Occupational Therapists - What They Do

Occupational therapists develop individual and group programs with people affected by illness, injury, developmental disorders, emotional or psychological problems and aging to maintain, restore or increase their ability to care for themselves and to engage in work, school or leisure. They also develop and implement health promotion programs with individuals, community groups and employers. They are employed in health care facilities, in schools, and by private and social services agencies, or they may be self-employed.

Job duties

This group performs some or all of the following duties:

Analyse clients' capabilities and expectations related to life activities through observation, interviews and formal assessments
Develop intervention programs to address clients' needs related to self-care, work and leisure activities
Maintain clients' records
Establish personalized care plans working as a member of an interdisciplinary team
Consult and advise on health promotion programs to prevent disabilities and to maximize independent function in all activities of life
May supervise support personnel and students and provide training.
Occupational therapists may specialize in working with specific populations such as children or adults, or persons with distinct problems such as dementia, traumatic brain injury and chronic pain, or provide special interventions such as return-to-work programs.

Job titles

occupational therapy rehabilitation consultant
clinical occupational therapist
community occupational therapist
occupational therapist (OT)
occupational therapist, case manager
occupational therapist, research and development

Employment Requirements

This is what you typically need for the job:

A university degree in occupational therapy including supervised fieldwork is required or Graduation from an occupational therapy program approved by the World Federation of Occupational Therapists (WFOT) is accepted in some provinces.
Completion of the national certification examination may be required.
Licensure with a regulatory body is required in all provinces.
Membership in the national association, Canadian Association of Occupational Therapists, is required in some provinces.
Occupational therapists may obtain expertise in a particular area through additional training or experience.

Essential Skills

Reading

Read labels on specialized equipment and garments to check size and instructions. (1)
Read brief e-mail from co-workers and colleagues about a variety of topics. (1)
Read newsletters produced by their employers to keep abreast of upcoming events and organizational changes. (2)
Read letters that provide or request information about clients. For example, they read letters from employers which provide information about clients' job tasks and Workers' Compensation Boards that inquire about clients' assessments and treatments. (2)
Read medical supply magazines and buyers' guides to learn about new equipment and supplies. (2)
Read lengthy test and assessment instrument administration manuals. They read about the methodologies used to develop the tests, the tests' psychometric properties, how to administer and score the tests and how to interpret the results. (3)
Read articles in trade publications to stay up-to-date on topics of interest. For example, they read articles on obstacles encountered when using aids to daily living. (3)
Read manuals and textbooks to learn about infrequently needed treatments. For example, they read procedures for splinting an elbow and splinting an entire arm to protect burned body areas. (3)
Read research articles in professional journals to keep abreast of new developments in products, theory and practice. For example, they may read articles on the role of the parasympathetic nervous system in children with disturbances in sensory processing. They may read articles to learn about evidence-based practices such as care alternatives for bariatric clients. They are required to understand and critically evaluate the scientific subject matter in these articles so that they can develop proposals, programs and program evaluation plans and support their practice through the adaptation of researched interventions. (4)
Read and interpret provincial and federal legislation relating to the field of occupational therapy and assess its application to their practice. (4)

Document use

Locate data on labels, such as the frequency of use of clients' medication, as part of the assessment of daily routines in home care visits. (1)
Complete administrative forms such as travel claim, sick leave and workload measurement. (2)
May examine assembly drawings to make minor adjustments to therapy equipment, aids to daily living and office equipment. (2)
Locate data in tables. For example, they review specifications of equipment to select appropriate matches for client needs. (2)
Enter data into tables. For example, they enter test results, activities and progress of clients and client groups into tables. (2)
Examine the accuracy of clients' drawings of geometric shapes when they administer and score tests of visual-motor abilities. (3)
Complete forms requiring the entry of detailed information about parts of the human body. For example, they may note particular damage to clients' joints on drawings or they may enter forty precise measurements for clients' hands when completing order forms for specialized gloves. (3)
Examine tabular data in journal articles and reports. For example, they scan tables of statistical data such as psychometric properties for new tests. They look at reliability and validity coefficients to be aware of the accuracy of assessment instruments. They may also review tables with information on the technical adequacy of a wide variety of assessment instruments used to measure outcomes in the treatment of strokes. For each of several criteria, they review ratings represented by symbols for the varying degrees of technical adequacy of each instrument. Using this information to determine the overall adequacy of each instrument requires knowledge of the assessment criteria and the compensatory relationships that can exist among them. (3)
Interpret scale drawings and sometimes extract measurements. For example, they may review scale drawings of proposed modifications to living spaces to assess their adequacy for adaptive equipment. (3)
Consult images such as radiographs, magnetic resonance imaging tests and videofluoroscopy tests to obtain information on clients' conditions. For example, they may examine videofluoroscopy results to identify problems with the passage of certain foods from the mouth to the esophagus for clients with swallowing difficulties. (3)

