Significant Points

• Employment is expected to grow much faster than average, and job opportunities should be good, especially for therapists treating the elderly.
• Occupational therapists are regulated in all 50 States; requirements vary by State.
• Occupational therapists are increasingly taking on supervisory roles, allowing assistants and aides to work more closely with clients under the guidance of a therapist.

Nature of the Work

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. 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. Therapists also face hazards such as back strain from lifting and moving clients and equipment.

Occupational therapists working for one employer full-time usually work a 40-hour week. Around 31 percent of occupational therapists worked part-time. It is not uncommon for occupational therapists to work for more than one employer at multiple facilities, which may involve significant travel time. Those in schools may participate in meetings and other activities during and after the school day.

Training, Other Qualifications, and Advancement

Occupational therapists are regulated in all 50 States. Individuals pursuing a career as an occupational therapist usually need to earn a post-baccalaureate degree from an accredited college or university or education deemed equivalent.

Education and training. 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.

Licensure. 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.

Certification and other qualifications. 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.

Advancement. 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 is expected to grow much faster than average. Job opportunities should be good, especially for occupational therapists treating the elderly.

Employment change. Employment of occupational therapists is expected to increase by 26 percent between 2008 and 2018, much faster than the average for all occupations. The increasing elderly population will drive growth in the demand for occupational therapy services. The demand for occupational therapists should continue to rise as a result of the increasing number of individuals with disabilities or limited function who require therapy services. Older persons have an increased incidence of heart attack and stroke, which will spur demand for therapeutic services. Growth in the population 75 years and older-an age group that suffers from high incidences of disabling conditions-also will increase demand for therapeutic services. In addition, medical advances now enable more patients with critical problems to survive-patients who ultimately may need extensive therapy. However, growth may be dampened by the impact of Federal legislation imposing limits on reimbursement for therapy services.

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 the federally funded extension of services for disabled students. Therapists will be needed to help children with disabilities prepare to enter special education programs.

Job prospects. Job opportunities should be good for licensed occupational therapists in all settings, particularly in acute hospital, rehabilitation, and orthopedic settings because the elderly receive most of their treatment in these settings. Occupational therapists with specialized knowledge in a treatment area also will have increased job prospects. Driver rehabilitation, training for the elderly, and ergonomic consulting are emerging practice areas for occupational therapy.