Occupational therapists help mentally, physically, developmentally or emotionally disabled individuals develop, recover, or maintain daily living and work skills. They help patients improve their basic motor functions and reasoning abilities, as well as help them learn to dress, bathe, cook, or operate machinery. Occupational therapists also help permanently disabled patients cope with the physical and emotional effects of being disabled. With support and direction, patients learn (or relearn) many of the day-to- day skills necessary to establish an independent, productive, and satisfying lifestyle.
Occupational therapists use activities of all kinds to treat patients. With children, occupational therapists often use toys or games. Therapy for adults may range from using a computer to cooking. In addition to being useful skills, they also improve memory, sequencing, and coordination - all of which are important for independent living. Woodworking or leatherworking may help increase strength, endurance, and dexterity, while word find games can help improve visual acuity and the ability to discern patterns. A patient suffering short-term memory loss, for instance, might be encouraged to make lists to aid recall. One with coordination problems might be given extra tasks to improve eye-hand coordination. Computer programs have been designed to help patients improve decision making, abstract reasoning, problem solving, and perceptual skills such as peripheral vision and discrimination of letters, colors, and shapes.
During each therapy session, the therapist assesses each activity's effectiveness and the patient's progress. These assessments are used to modify goals and procedures.
For permanently disabled patients, such as accident victims with spinal cord injuries or those with cerebral palsy or muscular dystrophy, therapists provide such adaptive equipment as wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work.
Some occupational therapists work with rehabilitation engineers to develop computer-aided adaptive equipment. Examples are micro processing devices that permit paralyzed patients to communicate, walk, or operate telephones and television sets.
Occupational therapists tend to work with individuals in a particular age group or with particular disabilities. In home health care, for instance, referrals often involve elderly patients; in schools, young children. A growing number of therapists work in the wellness and health promotion areas.
Occupational therapists in schools evaluate handicapped children's abilities, recommend therapy, modify classroom equipment, and in general, help them participate as fully as possible in school programs and activities. Their goal is to enable the child to learn, not to rehabilitate. If such therapy is required, it is usually received elsewhere.
Occupational therapists in mental health settings treat mentally ill, mentally retarded, or emotionally disturbed individuals. Emotional disorders may include alcoholism, drug abuse, depression, eating disorders, and stress-related disorders. To treat these problems, therapists develop activities that help people learn to cope with daily stresses. These activities may emphasize time management skills, budgeting, shopping, homemaking, and use of community resources such as public transportation.
Therapists also work to improve a patient's attitude and self-esteem. Concrete assistance might mean helping an accident victim regain a driver's license or encouraging a socially withdrawn person to interact with people.
Keeping notes is an important part of an occupational therapists job. Records are always kept for purposes of evaluating the patient, reporting to the physician, and billing.
Working Conditions:
Although occupational therapists generally work a 40-hour week, they may work evenings or weekends. Occupational therapists in schools work regular school hours and participate in meetings and other activities. In large rehabilitation centers, therapists may work in spacious rooms equipped with machines, hand tools, and other devices that often generate noise. Therapists may work in a kitchen when using food preparation as therapy. The job can be physically tiring because therapists are on their feet much of the time. Those delivering home health care may spend several hours a day driving from appointment to appointment. Therapists also face hazards such as back strain from lifting and moving patients and equipment.
Employment:
The largest number of jobs for occupational therapists was in hospitals, including a substantial number in rehabilitation and psychiatric hospitals. School systems are the second largest employer of occupational therapists. Other major employers include nursing homes, community mental health centers, adult day care programs, outpatient clinics, and residential care facilities.
A small but rapidly growing number of occupational therapists are in private practice. Some are solo practitioners, while others are in group practices. They see patients referred to them by physicians or other health professionals, or provide contract or consulting services to nursing homes, adult day care programs, and home health agencies.
Training, Other Qualifications, and Advancement:
A bachelor's degree in occupational therapy is the minimal requirement for entry into this field. Many States and the District of Columbia require a license to practice occupational therapy. To obtain a license, applicants must have a degree or a post-baccalaureate certificate from an accredited educational program and pass a national certification examination given by the American Occupational Therapy Certification Board. Those who pass the test are awarded the title of registered occupational therapist (OTR).
Most schools have full-time programs, although a growing number offer weekend, self-paced, or part-time programs. Occupational therapy coursework includes physical, biological, and behavioral sciences and the application of occupational therapy theory and skills. Successful completion of a minimum of 6 months of supervised clinical internship is also required.
Persons considering this profession should take courses in biology, anatomy, psychology, and other high school science courses. In addition to the physical sciences, high school students are advised to take courses in health, art, and the social sciences. College admissions offices also look with favor on applicants who have job or volunteer experience in the health care field. They know that exposure to the health care field, especially occupational therapy; helps prevent any misconceptions a student might have about the occupation.
Warmth and patience are needed to inspire both trust and respect. Ingenuity and imagination in adapting activities to individual needs are assets. Individuals working in home health care 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 due to anticipated growth in demand for rehabilitation and long-term care services.
Several factors are increasing the need for rehabilitative services. For instance, medical advances that are now saving more lives are at the same time creating a need for more therapy. Also, there is the anticipated demand generated by the baby-boom generation's move into middle age, a period when the incidence of heart attack and stroke increases. Additional services will be demanded by the population 75 years of age and above, a rapidly growing age group that suffers from a very high incidence of disabling conditions. Finally, additional therapists will be needed to help prepare handicapped children to enter special education programs in public schools or private clinics, as required by recent Federal legislation.
Due to rapid industry growth and more intensive care, hospitals will continue to employ the largest number of occupational therapists. Hospitals will also need occupational therapists to staff their expansion into home health care, rehabilitation programs, and outpatient clinics. Schools will remain the second largest employer of occupational therapists. Moderate growth will result from expansion of the school-age population and extended services for handicapped students.
The field of private practice will continue to provide a large number of new opportunities for occupational therapists willing to provide follow-up and long-term services to patients recently released from the hospital. Encouraging movement into private practice is a legislative change permitting occupational therapists to bill Medicare directly for services provided. Previously, such billings were submitted through a Medicare-approved facility such as a hospital or home health agency. Private practitioners will also find opportunities working as a contractor or consultant to hospitals, nursing homes, rehabilitation centers, group homes, and industrial settings.
The home health field is expected to experience very rapid growth. Encouraging this growth will be the rapidly growing number of people age 75 and older who are more likely to need home health care and the greater number of procedures and lifesaving technologies which require at-home follow-up.
Related Occupations
Occupational therapists use specialized knowledge to help individuals return to their normal activities and achieve maxi-mum independence. Other workers performing similar duties include orthotics, prosthetics, physical therapists, speech pathologists and audiologists, rehabilitation counselors, recreational therapists, art therapists, music therapists, and dance therapists.