Occupational Therapy (OT) is the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. It is an allied health profession performed by occupational therapists and Occupational Therapy Assistants. OTs often work with people with mental health problems, disabilities, injuries, or impairments. Having many advantages of occupational therapy, Siddha Spirituality for Swami Hrdas Life System has taken note of. Hence, learn about occupational therapy, definition, areas of practices, benefits, and how to become an occupational therapist.
Occupational therapy definition
The American Occupational Therapy Association defines an occupational therapist as someone who “helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, injury rehabilitation, and providing supports for older adults experiencing physical and cognitive changes.”
Typically, occupational therapists are university-educated professionals and must pass a licensing exam to practice. Occupational therapists often work closely with professionals in physical therapy, speech therapy, audiology, nursing, social work, clinical psychology, and medicine.
Areas of practice
The broad spectrum of Occupational Therapy practice makes it difficult to categorize the areas of practice, especially considering the differing health care systems globally. In this section, the categorization from the American Occupational Therapy Association is used.
Occupational therapy – Children and youth
In 1951, Joan Erikson became director of activities for the “severely disturbed children and young adults” at the Austen Riggs Center. At that time, “occupational therapy” was used “for keeping patients busy on useless tasks.” Erikson “brought in painters, sculptors, dancers, weavers, potters, and others to create a program that provided real therapy.”
Occupational therapists work with:
Occupational therapists assist children and their caregivers to build skills that enable them to participate in meaningful occupations. These occupations may include:
- Attending school
Occupational therapy with children and youth may take a variety of forms. For example:
- Promoting a wellness program in schools to prevent childhood obesity
- Facilitating handwriting development in school-aged children
- Providing individualized treatment for sensory processing difficulties
- Teaching coping skills to a child with a generalized anxiety disorder
Occupational therapists work in the school setting as a related service for children with an Individual Education Plan (IEP). Related services mean:
- Transportation and such developmental, corrective, and other supportive services
As are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification, and assessment of disabilities in children, counseling services, including:
- Rehabilitation counseling
- Orientation and mobility services
- Medical services for diagnostic or evaluation purposes
As a related service, occupational therapists work with children with varying disabilities to address those skills needed to access the special education program and support academic achievement and social participation.
Occupational therapists have specific knowledge to increase participation in school routines throughout the day, including:
- Modification of the school environment to allow physical access for children with disabilities
- Provide assistive technology to support student success
- Helping to plan instructional activities for implementation in the classroom
- Support the needs of students with significant challenges such as helping to determine methods for alternate assessment of learning
- Helping students develop the skills necessary to transition to post-high school employment, independent living and/or further education (AOTA, n.d.-a)
Occupational therapy – Health and wellness
The practice area of Health and Wellness is emerging steadily due to the increasing need for wellness-related services in occupational therapy. A connection between wellness and physical health, as well as mental health, has been found; consequently, helping to improve the physical and mental health of clients can lead to an increase in overall well-being.
As a practice area, health and wellness can include a focus on:
- Prevention of disease and injury
- Prevention of secondary conditions
- Promotion of the well-being of those with chronic illnesses
- Reduction of health care disparities or inequalities
- Enhancement of factors that impact the quality of life
- Promotion of healthy living practices, social participation, and occupational justice
Occupational therapy – Mental health
Mental health and the moral treatment era have been recognized as the root of occupational therapy. According to the World Health Organization, mental illness is one of the fastest growing forms of disability.
Mental health illnesses that may require occupational therapy include:
- Schizophrenia and other psychotic disorders
- Depressive disorders
- Anxiety disorders
- Eating disorders
- Trauma – and stressor-related disorders
Obsessive-compulsive and related disorders such as hoarding, and neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and learning disorders.
Occupational therapists work with older adults:
- To maintain independence
- Participate in meaningful activities
- Live fulfilling lives
Some examples of areas that occupational therapists address with older adults are:
- Aging in place
- Low vision
- Dementia or Alzheimer’s Disease (AD)
When addressing driving, driver evaluations are administered to determine if drivers are safe behind the wheel. To enable the independence of older adults at home, occupational therapists perform falls risk assessments, assess clients functioning in their homes, and recommend specific home modifications.
When addressing low vision, occupational therapists modify tasks and the environment.
While working with individuals with AD, occupational therapists focus on maintaining the quality of life, ensuring safety, and promoting independence.
Visual impairment is one of the top 10 disabilities among American adults. Occupational therapists work with other professions, such as optometrists, ophthalmologists, and certified low vision therapists, to maximize the independence of persons with a visual impairment by using their remaining vision as efficiently as possible.
AOTA’s promotional goal of “Living Life to Its Fullest” speaks to who people are and learning about what they want to do, particularly when promoting the participation in meaningful activities, regardless of visual impairment.
Occupational therapy for older adults with low vision includes:
- Task analysis
- Environmental evaluation
- Modification of tasks or the environment as needed
Many occupational therapy practitioners work closely with optometrists and ophthalmologists to address visual deficits in acuity, visual field, and eye movement in people with traumatic brain injury, including providing education on compensatory strategies to complete daily tasks safely and efficiently.
Occupational therapists address the need for rehabilitation following an injury or impairment. When planning treatment, occupational therapists address the physical, cognitive, psychosocial, and environmental needs involved in adult populations across a variety of settings.
Occupational therapy in adult rehabilitation may take a variety of forms:
- Working with adults with autism at day rehabilitation programs to promote successful relationships and community participation through instruction on social skills
- Increasing the quality of life for an individual with cancer by engaging them in occupations that are meaningful, providing anxiety and stress reduction methods, and suggesting fatigue management strategies
- Coaching individuals with hand amputations how to put on and take off a myoelectrically controlled limb as well as training for functional use of the limb
- As for paraplegics, there are such things as sitting cushion and pressure sore prevention. Prescription of these aids is the common job for paraplegics.
