Occupational Therapy
Occupational therapists (OTs) work with people who are injured, ill, or disabled, through the therapeutic use of meaningful everyday activities (occupations) to help them improve their participation in and satisfaction with home, work, and community life. OTs also work with groups of people to enhance participation and quality of life at the community level. Because OTs work not just in medical settings, it is helpful to use the word “client,” rather than “patient,” and a client may be an individual or a group of people. Occupational therapy is practiced by Registered Occupational Therapists (OTR/L or OT/L), who are licensed to practice by their State, and by Certified Occupational Therapy Assistants (COTA/L) who also are licensed to practice by their State.
Occupational therapists often do the following:
- Evaluate the client’s situation, including strengths and challenges. This may include reviewing existing information about the client (e.g., in a hospital setting this would include medical history), asking the client questions to understand their perspectives and goals, and observing them doing one or more of their daily activities. Sometimes OTs also administer tests of specific skills or abilities to do specific tasks.
- Work with the client to develop a treatment plan, identifying specific goals and the types of activities that will be used work toward those goals.
- Work with people in various disabling situations to problem-solve the best ways for them to develop or return to participation in activities and daily routines that are important to them (occupations). For instance, an OT may help a client with left-sided weakness after a stroke to use one-handed cooking strategies.
- Evaluate the environments (e.g., home, school, playground, grocery store, etc.), in which the client is participating, and identify adaptations, modifications, or technology that may help improve the client’s performance in that environment. For instance, the OT may suggest labeling kitchen cabinets for an older person whose memory is declining, or the use of ramps and accessible level activities for wheelchair users on a playground.
- Work with family members or other key people to implement strategies that support the client’s participation in meaningful occupations.
- Document evaluation and intervention activities, and report changes in client performance. This documentation is used to track progress, evaluate the efficacy of the intervention, modify intervention planning, create discharge plans, communicate with other professionals, and bill for OT services.
Occupational therapists work in a variety of different settings and can take on multiple roles in those settings over time. Some occupational therapists work with children with disabilities in educational settings or provide early intervention therapy to infants and toddlers who have, or are at risk of having, developmental delays or other disabilities. Other work settings include (but are not limited to) mental/behavioral health programs, nursing homes, retirement communities, in-patient and out-patient rehabilitation (children and adults), hospital acute-care, and hand therapy. Once an OT has some experience in a particular area, they may work to develop new programs, take on more leadership and supervisory roles, become a fieldwork educator for OT students, or create their own practice. OTs also have opportunities to develop advocacy skills and address issues of policy and system-level organization if they wish.