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“The Practice of Occupational Therapy” means the therapeutic use of everyday life occupations with persons, groups, or populations (clients) to support occupational performance and participation. Occupational therapy practice includes clinical reasoning and professional judgment to evaluate, analyze, and diagnose occupational challenges (e.g., issues with client factors, performance patterns, and performance skills) and provide occupation-based interventions to address them. Occupational therapy services include habilitation, rehabilitation, and the promotion of physical and mental health and wellness for clients with all levels of ability-related needs. Evaluation of factors affecting activities of daily living (ADLs), instrumental activities of daily living (IADLs), health management, rest and sleep, education, work, play, leisure, and social participation.
Occupational therapy interventions include assessment, design, fabrication, application, fitting, and training in the use of seating and positioning systems, assistive technology, adaptive devices, orthotic devices, and prosthetic devices. OTs also provide assessment, recommendation, and training to enhance functional mobility, including fitting and managing wheelchairs and other mobility devices. Interventions include exercises to improve motion, strength, and endurance for occupational participation, as well as remediation and compensation for visual deficits, such as low vision rehabilitation. Additionally, occupational therapy encompasses driver rehabilitation, community mobility, and the management of feeding, eating, and swallowing to support eating performance. The use of physical agent modalities, mechanical modalities, and therapeutic procedures (e.g., wound care, techniques for sensory, motor, perceptual, and cognitive processing, and manual therapy) further enhances performance skills.
Occupational therapists refer clients to healthcare providers and facilities for services and assessments that inform the occupational therapy plan of care.
Additionally, OTs engage in administration, consultation, education, and research to support and advance occupational therapy practice.
Most occupational therapists enter the occupation with a master’s degree in occupational therapy. In 2017, there were about 200 occupational therapy programs accredited by the Accreditation Council for Occupational Therapy Education, part of the American Occupational Therapy Association.
Admission to graduate programs in occupational therapy generally requires a bachelor’s degree and specific coursework, including biology and physiology. Many programs also require applicants to have volunteered or worked in an occupational therapy setting. Candidates should contact the program that they are interested in attending about specific requirements.
Master’s programs usually take 2 to 3 years to complete; doctoral programs take about 3 and a half years. Some schools offer a dual-degree program in which the student earns a bachelor’s degree and a master’s degree in 5 years. Part-time programs that offer courses on nights and weekends are also available. Both master’s and doctoral programs require at least 24 weeks of supervised fieldwork, in which prospective occupational therapists gain clinical work experience. In addition, doctoral programs require a 16-week capstone experience.
All states require occupational therapists to be licensed. Licensing requirements vary by state, but all require candidates to pass the national examination administered by the National Board for Certification in Occupational Therapy (NBCOT). To sit for the NBCOT exam, candidates must have earned a degree from an accredited educational program and completed all fieldwork requirements.
Therapists must pass the NBCOT exam to use the title “Occupational Therapist, Registered” (OTR). They must also take continuing education classes to maintain certification. The American Occupational Therapy Association also offers a number of board and specialty certifications for therapists who want to demonstrate their advanced or specialized knowledge in areas of practice, such as pediatrics, mental health, or low vision.