- Using and implementing new technology such as speech to text software and Nintendo Wii video games
- Communicating via telehealth methods as a service delivery model for clients who live in rural areas
- Working with adults who have had a stroke to regain strength, endurance, and range of motion on their affected side.
Travel occupational therapy
Because of the rising need for occupational therapists in the U.S., many facilities are opting for travel occupational therapists—who are willing to travel, often out of state, to work temporarily in a facility.
Assignments can range from 8 weeks to 9 months, but typically last 13–26 weeks in length. Most commonly (43%), travel occupational therapists enter the industry between the ages of 21–30.
Work and industry
Occupational therapists work with clients who have had an injury and are returning to work. OTs perform assessments to simulate work tasks in order to determine best matches for work, accommodations needed at work, or the level of disability.
The practice area of occupational justice relates to the “benefits, privileges and harms associated with participation in occupations” and the effects related to access or denial of opportunities to participate in occupations. Examples of populations that experience occupational injustice include:
- Homeless persons
- Survivors of natural disasters
For example, the role of an occupational therapist working with refugees could include:
- Addressing developmental delays and psychological trauma of children through participation in the occupation of play
- Training workers at refugee camps who work with children on common issues associated with child forced migration and strategies to address these issues through occupation
- Educating and lobbying politicians and the public on the effects of forced migration on children and what can be done
In contrast, occupational injustice relates to conditions wherein people are deprived, excluded or denied opportunities that are meaningful to them. Types of occupational injustices and examples within the OT practice include:
- Occupational deprivation: The exclusion from meaningful occupations due to external factors that are beyond the person’s control. As an example, a person who has difficulties with functional mobility may find it challenging to reintegrate into the community due to transportation barriers.
- Occupational apartheid: The exclusion of a person in chosen occupations due to personal characteristics such as age, gender, race, nationality or socioeconomic status. An example can be seen in children with developmental disabilities from low socioeconomic backgrounds whose families would opt out from therapy due to financial constraints.
- Occupational marginalization: Relates to how implicit norms of behavior or societal expectations prevents a person from engaging in a chosen occupation. As an example, a child with physical impairments may only be offered table-top leisure activities instead of sports as an extracurricular activity due to the functional limitations caused by his physical impairments.
- Occupational imbalance: The limited participation in a meaningful occupation brought about by another role in a different occupation. This can be seen in the situation of a caregiver of a person with a disability who also has to fulfill other roles such as being a parent to other children, a student or a worker.
- Occupational alienation: The imposition of an occupation which does not hold meaning for that person. In the OT profession, this manifests in the provision of rote activities which does not really relate to the goals or the interest of the client.
Within occupational therapy practice, injustice may ensue in situations wherein professional dominance, standardized treatments, laws and political conditions create a negative impact on the occupational engagement of our clients. Awareness of these injustices will enable the therapist to reflect on his own practice and think of ways in approaching their client’s problems while promoting occupational justice.
How to become an occupational therapist
Earn an associates degree
Occupational therapy careers require advanced degrees, but an occupational therapy assistant associate’s degree is a practical starting point. These two-year programs prepare students to sit for the Certified Occupational Therapist Assistant (COTA) exam, a national exam administered by the National Board for Certification in Occupational Therapy.
Students can gain knowledge and skills in subjects like biology; anatomy and physiology; mental and physical health theory and practice; pediatrics; and geriatrics. Programs typically include fieldwork, giving students hands-on occupational therapy assistant practice.
Take the Certified Occupational Therapy Assistant (COTA) exam
After completing their associate’s degree program, graduates interested in becoming occupational therapy assistants can sit for the COTA exam. The COTA is a computer-based exam comprised of 200 multiple choice questions. Upon passing, examinees will receive an official NBCOT certificate and wallet card around 4-6 weeks after the exam is scored.
Gain experience in the occupational therapy field
Advance your education
A master’s degree is required to become an occupational therapist. Students can either earn a bachelor’s degree in a related field, like biology or physiology, before advancing to a master’s program, or they can apply for a combined bachelor’s/master’s program.
In combined degree programs, students take undergraduate and graduate level courses in occupational therapy and can graduate with both a bachelor’s and a master’s degree. Master’s degree programs combine theory and practice to give students a comprehensive knowledge of occupational therapy.
Fieldwork is required and must be completed under the supervision of an occupational therapist. Master’s degree programs in occupational therapy aim to prepare students to sit for the Occupational Therapist Registered (OTR) exam.
Pass the Occupational Therapy Registered (OTR) exam
A passing score on the OTR exam is required to become a licensed occupational therapist. Like the COTA exam, the OTR is computer-based. There are three clinical simulation problems and 170 multiple choice questions that are designed to evaluate a candidate’s ability to make conclusions about client needs, get information about a client’s occupational performance and the factors that play into it, choose appropriate therapies and manage and direct occupational therapy services.
The exam application costs $515, or $555 for a paper application. Applicants need to submit either their school transcripts or their NBCOT Academic Credential Verification Form and undergo a character review. Once they pass the exam, prospective occupational therapists will receive an official certificate from the NBCOT and a wallet card.
Gain state licensure
Occupational therapists need to get licensed in the state in which they plan to practice. Licensure requirements vary between states, but they typically require an NBCOT score, academic transcripts, and a background check. Licensing fees also vary and can range from around $50 to $240. There may be additional fees for things like fingerprinting and temporary licenses as well. To keep their licensure up to date, occupational therapists need to take continuing education units. They can also pursue doctoral degrees to become specialists and gain specialization certifications.