Occupational Therapist Career

Occupational therapists (OTs) select and direct thera­peutic activities designed to develop or restore maxi­mum function to individuals with disabilities. There are approximately 92,000 occupational therapists employed in the United States.

Occupational Therapist Career History

Since about the 14th century, physicians have recog­nized the therapeutic value of providing activities and occupations for their patients. Observations that mental patients tended to recover more quickly from their illnesses if provided with tasks and duties led physicians to involve their patients in such activities as agriculture, weaving, working with animals, and sewing. Over time, this practice became quite common, and the conditions of many patients were improved.

Occupational Therapist CareerOccupational therapy as we know it today had its beginning after World War I. The need to help disabled veterans of that war, and years later the veterans of World War II, stimulated the growth of this field. Even though its inception was in the psychiatric field, occupational therapy has developed an equally important role in other medical fields, including rehabilitation of physically dis­abled patients.

Traditionally, occupational therapists taught creative arts such as weaving, clay modeling, leatherwork, jewelry making, and other crafts to promote their patients’ func­tional skills. Today, occupational therapists focus more on providing activities that are designed to promote skills needed in daily living, including self-care; employment education and job skills, such as typing, the operation of computers and computer programs, or the use of power tools; and community and social skills.

It is important to note the difference between occupational therapists and physical thera­pists. Physical therapy is chiefly concerned with helping people with physical disabilities or inju­ries to regain functions, or adapt to or overcome their physical limitations. Occupational thera­pists work with physical factors but also the psychological and social elements of their clients’ disabilities, helping them become as independent as possible in the home, school, and workplace. Occupational therapists work not only with the physically challenged, but with people who have mental and emotional dis­abilities as well.

Occupational Therapist Job Description

Occupational therapists use a wide variety of activities to help clients attain their goals for productive, independent living. These goals include developing maximum self-sufficiency in activities of daily living, such as eating, dressing, writing, using a telephone and other communication resources, as well as functioning in the community and the workplace.

In developing a therapeutic program for a client, the occupational therapist often works as a member of a team that can include physicians, nurses, psychiatrists, physical therapists, speech therapists, rehabilitation counselors, social workers, and other specialists. OTs use creative, educational, and recreational activities, as well as human ingenuity, in helping people achieve their full potential, regardless of their disabilities. Each therapy program is designed specifically for the individual client.

Occupational therapists help clients explore their likes and dislikes, their abilities, and their creative, educational, and recreational experiences. Therapists help people choose activities that have the most appeal and value for them. For example, an activity may be designed to promote greater dexterity for someone with arthritic fingers. Learning to use an adapted computer might help a young person with a spinal cord injury to succeed in school and career goals. The therapist works with the clients’ interests and helps them develop practical skills and functional independence.

The occupational therapist may work with a wide range of clients. They may assist a client in learning to use an artificial limb. Another client may have suffered a stroke or other neurological disability, and the therapist works with the client to redevelop the client’s motor functions or re-educate his or her muscle function. Therapists may assist in the growth and development of premature infants, or they may work with disabled children, helping them learn motor skills or develop skills and tools that will aid them in their education and social interaction.

Some therapists also conduct research to develop new types of therapies and activities and to measure the effectiveness of a therapy program. They may also design and make special equipment or splints to help clients perform their activities.

Other duties may include supervision of volunteer workers, student therapists, and occupational therapy assistants who give instruction in a particular skill. Ther­apists must prepare reports to keep members of the professional team informed.

Chief occupational therapists in a hospital may teach medical and nursing students the principles of occupational therapy. Many occupational therapists have administrative duties such as directing different kinds of occupational therapy programs, coordinating patient activities, and acting as consultants or advisors to local and state health departments, mental health authorities, and the division of vocational rehabilitation.

Occupational Therapist Career Requirements

High School

Since you will need to get a college degree, taking college preparatory classes in high school is a must. Courses such as biology, chemistry, and health will expose you to the science fields. Other courses, such as art and social sciences, will help give you an understanding of other aspects of your future work. Also important is a strong background in English. Remember, occupational therapy is a career oriented toward helping people. To be able to work with many different people with different needs, you will need excellent communication skills. Also keep in mind that college admission officers will look favor­ably at any experience you have had working in the health care field, either in volunteer or paid positions.

Postsecondary Training

To become an occupational therapist, you will need to complete an accredited program in occupational therapy. Accreditation is granted by the Accreditation Council for Occupational Therapy Education (ACOTE), which is a part of the American Occupational Therapy Associa­tion (AOTA). Currently, the ACOTE accredits bachelor’s degree programs, certificate programs for those who already have a bachelor’s degree in another field, and graduate (both master’s and doctoral) programs. As of 2007, however, anyone wishing to receive the professional credential, occupational therapist, registered (OTR), from the National Board for Certification in Occupa­tional Therapy (NBCOT) must have completed at least a master’s degree in the field. Because of this change, the ACOTE will no longer accredit bachelor’s degree pro­grams after 2007. Due to the change in requirements for the professional credential, many schools are closing their undergraduate-level programs and creating gradu­ate-level programs.

As an undergraduate, you will need to take courses emphasizing biological and behavioral sciences. Your studies should include classes on anatomy, physiology, neurology, psychology, human growth and develop­ment, and sociology. Clinical subjects cover general medical and surgical conditions and interpretation of the principles and practice of occupational therapy in pediatrics, psychiatry, orthopedics, general medicine, and surgery. Many bachelor’s degree programs require students to fulfill two years of general study before spe­cializing in occupational therapy during the last two years. Graduate-level programs cover many of the same subject areas but in greater depth. In addition, emphasis is put on research and critical thinking. Management and administration are also areas covered more thor­oughly in graduate programs.

