Occupational Therapist Career Guide

What Does an Occupational Therapist Do?

Occupational therapists evaluate and treat people who have injuries, illnesses, or disabilities to help them with vocational, daily living, and other skills that promote independence. They work with patients who have permanent disabilities (such as cerebral palsy), those recovering from injuries (like strokes or spinal cord injuries), and individuals with chronic conditions (such as diabetes or arthritis).

Typical responsibilities include:

• Evaluating clients' conditions by reviewing medical history, interviewing them, and observing them perform various tasks
• Developing and implementing treatment plans with specific activities to help clients work toward their goals
• Teaching patients to relearn daily living tasks, such as getting dressed or preparing meals
• Demonstrating exercises to help relieve pain and improve mobility
• Evaluating clients' homes, schools, or workplaces to identify accessibility improvements
• Recommending and teaching patients to use special equipment like mobility aids, wheelchairs, and eating aids
• Educating families about how to accommodate and care for their loved ones
• Assessing and recording clients' progress for evaluations and billing purposes

Occupational therapists work in various settings including hospitals (28%), private therapy offices (27%), schools (13%), home healthcare (8%), and nursing care facilities (7%). They may work as part of a healthcare team alongside doctors, nurses, and physical therapists. The work can be physically demanding, requiring long periods of standing and occasionally lifting or moving patients or equipment.

Education & Requirements

• Typical Education: Master's degree in occupational therapy (typically 2-3 years after bachelor's degree). Bachelor's degree can be in any subject, though programs often require coursework in biology, psychology, and other sciences. Some schools offer dual-degree programs where students earn both a bachelor's and master's degree.
• Licensure (Required): All states require occupational therapists to be licensed. Candidates must pass a national qualifying exam and complete supervised fieldwork during their degree program. Must use the title "Occupational Therapist Registered" (OTR) after passing the exam.
• Additional Certifications: Many employers require CPR or Basic Life Support (BLS) certification. Continuing education is required to maintain licensure.
• Key Skills: Communication and interpersonal skills for working with patients and families, compassion and empathy, patience, adaptability to adjust treatment plans based on patient needs, problem-solving abilities, and physical stamina for standing and assisting patients.
• Experience: Master's programs require supervised fieldwork hours. Many programs also prefer or require applicants to have volunteered or worked in an occupational therapy setting before admission.

Salary Information

According to the Bureau of Labor Statistics (May 2024 data):

• Median Annual Salary: $98,340 ($47.28 per hour)
• Entry-Level (10th percentile): $67,090
• Mid-Career (25th percentile): $77,700
• Experienced (75th percentile): $104,730
• Top Earners (90th percentile): $129,830
• Top-Paying States: California ($109,220), Nevada ($105,020), New Jersey ($104,710), Alaska ($100,810), Virginia ($97,980)
• Top-Paying Industries: Nursing care facilities ($103,210), Home healthcare services ($103,010), Hospitals ($100,770), Private therapy offices ($96,380), Educational services ($83,890)

Job Outlook & Growth

Employment of occupational therapists is projected to grow 14% from 2024 to 2034, much faster than the average for all occupations (3%). This represents an increase from 160,000 jobs in 2024 to 182,100 jobs by 2034—adding approximately 22,100 new positions.

About 10,200 job openings for occupational therapists are projected each year on average over the decade. Many openings will result from the need to replace workers who transfer to different occupations or retire.

Factors driving growth:

• Aging population: The growing size of the older adult population is a major driver. Older adults are more likely to experience disabilities and limitations in performing everyday tasks, creating increased demand for occupational therapy services to help maintain independence.
• Chronic conditions: Continued need for treatment of people with conditions like Alzheimer's disease, cerebral palsy, stroke, limb loss, diabetes, and arthritis.
• Developmental disorders: Ongoing treatment needs for children and young adults with developmental disorders such as autism spectrum disorder.
• Healthcare emphasis on independence: Growing recognition of occupational therapy's role in helping patients maintain quality of life and independence across all age groups.