Writing

Write short e-mail to arrange meetings, inform other team members about clients' status and to request assessments and treatments for their clients. (1)
Write on a white board to communicate with clients who are hearing impaired or have communication barriers. (1)
Write short summaries following appointments with clients. They record details of assessments or treatments provided, improvements or new problems noted and any other observations that seem pertinent. They may organize their comments using reporting forms or word processing templates. (2)
Write letters to community stakeholders and suppliers. For example, they may write letters to Workers' Compensation Boards to provide information about clients' treatment or equipment needs. They may write to suppliers to enquire about the availability and specifications for equipment or adaptive clothing to meet clients' needs. (2)
Write descriptions of clients' conditions and needs on standard forms. For example, they write general descriptions of clients' medical histories, assessment results, problems and goals on initial assessment forms. When requesting funding for modifications to clients' homes, they provide detailed descriptions of clients' functional difficulties and the building modifications required to address them. (3)
Write detailed client assessment reports at various stages of clients' cases. For example, they may write reports about initial assessments, annual reports during treatment and final reports after treatments. They also write about their developmental histories, assessment results, recommendations, treatments undertaken or planned and changes observed. The reports are meant for other professionals and non-professionals involved with the clients, such as family members and support staff. (4)
May write research proposals for review and approval by various committees and funding bodies. For example, they may propose research to evaluate self-care instruments or treatment programs. They provide sufficient detail to enable these committees to determine the acceptability of the proposed research. (4)
May write best-practices reports and guidelines for province-wide use by occupational therapists, selecting and synthesizing varied information from specialized catalogues, databases and websites. (4)

Numeracy

Money Math

Verify that clients have received the correct change in cash transactions when assessing banking skills. (1)
Calculate goods and services taxes when writing cheques for work-related books, courses or workshops. (2)

Scheduling, Budgeting & Accounting Math

Create a variety of activity and treatment schedules. For example, they may schedule several months of daily therapy activities for clients. They ensure that the schedules alternate daily exercises as needed and increase the intensity of exercises slowly over time. (1)
Prepare budgets for research proposals. They forecast costs such as stipends for participants and printing of test materials. (2)

Measurement and Calculation Math

Measure body dimensions and distances needed to turn wheelchairs using tapes and rulers. (1)
Add sub-test scores to calculate total scores. (1)
Use job-specific measuring tools and techniques. For example, they use goniometers to measure joint rotation and range of bodily movement in degrees. (3)

Data Analysis Math

Use job-specific measuring tools and techniques. For example, they use goniometers to measure joint rotation and range of bodily movement in degrees. (3)
Compare measures of client functioning. For example, they compare test results to normative data to determine current levels of functioning. They also compare current and previous levels of functioning to determine progress. (2)
Calculate averages, such as clients' average number of pressure sores before and after treatments, and the average time it takes them to walk fixed distances before and after treatments. (2)
Collect and analyze data for a wide variety of client and client environment assessments. For example, they may use the Enabler instrument, a strict methodology combining interviews and observation to assess functional limitations and the presence of physical environmental barriers for client groups and calculate a housing accessibility score. (3)
Calculate statistics such as the coefficients of variation to determine clients' constancy of effort across repetitions of exercises by calculating the average times that clients can hold up fixed weights and the standard deviations of these times. (4)

Numerical Estimation

Make time and space estimates. For example, they estimate the time it will take for clients to perform tasks to enable scheduling of treatments. They estimate clients' treatment and recovery times. They may estimate the space needed for wheelchairs, mechanical lifts and workers in homecare settings. (1)