In addition to classroom work, you must complete fieldwork requirements. According to the AOTA, stu­dents need to complete the equivalent of 24 weeks of supervised experience working with clients. This may be done on a full-time basis or a part-time (but not less than half-time) schedule. This training must be completed in order to qualify for professional certification.

Those working on bachelor’s degrees are now advised to continue their education to at least the master’s level. Doctoral programs in occupational therapy are also available. While those holding master’s degrees will prob­ably not see much difference in their starting salary as opposed to those with bachelor’s degrees, they will likely find, as their career develops, that it is easier to move into higher-level positions offering more responsibilities and higher pay. Those who want careers in teaching, admin­istration, and research should certainly obtain graduate education.

In addition to these full-time study options, there are a limited number of part-time and evening programs that allow prospective occupational therapists to work in another field while completing their requirements in occupational therapy.

Certification or Licensing

All states and the District of Columbia regulate the practice of occupational therapy through certification and licensing. National certification is granted by the NBCOT. In order to take the NBCOT exam, you must graduate from an accredited program and complete the clinical practice period. Those who pass this written test are given the designation, occupational therapist, reg­istered, and may use the initials OTR after their names.

Initial certification is good for five years and must be renewed every five years after that. Many hospitals and other employers require that their occupational thera­pists have the OTR designation. In addition, the NBCOT offers several specialty certifications, such as board certi­fied in pediatrics. To receive a specialty certification, you must fulfill education and experience requirements as well as pass an exam.

License requirements generally include graduation from an accredited program, passing the NBCOT certifi­cation exam, payment of license fees, and, in some cases, passing an exam covering state statutes and regulations. License renewal requirements vary by state.

Other Requirements

In order to succeed as an occupational therapist, you should enjoy working with people. You should have a patient, calm, and compassionate temperament and have the ability to encourage and inspire your clients. Like your clients, you may encounter frustrating situations as a therapist. For example, it can be difficult and stressful when a client does not respond to treatment as you had hoped. In such situations, occupational therapists need to be persistent, not giving up on the client. Imagination and creativity are also important at such times, because you may need to think of new ways to address the client’s problem and create new methods or tools for the client to use.

Exploring Occupational Therapist Career

While in high school, you should meet with occupational therapists, visit the facilities where they work, and gain an understanding of the types of equipment and skills they use. Many hospitals and occupational therapy facili­ties and departments also have volunteer opportunities, which will give you strong insight into this career.


There are approximately 92,000 occupational therapists at work in hospitals, schools, nursing homes, home health agencies, mental health centers, adult day care programs, outpatient clinics, and residential care facilities. The pro­fession has seen a growing number of therapists becom­ing self-employed, in either solo or group practice or in consulting firms.

Starting Out

Your school’s career services office is usually the best place to start your job search as a newly graduated occu­pational therapist. You may also apply directly to govern­ment agencies (such as the U.S. Public Health Service), private hospitals, and clinics. In addition, the AOTA can provide job seekers with assistance through its employ­ment bulletins.


Newly graduated occupational therapists usually begin as staff therapists and may qualify as senior therapists after several years on the job. The U.S. Army, Navy, Air Force, and the U.S. Public Health Service commission occupa­tional therapists; other branches of the federal service give civil service ratings. Experienced therapists may become directors of occupational therapy programs in large hos­pitals, clinics, or workshops, or they may become teachers. Some positions are available as program coordinators and as consultants with large institutions and agencies.

A few colleges and health agencies offer advanced courses in the treatment of special disabilities, such as those resulting from cerebral palsy. Some institutions provide in-service programs for therapists.


According to the U.S. Department of Labor, median sala­ries for occupational therapists were $56,860 in 2005. The lowest 10 percent earned $38,840 a year in 2005, and the top 10 percent earned more than $85,450.

Salaries for occupational therapists often vary accord­ing to where they work. In areas where the cost of living is higher, occupational therapists generally receive higher pay. Occupational therapists employed in public schools earn salaries that vary by school district. In some states, they are classified as teachers and are paid accordingly.

Therapists employed at hospitals and government and public agencies generally receive full benefit pack­ages that include vacation and sick pay, health insurance, and retirement benefits. Self-employed therapists and those who run their own businesses must provide their own benefits.

Work Environment

Occupational therapists work in occupational therapy workshops or clinics. As mentioned earlier, these work­shops or clinics can be found at a variety of locations, such as hospitals, long-term care facilities, schools, and adult day care centers. No matter what the location, though, these workshops and clinics are well-lighted, pleasant settings. Generally, therapists work eight-hour days and 40-hour weeks, with some evening work required in a few organizations.

Occupational Therapist Career Outlook

Opportunities for occupational therapists are expected to be highly favorable through 2014 and will grow much faster than the average for all other careers, according to the Occupational Outlook Handbook. This growth will occur as a result of the increasing number of middle-aged and elderly people that require therapeutic services. The demand for occupational therapists is also increas­ing because of growing public interest in and government support for people with disabilities and for occupational therapy programs helping people attain the fullest possible functional status. The demand for rehabilitative and long-term care services is expected to grow strongly over the next decade. There will be numerous opportunities for work with mental health clients, children, and the elderly, as well as with those with disabling conditions.

As the health care industry continues to be restruc­tured, there should be many more opportunities for occupational therapists in nontraditional settings. This factor and proposed changes in the laws should create an excellent climate for therapists wishing to enter private practice. Home health care may experience the greatest growth in the next decade.

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