Occupational therapists help patients improve their ability to perform tasks in living and working environments. They work with individuals who suffer from a mentally, physically, developmentally, or emotionally disabling condition. Occupational therapists use treatments to develop, recover, or maintain the daily living and work skills of their patients. The therapist helps clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. The goal is to help clients have independent, productive, and satisfying lives.
Occupational therapists help clients to perform all types of activities, from using a computer to caring for daily needs such as dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity or the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision-making, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing, and coordination—all of which are important for independent living.
Patients with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, often need special instruction to master certain daily tasks. For these individuals, therapists demonstrate the use of adaptive equipment, including wheelchairs, orthoses, eating aids, and dressing aids. They also design or build special equipment needed at home or at work, including computer-aided adaptive equipment. They teach clients how to use the equipment to improve communication and control various situations in their environment.
Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners might arrange employment, evaluate the work space, plan work activities, and assess the client's progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the client can succeed at work.
Assessing and recording a client's activities and progress is an important part of an occupational therapist's job. Accurate records are essential for evaluating clients, for billing, and for reporting to physicians and other healthcare providers.
Occupational therapists may work exclusively with individuals in a particular age group or with a particular disability. In schools, for example, they evaluate children's capabilities, recommend and provide therapy, modify classroom equipment, and help children participate in school activities. A therapist may work with children individually, lead small groups in the classroom, consult with a teacher, or serve on an administrative committee. Some therapists provide early intervention therapy to infants and toddlers who have, or are at risk of having, developmental delays. Therapies may include facilitating the use of the hands and promoting skills for listening, following directions, social play, dressing, or grooming.
Other occupational therapists work with elderly patients. These therapists help the elderly lead more productive, active, and independent lives through a variety of methods. Therapists with specialized training in driver rehabilitation assess an individual's ability to drive using both clinical and on-the-road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence, and alternative transportation options. Occupational therapists also work with clients to assess their homes for hazards and to identify environmental factors that contribute to falls.
Occupational therapists in mental health settings treat individuals who are mentally ill, developmentally challenged, or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to engage in and cope with daily life. Activities might include time management skills, budgeting, shopping, homemaking, and the use of public transportation. Occupational therapists also work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders, or stress-related disorders.
Work Environment
Occupational therapists held about 131,600 jobs in 2020. The largest employers of occupational therapists were as follows:
- Hospitals; state, local, and private - 29%
- Offices of physical, occupational and speech therapists, and audiologists - 25%
- Elementary and secondary schools; state, local, and private - 12%
- Nursing care facilities (skilled nursing facilities) - 8%
- Home healthcare services - 8%
Therapists may spend a lot of time on their feet while working with patients. They also may be required to lift and move patients or heavy equipment. Many work in multiple facilities and have to travel from one job to another.
Work Schedules
Most occupational therapists work full time. They may work nights or weekends, as needed, to accommodate patients’ schedules.
Education & Training Required
A master's degree or higher in occupational therapy is the typical minimum requirement for entry into the field. In addition, occupational therapists must attend an academic program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) in order to sit for the national certifying exam. In 2009, 150 master's degree programs or combined bachelor's and master's degree programs were accredited, and 4 doctoral degree programs were accredited. Most schools have full-time programs, although a growing number are offering weekend or part-time programs as well. Coursework in occupational therapy programs include the physical, biological, and behavioral sciences as well as the application of occupational therapy theory and skills. All accredited programs require at least 24 weeks of supervised fieldwork as part of the academic curriculum.
People considering this profession should take high school courses in biology, chemistry, physics, health, art, and the social sciences. College admissions offices also look favorably on paid or volunteer experience in the healthcare field. Relevant undergraduate majors include biology, psychology, sociology, anthropology, liberal arts, and anatomy.
Certifications Needed
All States regulate the practice of occupational therapy. To obtain a license, applicants must graduate from an accredited educational program and pass a national certification examination. Those who pass the exam are awarded the title “Occupational Therapist Registered (OTR).” Specific eligibility requirements for licensure vary by State; contact your State’s licensing board for details.
Some States have additional requirements for therapists who work in schools or early intervention programs. These requirements may include education-related classes, an education practice certificate, or early intervention certification.
Other Skills Required
Certification is voluntary. The National Board for Certifying Occupational Therapy certifies occupational therapists through a national certifying exam. Those who pass the test are awarded the title Occupational Therapist Registered (OTR). In some States, the national certifying exam meets requirements for regulation while other States have their own licensing exam.
Occupational therapists are expected to continue their professional development by participating in continuing education courses and workshops. In fact, a number of States require continuing education as a condition of maintaining licensure.
Occupational therapists need patience and strong interpersonal skills to inspire trust and respect in their clients. Patience is necessary because many clients may not show immediate improvement. Ingenuity and imagination in adapting activities to individual needs are assets. Those working in home healthcare services also must be able to adapt to a variety of settings.
How to Advance
Therapists are increasingly taking on supervisory roles in addition to their supervision of occupational therapy assistants and aides. Occupational therapists may advance their careers by taking on administrative duties at hospitals or rehabilitation centers.
Occupational therapists also can advance by specializing in a clinical area and gaining expertise in treating a certain type of patient or ailment. Therapists may specialize in gerontology, mental health, pediatrics, and physical rehabilitation. In addition, some occupational therapists choose to teach classes in accredited occupational therapy educational programs.
Job Outlook
Employment of occupational therapists is projected to grow 17 percent from 2020 to 2030, much faster than the average for all occupations.
About 10,100 openings for occupational therapists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
Occupational therapy will continue to be an important part of treatment for people with various illnesses and disabilities, such as Alzheimer’s disease, cerebral palsy, autism, or the loss of a limb. However, demand for occupational therapy services is related to the ability of patients to pay, either directly or through health insurance.
The need for occupational therapists is expected to increase as the large baby-boom generation ages and people remain active later in life. Occupational therapists can help senior citizens maintain their independence by recommending home modifications and strategies that make daily activities easier. Therapists also play a role in the treatment of many conditions and ailments commonly associated with aging, such as arthritis and stroke.
Occupational therapists also will be needed in a variety of healthcare settings to treat patients with chronic conditions, such as diabetes. Patients will continue to seek noninvasive outpatient treatment for long-term disabilities and illnesses, either in their homes or in residential care environments. These patients may need occupational therapy to become more independent and to perform a variety of daily tasks.
Demand for occupational therapy services also will stem from patients with autism spectrum disorder. Therapists will continue to be needed in schools to assist children with autism in improving their social skills and accomplishing a variety of daily tasks.
Earnings
The median annual wage for occupational therapists was $85,570 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $60,680, and the highest 10 percent earned more than $123,840.
In May 2021, the median annual wages for occupational therapists in the top industries in which they worked were as follows:
- Home healthcare services - $98,700
- Nursing care facilities (skilled nursing facilities) - $98,390
- Hospitals; state, local, and private - $95,590
- Offices of physical, occupational and speech therapists, and audiologists - $80,450
- Elementary and secondary schools; state, local, and private - $77,290
Most occupational therapists work full time. They may work nights or weekends, as needed, to accommodate patients’ schedules.
