Although no schools are dedicated exclusively to training occupational therapists, most universities offer undergraduate courses to prepare students for graduate study and certification. There are around 117,000 licensed occupational therapists and occupational therapy assistants practicing in the United States, and there are 324 occupational therapy schools at colleges or universities. As of 2007, all occupational therapists must have at least a master’s or doctoral degree for certification, while occupational therapy assistants and aides are required to have completed undergraduate bachelor’s or associate’s degrees with relevant courses and supervised fieldwork. Graduate school students learn through regular classroom courses and supervised fieldwork and internships within occupation therapy centers and practices.
Once a student graduates from a master’s program, he or she is eligible to take the Occupational Therapist Registered (OTR) examination, which is administered by the National Board for Certification in Occupational Therapy (NBCOT).
Individuals with undergraduate degrees can work as assistant occupational therapists or occupational therapy aides, which can be rewarding on a personal level but with significantly lower income potential. However, many occupational therapy assistants later go on to achieve advanced degrees, drawing from their experience with patients and practitioners.
Both master’s and doctoral degrees prepare graduates for certification as entry-level practitioners; however, a doctoral degree offers additional semesters with courses focusing on clinical practice and research, administration, leadership, program and policy development, advocacy, education, and theory development. Both master’s and doctoral degrees require fieldwork experience, but entry-level doctoral students must also complete research projects.
There are also combined bachelor’s and master’s degree programs. After achieving a baccalaureate degree, a student then enters the occupational therapy school’s master’s program.
Interestingly, informal surveys of entry-level doctoral graduates show that they do not typically receive higher salaries than those with master’s degrees; however, they are more qualified to advance into higher-paying, more specialized positions in the workforce, especially in administration.
Occupational Therapy Licenses
Graduates from occupational therapy schools are licensed at the state level. Each state has different licensing and continuing education requirements, as well as periodic testing for license renewal—usually annually or every other year.
In order to renew a license, both occupational therapists and occupational therapy assistants are required to complete a specified number of professional development units through participation in professional development activities. These vary by state but include continuing education classes, publication in peer-reviewed journals, attendance at conferences and seminars, and a wide range of other actions. In California and Connecticut, for example, practitioners must complete 24 professional development units every two years.
Most state websites list the requirements for occupational therapy licensing and continuing education, and voluntary certification is also available through the National Board for Certifying Occupational Therapy (NBCOT). The national certification exam meets the requirements for licensing in some states, while others have their own examinations.
A national organization, the Rehab License Network, in an excellent online resource for learning more about industry news, job outlooks, opportunities, license requirements, and other information for students and graduates of occupational therapy schools.
Occupational Therapy Assistant
Students who do not or cannot commit to pursuing a master’s degree at occupational therapy schools can complete a four-year undergraduate degree to become an occupational therapy assistant or aide, and most universities offer such programs. After graduating, occupational therapy assistants usually work directly under a licensed occupational therapist, helping him or her with basic patient rehabilitative activities, preparing and testing therapeutic equipment, and helping with different clerical tasks.
Occupational therapy aide programs award two-year associate’s degrees and include three academic semesters and one semester of full-time internship. Given the necessary skills and knowledge required to become an occupational therapy aide, applicants must be prepared to make a strong commitment to both academic course work and internship training. Most states regulate the practice of occupational therapist assistants and aides either by licensing, registration, or certification, and these requirements vary by state.
Under the supervision of an occupational therapist, occupational therapy assistants and aides work toward improving each patient’s quality of life and their abilities to perform everyday tasks. For example, they help injured workers re-enter the labor force by teaching them how to compensate for lost motor skills or help those with learning disabilities increase their independence.
Occupational therapy assistants follow exercises outlined in a treatment plan developed in collaboration with an occupational therapist, and these activities can range from teaching a client how to safely move from a bed into a wheelchair to the best way to stretch and work hand muscles. Assistants also monitor an individual’s activities to make sure that they are performed correctly and provide encouragement, documenting each patient’s progress for the occupational therapist. If treatment is not having the intended effect or the client is not improving as expected, the supervising occupational therapist may alter the treatment program to achieve better results. In addition, occupational therapist assistants document the billing of the client’s health insurance provider.
Occupational therapy aides are less involved with patients. Instead, they are charged with preparing learning materials and assembling the equipment used during treatment. Aides are not regulated by states, so the law does not allow them to perform as wide a range of tasks as occupational therapy assistants. Occupational therapy assistants and aides need to have a moderate degree of strength because physical exertion is usually required when assisting patients. For example, assistants and aides may need to physically lift patients, and kneeling, stooping, and standing for long periods of time also are part of the job.
The hours and days that occupational therapy assistants and aides work varies by facility and whether they are full time or part time. Many outpatient therapy offices and clinics have evening and weekend hours to coincide with patients’ schedules, so the ability to have a flexible schedule is important.
Annual salaries for occupational therapy assistants vary by location but typically range from $39,000 to $57,000 per year. Most earn between $43,000 and $52,000, and their mean salary is $47,000, according to the U.S. Bureau of Labor Statistics.
Employment for occupational therapy assistants and aides is expected to grow much faster than average in the years to come as demand rises and occupational therapists increasingly need their services.
Occupational therapy assistants also must attend occupational therapy schools accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) in order to take the national certifying exam. In 2009, there were 135 ACOTE-accredited occupational therapy assistant programs in the United States.
At occupational therapy schools, the first year of study for an assistant usually involves a basic introduction to health care and medical terminology, anatomy, and physiology. Second-year courses include occupational therapy classes in such areas as mental health, adult physical disabilities, gerontology, and pediatrics. Students also must complete at least 16 weeks of supervised fieldwork in a clinic or community setting.