How to Break Into This Field

1. Complete prerequisite coursework: Earn a bachelor's degree (any major, though biology, psychology, kinesiology, or health sciences are common). Ensure you complete required science courses (biology, anatomy, psychology) for graduate program admission.
2. Gain exposure to the field: Volunteer or work in occupational therapy settings—many master's programs require or strongly prefer this experience. Shadow practicing occupational therapists to confirm your interest and build connections.
3. Apply to accredited master's programs: Research programs accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Programs typically take 2-3 years and include supervised fieldwork requirements.
4. Complete fieldwork requirements: During your master's program, you'll complete a specified number of supervised clinical hours working with real patients in various settings.
5. Pass the national certification exam: After completing your degree and fieldwork, take the National Board for Certification in Occupational Therapy (NBCOT) exam to earn the OTR credential.
6. Obtain state licensure: Apply for licensure in your state (all 50 states require licensure). Requirements vary by state but include passing the national exam and meeting continuing education requirements.
7. Consider specializations: After gaining experience, you can specialize in areas like pediatrics, geriatrics, mental health, hand therapy, or assistive technology.
8. Join professional organizations: The American Occupational Therapy Association (AOTA) provides networking, continuing education, and career resources.

Career Path & Advancement

Typical career progression for occupational therapists:

• Entry-Level OT (0-2 years): Work under supervision of experienced therapists, building skills across diverse patient populations and treatment settings. Focus on developing clinical competencies and completing continuing education requirements.
• Staff Occupational Therapist (2-5 years): Work independently with assigned caseload, develop treatment plans, and may begin mentoring occupational therapy assistants and students completing fieldwork.
• Senior/Lead Occupational Therapist (5-10 years): Take on more complex cases, mentor junior staff, may specialize in specific populations (pediatrics, geriatrics, hand therapy, mental health) or treatment approaches.
• Specialization Track: Pursue advanced certifications in areas like hand therapy (CHT), pediatrics, neurorehabilitation, low vision, or driving rehabilitation. Specialists often command higher salaries and work with more complex cases.
• Management Track: Advance to Rehabilitation Director, OT Department Manager, or Director of Therapy Services. Oversee teams of therapists and assistants, manage budgets, develop programs, and ensure compliance with regulations.
• Advanced Practice: Some pursue doctoral degrees (OTD) for roles in research, academia, program development, or advanced clinical practice. Others become consultants, working with healthcare systems, schools, or businesses on accessibility and workplace modifications.
• Alternative Paths: Transition to roles in case management, healthcare administration, medical equipment sales, insurance companies (reviewing claims), or starting a private practice.

Advancement opportunities are strong due to the field's projected 14% growth rate and the diverse settings where OTs work. Supervisory and management positions typically require several years of clinical experience plus demonstrated leadership abilities.

Pros & Cons

Related Careers

If you're interested in Occupational Therapist, you might also consider:

• Physical Therapist — Helps injured or ill people improve movement and manage pain (requires doctoral degree, median pay $101,020)
• Occupational Therapy Assistant — Works under OT supervision to provide treatments and help with daily activities (requires associate degree or certificate, median pay $66,050)
• Speech-Language Pathologist — Assesses and treats people with communication and swallowing disorders (requires master's degree, median pay $95,410)
• Recreational Therapist — Plans recreation-based treatment programs for people with disabilities or illnesses (requires bachelor's degree, median pay $60,280)
• Nurse Practitioner — Provides primary and specialty healthcare, coordinates patient care (requires master's degree, median pay $132,050)
• Orthotist/Prosthetist — Designs, fits, and adapts medical devices like braces and artificial limbs (requires master's degree, median pay $78,310)
• Physician Assistant — Examines, diagnoses, and treats patients under physician supervision (requires master's degree, median pay $133,260)
• Rehabilitation Counselor — Helps people with disabilities live independently through counseling and support services