What is Occupational Therapy?

Occupational therapy strives to support health and participation in life through engagement in occupation. Occupational therapists apply "core values, knowledge, and skills to assist clients to engage in everyday activities or occupations that they want and need to do in a manner that supports health and participation (American Occupational Therapy Association, 2008)."

Occupational therapists work with individuals with physical, development, emotional, or mental disabilities or illness. They work to recover and maintain functioning in life tasks and prevent disability, injury, or illness from occuring.

Occupations

Occupations are the basis for the profession of occupational therapy and they are what practice revolves around. However, defining the term occupation is challenging due to the fact that there can be several meanings for occupation. Some definitions for occupations are:

• "Properly using time that includes work, and worklike activities and recreational activities."
• "Specific chunks of activity within the ongoing stream of human behavior which are named in the lexicon of culture. These daily pursuits are self-initiated, goal directed, and socially sanctioned."
• "Groups of activities and tasks of everyday life, named, organized, and given value and meaning by individuals and culture."
• "The activities that comprise our life experience and can be named in the culture (Crepeau, Cohn, & Schell, 2009)."

The broad range of occupations are be sorted into categories that are called areas of occupation.

• Activities of daily living
• Bathing, dressing, eating
• Instrumental activities of daily living
• Care of others, pets, shopping
• Rest and Sleep
• Education
• Formal and informal educational participation
• Work
• Paid employment and volunteer activities
• Play
• Activity that provide enjoyment, entertainment, amusement, or diversion
• Leisure
• Nonobligatory activity during discretionary time
• Social Participation
• Community, family, peer, friend (American Occupational Therapy Association, 2008)  

Academic Preparation

Academic Preparation

• Pre-requisites to enter OT program
• Bachelor's degree
• Examples: biology, kinesiology, psychology, community health, sociology, anatomy

• Core courses: anatomy and physiology, statistics, physics, sociology, others
• Student must then complete an entry-level master's degree program (MOT) from an ACOTE accredited program.
• Courses in the program will focus on structure and funtion of human body, human development, occupational therapy process, theory, screening, evaluation, management, and research.
• Students must also complete six months of supervised fieldwork
• After completion of fieldwork, student must successfully complete the National Board for Certification in Occupational Therapy Examination and apply for state licensure.
• Students may also complete an entry-level doctoral degree (DOT)
• Additional semesters of study focusing on clinical practice skills, research skills, administration, leadership, program and policy development, advocacy, education, and theory development.
• Must complete a 16 week experiential component and culminating project.
• Accreditation Council for Occupational Therapy Education (ACOTE)
• 86 years of accrediting occupational therapy programs
• AOTA credentialing body
• There are a great deal of standards that a program must meet in order to become accredited, which can be reviewed here:  http://www.aota.org/Educate/Accredit/StandardsReview.aspx
• On-site evalutions for initial accreditation are conducted at 5 to 7 year intervals and at 5, 7, or 10 year intervals for continuing accreditation (American Occupational Therapy Association, 2010).

National and State Licensing

National Licensing

• In order to practice, all occupational therapists must successfully complete the National Board for Certification in Occupational Therapy (NBCOT).  
• NCBOT is a not-for-profit credentialing agency for occupational therapists and assistants.
• They develop, adminster, and review the certification process to ensure it reflects standards of competent practice.
• In order to sit for the exam, the individual must have graduated from ACOTE accredited occupational therapy or assistant program and completed required fieldwork.

 

http://www.nbcot.org/

State Licensing

• Occupational therapy is regulated in all 50 states, as well as Puerto Rico and Guam.
• Types of regulation vary from state to state from licensure, which is the strongest form of regulation, to title protection or trademark, which is the weakest form.
• Regulation is in place to protect consumers from unqualified practitioners.
• In the state of Florida, occupational therapists are required to obtain state licensure. This is regulated by the Florida Department of Health.
• In order to obtain a license, one must:
• Graduate from an accredited OT program
• Complete fieldwork requirements
• Pass the NBCOT Certification Exam
• Apply for a license and pay a fee

    

http://www.doh.state.fl.us/mqa/occupational/

Professional Education

Professional Education

• Occupational therapists are required to participate in continuing education as a part of their license renewal process.
• Continuing education can be in the form of meetings, conferences, lectures, workshops, seminars, and symposia.
• The number of hours required varies from state to state.
• In Florida, occupational therapists are required to complete 26 hours of continuing education every two years. They also must complete a two hour prevention of medical errors course, a two hours laws and rules course, and a one hours HIV/AIDS education course (Florida Department of Health, 2010).

Credentialing

·         Allows the public to know that the occupational therapist has at least the minimal standards to provide competent services.

·         State licensure is an example of credentialing.

·         The National Board for Certification in Occupational Therapy (NBCOT) is a private credentialing organization that allows the therapist to use the initials OTR (registered occupational therapist).

Type of Practitioners

Occupational Therapist

• Occupational therapists assess clients to establish a need for intervention, then plan and implement appropriate interventions in order to improve the occupational functioning of their clients. 
• They provide services to individuals, organizations, and populations within a wide range of settings and age groups.  

Occupational Therapy Assistant (OTA)

• OTAs work under the supervision of and in collaboration with occupational therapists to provide occupational therapy treatments.
• They may assist in treatment planning, documentation, and some routine functions.
• Requires an Associate's degree in an academic program approved by the ACOTE, three months of fieldwork, successful completion of the NBCOT examination, and meet any state licensur/certification requirements (Bureau of labor statistics, 2009).

Occupational Therapy Aides

• Work under the supervision of an occupational therapist or occupational therapy assistant.
• General tasks include preparing materials and equipment.
• Perform many clerical tasks such as scheduling appointments, managing supplies, and completing insurance forms or other paperwork.
• Minimum requirement of a high school diploma (Bureau of labor statistics, 2009).

Practice Areas and Settings

Practice Areas

Occupational therapy services are provided on the individual, organzation, and population level. People of all ages, genders, cultures, and ethnicities can benefit from occupational therapy. The six main practice areas are:

• Children and Youth
• Provides services to infants, toddlers, children and their family.
• Work in collaboration with teachers, special educations, and other medical personnel.
• Pediatric occupational therapists deal with early intervention, mental health disorders, sensory integration, and transition services.
• Children's main occupation is play so that is the primary focus of occupational therapy for children.
• Health and Wellness
• An individuals health is directly related to the physical and emotional well-being.
• There is an increased demand for this area of practice due to an increasing aging population, the growing rates of obesity, the focus of health care disparities, and the effect of technology on health.
• Mental Health
• Treat clients with mood disorders, post traumatic stress disorder, drug and alcohol abuse, schizophrenia, and many other mental health disorders.
• The main goal for occupational therapy in mental health is to facilitate the development of skills needed for independent, interdependent, and productive living.
• Productive Aging
• Due to the aging population, changing work force, and increased focus of quality-of-life, this is becoming a popular area of practice.
• Rehabilitation, Disability, and Participation
• Concentrates of the needs of those who have injuries, illnesses, or deficits from other causes that inhibits their occupational performance.
• Help clients return to the activities that they need and want to do.
• Work and Industry
• Services in ergonomics, work rehabilitation, return to work programs, and employment of individuals with developmental disabilities (American Occupational Therapy Association, 2010).

OT Practice Settings

The list of practice settings for occupational therapists is extensive. It includes, but is not limited to:

• Skilled nursing facilities
• Psychiatric hospitals
• Schools
• Hospitals
• Clinics
• Home care
• Assisted living facilities
• Acute rehabilitation
• Day care centers/preschools
• Hospice
• Sheltered workshops
• Wellness centers