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Objective: To analyse in detail therapists' and patients' communication practices during physiotherapy goal-setting in stroke rehabilitation settings. To deduce explanations for observed practices. To contribute to understanding of the communication challenges entailed in goal-setting.

Design: A conversation analytic study of video-recorded treatment sessions.

Setting: Physiotherapy ‘gyms’ in four UK hospitals.

Subjects: The 74 recorded sessions involved 21 patients (52-86 years, 11 female) and 10 senior physiotherapists. Patients' disabilities varied; none were severely aphasic. Nine of the therapists were female, post qualification experience ranged from 3 to 23 years.

Findings: Eight goal-setting episodes were identified. In all but one, therapists supplied the target problems or abilities for which goals were subsequently set. The case in which the patient was asked to propose problems prior to goal-setting is …