Oral communication

Exchange information about clients with co-workers, colleagues, employers and family members. For example, they advise other multi-disciplinary team members about clients' progress, request copies of clients' job descriptions from employers and talk to family members about on-going therapy. At all times, they must ensure that patients' privacy rights are respected. (1)
Speak with supervisors to request permission to attend professional development activities. (2)
Exchange with clients about their conditions and treatment plans. They conduct interviews with clients to obtain data for measurement methodologies. They establish relationships with clients to engage them in their progress. For example, they may coach stroke victims to help them regain their confidence to drive. They may need to overcome clients' reluctance to undertake treatment and adapt to the communication difficulties of hearing-impaired or brain-injured clients. (2)
Facilitate client activities, workshops and present information to small groups of clients and co-workers. For example, they may facilitate discussions among seniors about activity plans and accompany them on outings. They may lead workshops to help clients master relaxation techniques. They may present the results of studies or surveys to co-workers. (2)
Present information on clients' conditions, treatments and progress at case conferences and problem solving meetings with other multi-disciplinary team members. They consider suggestions offered by other team members and may collaboratively develop client treatments. Clear communication is important to ensure all team members know what is expected of them and keep treatment plans on track. (3)
Speak with clients or their representatives such as parents or adult children about treatments and prognoses. They provide information on the implications of conditions, including limitations. They may also negotiate solutions to resolve conflicts about treatments. They use plain language and concrete examples to convey the purpose, techniques and effectiveness of proposed treatments. They must communicate well to obtain agreement or adherence to recommended treatment plans. (3)
Facilitate and contribute to discussions among large groups of stakeholders to develop collaborative solutions for client groups. For example, they facilitate meetings with mental-health professionals, community group representatives and municipal officials to develop employment opportunities for client groups with mental health illnesses. (3)
Exchange detailed treatment information with other specialists such as doctors, nurses and physiotherapists. For example, they may ask plastic surgeons about splinting requests in clients' files and discuss the degrees of flexion and extension needed to optimize surgery outcomes. They may need to defend and justify their use of treatments to other professionals, citing research literature or their own experience, or negotiate to reach consensus on treatments. (3)
May make formal presentations. For example, they may present research findings or new approaches to treatment to groups of colleagues at work or audiences at conferences. They may make presentations to decisional bodies such as municipal councils and school boards to advocate better accessibility to resources for client groups. (3)

Thinking

Problem Solving

Encounter clients who are antagonistic or refuse treatment. They seek information about clients' motivations, attempt alternative treatments and consult with other therapy team members. (2)
Are unable to use standard approaches to enable the performance of daily living tasks when clients have special needs. For example, occupational therapists may habituate elderly arthritic clients to the safe use of footstools to access household appliances and cupboards. (2)
Cannot use standard technical aids with clients who have special needs. For example, they adapt generic foot splints for patients who are missing toes, adapt backboards when bathtub benches prove to be ineffective or obtain button-less dresses for female clients who cannot dress themselves. (3)
Cannot continue with ongoing treatment plans when clients exhibit signs of new difficulties or do not progress as originally forecasted. They gather data on the new symptoms and brainstorm new treatment approaches with other therapy team members. (3)
Encounter colleagues and co-workers who are reluctant to contribute to developing or adopting best practices for shared populations of clients. They promote understanding of best practices, identify areas of mutual interest and discuss the benefits to clients of adopting a common definition of best practices. (4)

Decision Making

Decide which psychometric tests or assessments of activities of daily living they will use with clients to support their formulation of treatment plans. They require considerable judgment to determine the extent to which instruments can provide valid and reliable information. They also consider the practical aspects of assessment such as time, effort and amount of training required to administer the instruments. Instruments that yield inaccurate results can lead to the formulation of treatments that are ill-suited to clients' conditions. (3)
Decide on the nature, frequency and venue of treatment programs. They select treatments based on assessment results, treatment priority guidelines, evidence of efficacy and experience with varied clients. Decisions about frequency and venue require balancing many factors such as clients' comfort, economic resources and schedules. (3)
Decide when to stop delivering particular types of treatment. They consider clients' progress to date, their probable future progress, the need for other forms of intervention and their comparative benefits. Their decisions can be revised, but too many changes can upset clients and slow their progress. (3)
May decide to recommend that clients are ready to return to work. They consider multiple sources of information including the physical and cognitive demands of clients' their jobs, assessed functional capacities, and ergonomic analyses of physical environments. Delaying return to work can result in legal proceedings with insurance companies, while premature return can result in setbacks. (3)

Critical Thinking

Evaluate the urgency of clients' cases when planning their daily treatment schedules. They use and adapt general protocols on treatment priorities and consider clients' conditions and treatment needs. (2)
Evaluate the utility and functionality of assistive devices and treatment aids they recommend to clients. They consider clients' safety, the nature and severity of impairments, the probability of improvements in their functioning, the cost of the aids and the ease of obtaining them. Client preferences for colour, style or place of manufacture may also be criteria. Ensuring they have the most effective aids and assistive devices is a key part of the therapy. (2)
Evaluate the relative effectiveness of different therapeutic treatments and the adequacy of available information. They consider professional theory, current best-practice guidelines, clients' conditions and their immediate and longer-range goals. They question other occupational therapists about their experiences with different treatments. Lack of information and practical experience may hinder the evaluation of some types of therapies. (3)
May evaluate the accessibility and safety of clients' homes. While their safety is the primary concern, they also consider the extent of modifications needed, associated costs, clients' ability to pay for modifications and the probability of clients' obtaining financial support for the modifications. For those wishing to remain in their homes indefinitely, they consider current and future levels of functioning and support networks. (3)
May evaluate clients' rehabilitation potential. For example, occupational therapists assess clients' current levels of physical and cognitive functioning, identify and assess barriers to progress, and establish prognoses based on the interaction between clients' capabilities and the number and types of barriers they face. They may provide their assessments to insurance companies and Workers' Compensation Boards when clients' continuing employment is in question. (3)
Evaluate clients' progress in treatment programs. They use information from formal assessments, observation of their behaviours, treatment guidelines and personal experience to judge if treatment goals are being met. They may need to explain and justify their evaluations and therapeutic values when other professionals disagree. (3)
Evaluate clients' ability to work and live independently. They consider how well clients carry out a variety of tasks and assess supports available in their homes or workplaces. They gather and analyze information from observations, formal assessments and consultations with other professionals, clients' family and staff. The occupational therapists' opinions are significant factors in treatment and discharge planning. (3)

