What Is Occupational Therapy (OT)?

by Trevor St. Clair, OTD, MS, OTR/L

I’m often asked, “What is occupational therapy?” and “What does an occupational therapist do?” These are tough questions to answer briefly because OT is an innovative, evergrowing and evolving profession, but let’s give it a shot.

Occupational therapy is a type of rehabilitation that incorporates the activities that are important to the client into the rehabilitation process (American Occupational Therapy Association PDF). In the field, we refer to these activities as valued occupations. Occupational therapists collaborate with their clients to help them do the things that they need and want to do through rehabilitation, modification or environmental adaptation.

As you can imagine, the activities that are important and meaningful to clients vary from person to person. Valued occupations include the things that we usually think of as an “occupation” – that is, what someone does for their job to earn a living – but valued occupations also include things like hobbies, chores, and activities of daily living (ADLs) such as bathing, getting dressed, using the toilet, and eating (Centers for Medicare & Medicaid Services PDF).

Because of this, there’s a broad scope of challenges that occupational therapists can address – much broader than most people think. And because people of all ages have valued occupations, occupational therapists work with clients of all ages to help them achieve their goals.

Note: If you think you or someone you know may need occupational therapy, you typically need a referral from a physician to be evaluated by an occupational therapist in a clinical setting.

Examples of Occupational Therapy in Action

What does this look like in practice? Let’s look at a couple of examples.

Suppose a carpenter injures their hand to the extent that they can no longer do their work. An occupational therapist could work with the carpenter to rehabilitate their hand (rehabilitation), find alternative ways for them to use tools (modification), and/or modify the environment to ensure safety while doing the work (environmental adaptation). 

Another example, this one from my personal experience: I once provided occupational therapy for a junior in high school who had suffered a stroke that left him with limited use of his right arm. He wanted to live independently in an apartment when he went to college, but feared that not being able to cook for himself could make that impossible. 

He expressed a desire to take a cooking class at his high school but worried about how he could manage with only one functional arm. I evaluated his needs through the lens of occupational therapy and identified adaptive equipment that could enable him to fully participate. I worked with him and his teacher, demonstrating how to use specialized tools, bowls and plates designed for one-handed use. Over time, he gained the skills and confidence to overcome this challenge. By the time he graduated high school two years later, he was ready to live independently in his own apartment while attending college, achieving the goal he once thought was out of reach.

Both of these examples deal primarily with physical limitations, but OTs also work in the mental and emotional realm as well – more on that soon.

Occupational Therapy Tasks and Skills

Occupational therapists do much more than what’s been described in the examples so far. They perform evaluations on clients, develop treatment plans in collaboration with their clients and interdisciplinary teams, and facilitate evidence-based assistance, also known as interventions. 

Occupational therapy interventions can make use of:

• Physical agent modalities (hot/cold therapy, electrical stimulation, etc.)
• Self-regulation strategies to manage emotions, behaviors and sensory needs
• A wide range of assistive technology, from wheelchairs to adapted versions of tools and equipment to software and more

Client and caregiver training are also very important to occupational therapy interventions. Oftentimes when someone goes home from an acute hospital setting, rehabilitation center, or skilled nursing facility, their caregiver needs training from an occupational therapist so that they can help the client be safe at home. This can involve things like transfer training to help someone get out of bed or move from a walker to a chair. 

The skills that are developed during occupational therapy school focus on clinical reasoning, reflective and evidence-based practice, biomedical rehabilitation, and psychosocial interventions. 

Psychosocial Component: Not Just About the Body

Occupational therapy’s roots began in mental health. Due to rising needs in mental health, the psychosocial component of occupational therapy is more important now than it has ever been. Occupational therapists can provide services in mental and behavioral health settings helping clients with a variety of mental health conditions learn coping mechanisms and build life skills.

As one example, occupational therapists collaborate with other mental health professionals to prepare children with autism to go to school by teaching them how to regulate their nervous systems.

The psychosocial component of OT is one reason why a number of occupational therapists major in psychology, though many study kinesiology or exercise science.

Occupational Therapy Specialties

Every occupational therapist comes into the field as an entry-level generalist. However, with additional training, occupational therapists can specialize to become any of the following, among other specialties:

• Certified driver rehabilitation specialist
• Assistive technology professional
• Seating and mobility specialist
• Certified autism specialist
• Certified low vision specialist
• Certified brain injury specialist

One of the many great things about occupational therapy is that you can change your practice area. I’ve personally worked in three practice areas: school-based pediatrics, acute hospital settings and autism-specific sensory clinics.

Occupational therapists can also become professors who train future occupational therapists, as well as conduct research. 

With such a broad scope, occupational therapists commonly work in a variety of settings, such as:

• Hospitals
• Schools
• Outpatient clinics
• Industrial rehabilitation
• Inpatient rehabilitation
• Skilled nursing facilities
• Hand therapy clinics

However, there are always emerging areas of practice for occupational therapists as the field continues to evolve.

Job Outlook and Pay

The Bureau of Labor Statistics predicts an 11% growth in employment from 2023 to 2033 – considered much faster than average growth – with over 9,000 job openings each year.

Occupational therapists have a median salary of over $96,000 per year.