside, or as an alternative to, in-person rehabilitation. Goal setting is a core component of client-centred rehabilitation; however, how therapists conduct goal setting remotely remains poorly understood, particularly in East Asian contexts. To our knowledge, no qualitative study has specifically examined remote goal setting in telerehabilitation in Japan.

Objective:

This qualitative study explored how Japanese rehabilitation therapists experienced delivering goal setting via telerehabilitation. Nine therapists participated, comprising seven occupational therapists and two physical therapists, working across hospital, private-practice, and community-based settings. Understanding therapists’ experiences may provide evidence for refining remote goal-setting practices, developing telerehabilitation-specific clinical training, and informing service-delivery models in Japan.

Methods:

Individual semi-structured interviews were conducted via Zoom in Japanese. Participants were recruited from nine different workplaces across Japan, including metropolitan areas such as Tokyo and regional areas such as Hokkaido and Nagasaki. Data were analysed using reflexive thematic analysis within a contextualist epistemology, following Braun and Clarke. Trustworthiness was considered using Nowell and colleagues’ criteria, and reporting followed the Consolidated Criteria for Reporting Qualitative Research.

Results:

Four themes were constructed: (1) difficulties in assessment and goal setting because of reduced visibility and inability to touch; (2) a shift from direct intervention to coaching-oriented goal setting; (3) needs that became visible in clients’ own living environments; and (4) reframing goals to sustain continuity through ongoing monitoring. Therapists described remote goal setting as a practice shaped by both constraint and possibility. The loss of direct physical and contextual information was partly offset by increased visibility of clients’ everyday contexts, prompting therapists to reorient goal setting toward continuity, ongoing monitoring, and structured follow-up.

Conclusions:

Remote goal setting should not be understood simply as a diminished version of face-to-face practice, but as a distinct form of rehabilitation practice requiring specific clinical reasoning, communication strategies, and implementation supports. Its integration into Japanese rehabilitation services may require structured preparation, hybrid pathways that combine remote and in-person assessment, and telerehabilitation-specific clinician training. Further research should incorporate clients’ and families’ perspectives and evaluate hybrid models of goal setting across diverse rehabilitation populations.