Job Task Planning and Organizing

Own Job Planning and Organizing

Occupational therapists organize their own schedules of appointments and administrative tasks under the general direction of their program or unit managers. They coordinate their treatment schedules with other members of medical or therapeutic teams in hospitals and clinics. Their daily routine is occasionally broken for emergencies or requests for assistance by other team members. (2)

Planning and Organizing for Others

Occupational therapists may advise management about treatment programs, facility designs, equipment purchases and the appropriateness of policies or procedures. They demonstrate, assign and monitor task performance by aides, coordinating with other team members to ensure the best use is made of the aides' time. (2)

Significant Use of Memory

Recall details of clients' behaviours during assessment so that they can document them after sessions.
May remember the codes used to record time spent on different types of activities.
Recall clients' names and the names of others involved in their treatment such as parents, teachers and caregivers.
Recall clients' characteristics and behaviours from one meeting to the next. For example, they may remember characteristics such as handedness, hypersensitivity to noise or tendencies to perform certain tasks atypically.

Finding Information

Find information about client conditions, environments, abilities and reactions to therapy from clients, co-workers, colleagues and clients' families, friends, employers, service providers and doctors. They run assessment tests and collect and analyze data using established methodologies. They use the information they gather to determine treatment approaches to propose and adopt. (3)
Find information about new treatments, evidence-based practices and rare medical conditions by questioning colleagues and co-workers, reading textbooks and journal articles and searching the Internet. They use the information they collect to better understand the implications of clients' conditions and to decide which treatment approaches they will adopt. (3)
May work on major research projects that affect professional practices. They use library catalogues, databases and websites to conduct comprehensive literature reviews. They search through hundreds of sources, including websites, textbooks, abstracts and journal articles to identify and review in detail hundreds of articles on particular topics. They synthesize the information in reports and guidelines for province-wide use by other occupational therapists. (4)

Digital technology

Use word processing. For example, they create, edit and format documents such as letters, client reports and informational handouts. They use common formatting features and generate tables to organize information such as schedules or budgets. (2)
Use databases. For example, they access information such as their previous and most recent test results in clients' files. (2)
Use spreadsheets. For example, they enter and update scheduling information and create formulas for entering and updating budget information. (2)
May use computer-assisted design, manufacturing and machining. For example, they may do simple programming of assistive technologies for clients. (2)
Use the internet. For example, they obtain information on medical conditions, treatment practices and assistive devices by using search engines, navigating to varied sites and bookmarking sites that are most useful. (2)
May use other computer and software applications. For example, they may play videogames with children as part of treatment plans. They may use distance education software such as LiveClassroom to enable consultation with colleagues regarding client treatment. (2)
May use graphics software. For example, they use presentation software such as PowerPoint to prepare slide shows. They create tables, import pictures and use formatting features such as slide styles and design templates. (3)
Use communications software. For example, they exchange e-mail with co-workers, colleagues, clients, employers, care givers, suppliers and others. They spell check messages, include hyperlinks, attach documents, create address books, assemble distribution lists and assign message priorities. Because they interact with a wide circle of professionals and community members, most occupational therapists regard e-mail as a critical communication channel. (3)

Other Essential Skills:

Working with Others

Occupational therapists assess and treat clients individually in many cases. They seek the assistance of others to assess clients' daily functioning or to transfer clients from beds to wheelchairs. Other occupational therapists work collaboratively with multi-disciplinary teams to coordinate treatments, programs and program evaluations. (3)

Continuous Learning

Occupational therapists set their own learning goals and, in consultation with supervisors and professional requirements, they determine how they will reach these goals. They learn continuously on the job because all clients are unique and assessment and treatment approaches continue to evolve. They also learn by sharing information with co-workers and colleagues, by conducting on-line database searches and reading professional publications. They attend workplace information sessions, training offered by their employers and professional conferences. They adapt what they have learned when they encounter clients with unique needs. (3)