Employment is projected to increase much faster than the average,
as rapid growth in the number of middle-aged and elderly individuals
increases the demand for therapeutic services.
Beginning in 2007, a masterís degree or higher in occupational
therapy will be the minimum educational requirement.
Occupational therapists are increasingly taking on supervisory
roles, allowing assistants and aides to work more closely with
clients under the guidance of a therapist, in an effort to reduce
the cost of therapy.
More than a quarter of occupational therapists work part time.
Nature of the Work
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 coordinationóall
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, orthotics,
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
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. A therapist may work with children
individually, lead small groups in the classroom, consult
with a teacher, or serve on a curriculum or other administrative
committee. Early intervention therapy services are provided
to infants and toddlers who have, or at the risking of having,
developmental delays. Specific therapies may include facilitating
the use of the hands, promoting skills for listening and following
directions, fostering social play skills, or teaching dressing
and grooming skills.
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. Therapists with specialized
training in driver rehabilitation assess an individualís 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 the client to asses the home for hazards and to identify
environmental factors that contribute to falls.
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
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 health care providers.
Occupational therapists in hospitals and other health care
and community settings usually work a 40-hour week. Those
in schools may participate in meetings and other activities
during and after the school day. In 2004, 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 health care 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.
Because of rising health care 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.
Training, Other Qualifications, and Advancement
Currently, a bachelorís degree in occupational therapy is
the minimum requirement for entry into the field. Beginning
in 2007, however, a masterís degree or higher will be the
minimum educational requirement. As a result, students in
bachelorís-level programs must complete their coursework and
fieldwork before 2007. All States, Puerto Rico, Guam, 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 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 requirements.
In 2005, 122 masterís degree programs offered entry-level
education, 65 programs 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
are offering weekend or part-time programs as well. Bachelorís
degree programs in occupational therapy are no longer offered
because of the requirement for a masterís degree or higher
beginning in 2007. In addition, post baccalaureate certificate
programs for students with a degree other than occupational
therapy are no longer offered.
Occupational therapy coursework includes the physical, biological,
and behavioral sciences and the application of occupational
therapy theory and skills. The 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 health care field.
Relevant undergraduate majors include biology, psychology,
sociology, anthropology, liberal arts, and anatomy.
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 rapid improvement.
Ingenuity and imagination in adapting activities to individual
needs are assets. Those working in home health care services
must be able to adapt to a variety of settings.
Occupational therapists held about 92,000 jobs in 2004. About
1 in 10 occupational therapists held more than one job. The
largest number of jobs were in hospitals. Other major employers
were offices of other health practitioners (including offices
of occupational therapists), public and private educational
services, and nursing care facilities. Some occupational therapists
were employed by home health care services, outpatient care
centers, offices of physicians, individual and family services,
community care facilities for the elderly, and government
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 day care programs, and home health care agencies.
Employment of occupational therapists is expected to increase
much faster than the average for all occupations through 2014.
The impact of proposed Federal legislation imposing limits
on reimbursement for therapy services may adversely affect
the job market for occupational therapists in the short run.
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 demand for therapeutic services.
Growth in the population 75 years and olderóan age group that
suffers from high incidences of disabling conditionsóalso
will increase demand for therapeutic services. Driver rehabilitation
and fall-prevention training for the elderly are emerging
practice areas for occupational therapy. In addition, medical
advances now enable more patients with critical problems to
surviveópatients 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, the extension of services for
disabled students, and an increasing prevalence of sensory
disorders in children. Therapists will be needed to help children
with disabilities prepare to enter special education programs.
Median annual earnings of occupational therapists were $54,660
in May 2004. The middle 50 percent earned between $45,690
and $67,010. The lowest 10 percent earned less than $37,430,
and the highest 10 percent earned more than $81,600. Median
annual earnings in the industries employing the largest numbers
of occupational therapists in May 2004 were:
Home health care services
Offices of other health practitioners
Nursing care facilities
General medical and surgical hospitals
Elementary and secondary schools
Occupational therapists use specialized knowledge to help
individuals perform daily living skills and achieve maximum
independence. Other workers performing similar duties include
audiologists, chiropractors, physical therapists, recreational
therapists, rehabilitation counselors, respiratory therapists,
and speech-language pathologists.
Sources of Additional Information
For more information on occupational therapy as a career,