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Adapted from the Bureau of Labor Statistics' Occupational Outlook Handbook, 2006-07 Edition
Significant Points
- 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.
- A master’s degree or higher in occupational therapy became the minimum educational requirement in 2007.
- 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 decision-making, abstract-reasoning, problem-solving and perceptual skills, as well as memory, sequencing and coordination -- all 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, splints 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 client's progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.
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 and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. 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.
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 disorders.
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.
Working Conditions
Occupational therapists in hospitals and other healthcare 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 healthcare 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 healthcare 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.
Employment
Occupational therapists held about 92,000 jobs in 2004. About one 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 healthcare services, outpatient care centers, offices of physicians, individual and family services, community care facilities for the elderly, and government agencies.
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 daycare programs and home healthcare agencies.
Training, Other Qualifications and Advancement
Beginning in 2007, a master’s degree in occupational therapy or higher became the minimum educational requirement for entry into the field. 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 “Occupational Therapist Registered (OTR).” 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 master’s degree programs offered entry-level education, 65 programs offered a combined bachelor’s and master’s degree, and five 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. Bachelor’s degree programs in occupational therapy are no longer offered because of the requirement for a master’s 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 six 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 healthcare 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 healthcare services must be able to adapt to a variety of settings.
Job Outlook
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 generation’s 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 older -- an age group that suffers from high incidences of disabling conditions -- also 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 survive—patients 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.
Earnings
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 healthcare services: $58,720
- Offices of other health practitioners: $56,620
- Nursing care facilities: $56,570
- General medical and surgical hospitals: $55,710
- Elementary and secondary schools: $48,580
Related Occupations
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, contact: