Discuss barriers and facilitators to effective communication with a client as an occupational therapist. Communication is considered a two-way process, involving at least two people sharing information (Higgs, Sefton, Street, McAlister, & Hay, 2005). It can occur through speech or vocalization (e.g. crying), nonverbal cues such as facial expressions, gestures, eye contact, and through written forms or other material forms such as images (O'Toole, 2012). Communication is considered effective when the intended meaning of the conveyed message is received and understood by both parties and a point of common understanding is reached (O'Toole, 2012). The goal of effective communication between an occupational therapist (OT) and a client is to ultimately provide an intervention that creates positive participation in occupations which in turn leads to improved health and well-being of the client. This goal can best be achieved through the application of client-centered practice, which is accomplished through the development of both mutual understanding and a therapeutic relationship (O'Toole, 2012). Mutual understanding is defined as common understanding of communicative meaning and is a critical component in achieving client-centered practice (O'Toole, 2012). Effective communication between an OT and a client leads to the establishment of empathy, respect and trust which form the basis for mutual understanding (O'Brien & Hussey, 2013). Respect refers to showing respect for what a client is expressing while empathy is the “direct, clear, and accurate recognition of the individual's emotions” (O'Toole, 2012, p.14). If communication is effective in developing empathy and respect, then customer participation in all aspects… at the center of the paper… and if possible, barriers such as tables should be avoided (Cole, 2005). In group intervention the positioning of the chairs is very important to facilitate communication. A circular shape should be formed to allow all parties to communicate; this is to avoid OT being the center of all communication (Cole, 2005). Effective communication is important in all aspects of life but particularly in facilitating an effective intervention between an OT and a client. As with OT, effective communication plays a vital role in building a client-centered practice, which is one of the main goals of OT intervention. If verbal and nonverbal communication cues are misused or misinterpreted, this relationship can be damaged. It is therefore very important to be aware of the barriers that can hinder and implement strategies that promote effective communication.