Applicants to occupational therapy assistant programs can improve their chances of admission by taking high school courses in biology and health or by performing volunteer work in nursing care facilities, occupational or physical therapists’ offices, hospitals, or other health care settings.
Forty states and the District of Columbia regulate occupational therapy assistants through licensing, registration, or certification, but eligibility requirements vary by state. In addition, some states have additional requirements for occupational therapy assistants who work in schools or early intervention programs, such as education-related classes, and require an education practice certificate or early intervention certification. Contact your state’s licensing board for specific regulatory requirements.
The National Board for Certifying Occupational Therapy (NBCOT) certifies occupational therapy assistants through a national certifying exam held at different times throughout the year. Those who pass the test are awarded the title Certified Occupational Therapy Assistant (COTA). The national certifying exam meets requirements for regulation in some states, but others have their own licensing exams.
Occupational therapy assistants are also expected to continue their professional development by participating in continuing education courses and workshops in order to maintain certification.
Some university occupational therapy schools offer undergraduates academic programs leading to completion of a bachelor of science in interdisciplinary health services, with a course track in occupational therapy, which is then followed immediately by an 18-month, 30-credit hour master of science degree in occupational therapy. Such programs usually include prerequisites and professional core courses as well as supervised fieldwork at clinical sites. Learning formats usually include traditional classroom course work, Internet, face-to-face, interactive Internet, and audio and video courses.
An associate of science pre-occupational therapy degree leading to graduate school is offered at many colleges. This is a two-year course of study that requires 60 hours of general education and elective courses. A student in a typical occupational therapy assistant program must complete second-level (200) biology and physiology courses with at least a C average, as well as primary (100-level) psychology, speech, and English classes. In addition, students must be certified in CPR, be computer proficient, and also provide a background check.
Although background checks are not used in the admission review process, some clinical sites require such checks as a condition of participation, and students must do supervised fieldwork at such sites to complete the program. If a student is unable to participate due to the results of a criminal background check, they may not be able to complete the degree requirements and cannot graduate from the program. Individuals with felony convictions are not eligible for certification.
To become a certified occupational therapist, it is necessary to achieve a master’s or doctoral degree, but occupational therapy schools offer four-year degrees in pre-occupational therapy geared toward preparing students for graduate study, as well as occupational therapy assistant bachelor’s degrees. Occupational therapy schools have different requirements for graduate admission than either a postbaccalaureate or a combined bachelor’s and master’s entry-level degree, so it is important to know these requirements before seeking admission.
College preparation courses for students seeking advanced degrees at occupational therapy schools emphasize not only health and social sciences, such as anatomy, physiology, neurology, psychology, and sociology but also course work in measuring physical performance, occupational therapy theory, intervention, counseling, and rehabilitation technology.
Combined bachelor’s and master’s degree programs are accredited occupational therapy schools that accept undergraduates. After completing master’s-level academic courses and fieldwork, students at occupational therapy schools are awarded entry-level master’s degrees, and graduates are then eligible to take the national NBCOT certification examination. In addition to the academic requirements, an approved supervised clinical training period of six months is required for professional certification.
To become certified to practice as an OTR, you must have a master’s or doctoral degree from an occupational therapy school. Each potential occupational therapist must attend an academic program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) in order to sit for the national certifying exam.
In 2009, 150 master’s degree programs or combined bachelor’s and master’s programs were accredited at universities with occupational therapy programs, as well as 4 doctoral degree programs. Most occupational therapy schools have full-time programs, although a growing number are offering weekend or part-time programs as well. Courses cover basic physical, biological, and behavioral sciences, as well as courses on applying occupational therapy theory and skill, and all accredited programs require a minimum of 24 weeks of supervised fieldwork.
Schools offering master of science occupational therapy degrees have different requirements for graduation, but many also provide students with the ability to apply their learning in specialized areas, such as pediatric occupational therapy, community gerontology, and advanced research methods.
Median annual wages for certified master’s graduates in occupational therapy vary by region and types of practice but range from $55,090 to $81,000 per year. Occupational therapists in the lowest 10 percent income range earn less than $42,000, but the highest 10 percent can earn $98,000 or more.
Median annual wages in industries employing the largest numbers of occupational therapists are:
- $74,510 at in-home health care,
- $72,790 at nursing homes,
- $69,360 at general health care practitioner offices,
- $68,100 at medical and surgical hospitals,
- $60,020 at elementary and secondary schools.
Some new graduates of occupational therapy schools may be able to teach at colleges or institutions, but it depends on the institution. Someone with an entry-level doctoral degree may be hired as a faculty member to teach at a college or university; however, each institution has specific requirements for faculty members, and many individuals with entry-level degrees may not meet these qualifications.
Because educational curricula for master’s and doctoral programs at different occupational therapy schools vary, it can cause some confusion when comparing programs and degrees. However, according to the U.S. Bureau of Labor Statistics (BLS), opportunities in the years to come will be greater for graduates of occupational therapy schools with doctoral degrees to find employment in technology, program development, staff development, administration, program and policy development, advocacy, education, and theory research and development.
Individuals with entry-level doctoral degrees have been hired in teaching, research, and administrative positions at universities and colleges, but as the number of therapists with such degrees increases, such positions are expected to become more scarce and applications more competitive, according to the BLS.
A doctoral degree does not guarantee higher salaries for new graduates, according to surveys of entry-level doctoral graduates; however, many are able to fill unique positions due to their advanced degrees. For example, in specifically designated administrative positions within school systems, an advanced degree may result in a higher starting salary. The market value of entry-level doctoral-degreed graduates from occupational therapy schools is complex due to the rapidly changing health care situation in the United States and other factors, although certified occupational therapists with additional education or experience and those with advanced degrees are expected to be more in demand in the coming years.