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Occupational therapists help individuals with mentally, physically, developmentally, or emotionally disabling conditions to develop, recover, or maintain daily living and work skills. They not only help patients improve basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. Their goal is to help patients have independent, productive, and satisfying lifestyles.
Occupational therapists assist patients in performing activities of all kinds, 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 paper and pencil games may be chosen to improve visual acuity and the ability to discern patterns. A patient suffering short-term memory loss, for instance, might be encouraged to make lists to aid recall. One with coordination problems might be given extra tasks to improve hand-eye coordination. Computer programs have been designed to help patients improve decisionmaking, abstract reasoning, problem solving, and perceptual skills, as well as memory, sequencing, and coordination-all of which are important for independent living.
For those with permanent functional disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, therapists provide such adaptive equipment as wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop and teach patients to operate computer-aided adaptive equipment, such as microprocessing devices that permit individuals with severe limitations to communicate, walk, operate telephones and television sets, and control other aspects of their environment.
Some occupational therapists, called industrial therapists, help patients find and hold a job. They arrange employment, plan work activities and evaluate the patient's progress.
Occupational therapists may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, they evaluate children's abilities, recommend therapy, modify classroom equipment, and in general, help children participate as fully as possible in school programs and activities.
Occupational therapists in mental health settings treat mentally ill, mentally retarded, or emotionally disturbed individuals. To treat these problems, therapists choose activities that help people learn to cope with daily life. Activities include time management skills, budgeting, shopping, homemaking, and use of public transportation. They may also work with patients suffering from alcoholism, drug abuse, depression, eating disorders, and stress related disorders.
Recording a patient's activities and progress is an important part of an occupational therapist's job. Accurate records are essential for evaluating patients, billing, and reporting to physicians.
Occupational therapists in hospitals and other health care settings generally work a regular 40-hour week. Those in schools may also participate in meetings and other activities, during and after the school day. In large rehabilitation centers, therapists may work in spacious rooms equipped with machines, tools, and other devices that may generate noise. The job can be tiring because therapists are on their feet much of the time. Those providing home health care may spend several hours a day driving from appointment to appointment. Therapists also face hazards such as backstrain from lifting and moving patients and equipment.
Occupational therapists held about 54,000 jobs in 1994. The largest number of jobs were in hospitals, including many in rehabilitation and psychiatric hospitals. School systems are the second largest employer of occupational therapists. Other major employers include offices of occupational therapists and other health practitioners, nursing homes, community mental health centers, adult daycare programs, job training services, and residential care facilities.
A small but rapidly growing number of occupational therapists are in private practice. Some are solo practitioners, while others are in group practices. They see patients referred by physicians or other health professionals, or provide contract or consulting services to nursing homes, adult daycare programs, and home health agencies.
A bachelor's degree in occupational therapy is the minimal requirement for entry into this field. In addition, 39 States, Puerto Rico, and the District of Columbia require a license to practice occupational therapy. To obtain a license, applicants must have a degree or a post-bachelor's certificate from an accredited educational program and pass a national certification examination given by the American Occupational Therapy Certification Board. Those who pass the test are awarded the title of registered occupational therapist.
In 1994, entry level education was offered in 69 bachelor's degree programs; 9 post-bachelor's certificate programs for students with a degree other than occupational therapy; and 19 entry level master's degree programs. 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 clinical internship is also 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 with favor on paid or volunteer experience in the health-care field.
Warmth and patience are needed to inspire both trust and respect. Ingenuity and imagination in adapting activities to individual needs are assets. Individuals working in home health care must be able to successfully adapt to a variety of settings.
Job opportunities for occupational therapists are expected to continue to be excellent. Employment of occupational therapists is expected to increase much faster than the average for all occupations through the year 2005 due to anticipated growth in demand for rehabilitation and long-term care services. Several factors are increasing the need for rehabilitative services. Medical advances are now making it possible for more patients with critical problems to survive. These patients, however, may need extensive therapy. Also, there is the anticipated demand generated by the baby-boom generation's move into middle age, a period during which the incidence of heart attack and stroke increases. Additional services will also be demanded by the population 75 years of age and above, a rapidly growing age group that suffers from a very high incidence of disabling conditions. Finally, additional therapists will be needed to help children with disabilities prepare to enter special education programs, as required by recent Federal legislation.
Due to industry growth and more intensive care, hospitals will continue to employ the largest number of occupational therapists. Hospitals will also need occupational therapists to staff their growing home health-care and outpatient rehabilitation programs.
Moderate growth in schools will result from expansion of the school-age population and extended services for disabled students.
Movement into private practice has been made more attractive by a legislative change which permits occupational therapists to bill Medicare directly for services provided. Previously, billings were submitted through a hospital, home health agency, or other Medicare-approved facility.
Employment of occupational therapists in the home health field is expected to grow very fast. The rapidly growing number of people age 75 and older who are more likely to need home health care, and the greater use of at-home followup care will encourage this growth.
According to a national survey of hospitals and medical centers conducted by the University of Texas Medical Branch, the median annual salary for occupational therapists, based on a 40-hour week and excluding shift or area differentials, was $39,634 in October 1994. The average minimum was $33,728 and the average maximum was $49,392. Some States classify occupational therapists employed in public schools as teachers and pay accordingly.
Therapists in private practice generally earned more than salaried workers.
Occupational therapists use specialized knowledge to help individuals perform daily living skills and achieve maximum independence. Other workers performing similar duties include orthotists, prosthetists, physical therapists, chiropractors, speech pathologists and audiologists, rehabilitation counselors, recreational therapists, art therapists, music therapists, dance therapists, horticultural therapists, and manual arts therapists.
For more information on occupational therapy as a career, a list of education programs, and requirements for certification, write to:
The American Occupational Therapy Association, 4720 Montgomery Ln., P.O. Box 31220, Bethesda, MD 20824-1220.
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