Occupational therapists (OTs) help people improve their ability to perform tasks in their daily living and working environments. They work with individuals who have conditions that are mentally, physically, developmentally, or emotionally disabling. They also help them to develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. Their goal is to help clients have independent, productive, and satisfying lives.
Occupational therapists assist clients in performing activities of all types, ranging 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 and 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 decisionmaking, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing, and coordinationall of which are important for independent living.
Therapists instruct those with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, in the use of adaptive equipment, including wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop computer-aided adaptive equipment and teach clients with severe limitations how to use that equipment in order to communicate better and control various aspects of their environment.
Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange employment, evaluate the work environment, plan work activities, and assess the clientís progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.
Occupational therapists may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, they evaluate childrenís abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. Occupational therapy also is beneficial to the elderly population. Therapists help the elderly lead more productive, active, and independent lives through a variety of methods, including the use of adaptive equipment.
Occupational therapists in mental-health settings treat individuals who are mentally ill, mentally retarded, or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to engage in and cope with daily life. Activities include time management skills, budgeting, shopping, homemaking, and the use of public transportation. Occupational therapists also may work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders, or stress-related disorders.
Assessing and recording a clientís activities and progress is an important part of an occupational therapistís job. Accurate records are essential for evaluating clients, for billing, and for reporting to physicians and other healthcare providers.
Occupational therapists in hospitals and other healthcare and community settings usually worked a 40-hour week. Those in schools may participate in meetings and other activities during and after the school day. In 2002, more than a quarter of occupational therapists worked part time.
In large rehabilitation centers, therapists may work in spacious rooms equipped with machines, tools, and other devices generating noise. The work can be tiring, because therapists are on their feet much of the time. Those providing home healthcare services may spend time driving from appointment to appointment. Therapists also face hazards such as back strain from lifting and moving clients and equipment.
Therapists increasingly are taking on supervisory roles. Due to rising healthcare costs, third-party payers are beginning to encourage occupational therapist assistants and aides to take more hands-on responsibility. By having assistants and aides work more closely with clients under the guidance of a therapist, the cost of therapy should decline.
Occupational therapists held about 82,000 jobs in 2002. About 1 in 10 occupational therapists held more than one job. The largest number of jobs was in hospitals. Other major employers were offices of other health practitioners (which includes offices of occupational therapists), public and private educational services, and nursing care facilities. Some occupational therapists were employed by home healthcare services, outpatient care centers, offices of physicians, individual and family services, community care facilities for the elderly, and government agencies.
A small number of occupational therapists were self-employed in private practice. These practitioners saw clients referred by physicians or other health professionals or provided contract or consulting services to nursing care facilities, schools, adult daycare programs, and home healthcare agencies.
Currently, a bachelorís degree in occupational therapy is the minimum requirement for entry into this field. Beginning in 2007, however, a masterís degree or higher will be the minimum educational requirement. As a result, students in bachelorís-level programs should complete their coursework and fieldwork before 2007. All States, Puerto Rico, and the District of Columbia 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 ďOccupational Therapist Registered (OTR).Ē
In 2003, entry-level education was offered in 38 bachelorís degree programs, 3 postbaccalaureate certificate programs for students with a degree other than occupational therapy, and 86 entry-level masterís degree programs. There were 48 programs that offered a combined bachelorís and masterís degree and 5 offered an entry-level doctoral degree. Most schools have full-time programs, although a growing number also offer weekend or part-time programs.
Occupational therapy coursework includes physical, biological, and behavioral sciences and the application of occupational therapy theory and skills. Completion of 6 months of supervised fieldwork also is required.
Persons considering this profession should take high school courses in biology, chemistry, physics, health, art, and the social sciences. College admissions offices also look favorably at paid or volunteer experience in the healthcare field.
Occupational therapists need patience and strong interpersonal skills to inspire trust and respect in their clients. Ingenuity and imagination in adapting activities to individual needs are assets. Those working in home healthcare services must be able to adapt to a variety of settings.
Employment of occupational therapists is expected to increase faster than the average for all occupations through 2012. The impact of proposed Federal legislation imposing limits on reimbursement for therapy services may adversely affect the job market for occupational therapists in the near term. However, over the long run, the demand for occupational therapists should continue to rise as a result of growth in the number of individuals with disabilities or limited function who require therapy services. The baby-boom generationís movement into middle age, a period when the incidence of heart attack and stroke increases, will spur the demand for therapeutic services. Growth in the population 75 years and olderan age group that suffers from high incidences of disabling conditionsalso will increase the demand for therapeutic services. In addition, medical advances now enable more patients with critical problems to survivepatients who ultimately may need extensive therapy.
Hospitals will continue to employ a large number of occupational therapists to provide therapy services to acutely ill inpatients. Hospitals also will need occupational therapists to staff their outpatient rehabilitation programs.
Employment growth in schools will result from the expansion of the school-age population and extended services for disabled students. Therapists will be needed to help children with disabilities prepare to enter special education programs.
Median annual earnings of occupational therapists were $51,990 in 2002. The middle 50 percent earned between $42,910 and $ 61,620. The lowest 10 percent earned less than $35,130, and the highest 10 percent earned more than $74,390. Median annual earnings in the industries employing the largest numbers of occupational therapists in 2002 were as follows:
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2004-05 Edition,
Occupational Therapists, on the Internet at
(visited July 09, 2004).