[institute for career research] career as an occup(bookzz.org)

7/25/2019 [Institute for Career Research] Career as an Occup(BookZZ.org)

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CAREERAS AN

OCCUPATIONAL

THERAPIST


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Research Number 102ISBN 1-58511-102-3

DOT Number 076.121-010, 355.377-010, 076.364-010

CAREER AS AN

OCCUPATIONALTHERAPIST

Healthcare ProfessionalHelping People With Disabilities Regain Skills TheyNeed To Live Full And Independent Lives

You Can Make a Real Positive Difference in ThisVitally Needed Service Profession

Achild born with cerebral palsy learns how to walk withcrutches so that he can play with other kids.

Ateenager who suffers from a spinal cord injury caused by acar accident relearns the daily living skills that will help her

return to school and graduate with her class.

Awoman with depression regains her ability to find meaning

in daily activities.

Afactory worker injured on the job is able to return to work

after adaptations are made at his plant.

Anelderly stroke victim relearns how to bathe, shave, and

dress himself and, in the process, develops a new sense ofindependence.

THESE ARE JUST A FEW OF THE scenarios made possible with the helpof a skilled and caring occupational therapist. In this sense, the wordoccupational doesnt mean specifically relating to ones workoccupation, but to the tasks or activities with which the therapistoccupies the time of a client.

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Occupational therapists (OTs) work with people who have mental,emotional, and/or physical disabilities. OTs use goal-directed activities thatare purposeful and meaningful to help their clients develop or regain theskills they need to live as independently as possible.

For example, an occupational therapist might work with a prematureinfant using sensory stimulation to promote the development of the babysimmature nervous system. Or a therapist may work with an adult who hashad a spinal cord injury to adapt his home and workplace so he canresume daily activities, or provide an individual with emotional orpsychiatric problems with coping strategies to deal with the stresses ofdaily life.

Occupational therapists also help people with injuries or illnesses to

make difficult life transitions, such as returning to school or work. Andthey assist employers in making adaptations in the workplace so that adisabled employee can return to his job.

Occupational therapists have many roles. They often work directlywith people who need their services, or they may evaluate clients, planappropriate treatment and supervise someone else who works directly withthe client. Additionally, they may act as consultants, managers,researchers, and educators.

Occupational therapists work in many different settings and withpersons of all ages. They may work in public and/or private schools withchildren who are learning disabled, physically challenged, and/ordevelopmentally delayed. Medical settings (including hospitals,rehabilitation clinics, and nursing homes) are traditional sites where OTswork, usually with clients who have had their lives interrupted by acuteand chronic illnesses and conditions such as head injuries, strokes,depression, or arthritis. Less traditional but increasingly common work

settings are community environments and clients homes and workplaces.

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RELATED OCCUPATIONS

OCCUPATIONAL THERAPISTS USE SPECIALIZED KNOWLEDGE TO HELP INDIVIDUALS

perform daily living skills and achieve maximum independence. Otherhealthcare specialists performing similar duties include orthotists,

prosthetists, physical therapists, chiropractors, speech pathologists,audiologists, rehabilitation counselors, and recreational therapists.

Occupational Therapy and Physical Therapy Occupationaltherapists and physical therapists (PTs) often work as a team to helppatients achieve as much recovery and independence as possible. In ageriatric setting, for example, a PT may evaluate how well clients use theirlower extremities their bed mobility, gait, and ability to transfer from awheelchair to a bed. For the same clients and setting, an OT may evaluatehow well clients use their upper extremities, looking for range of motionand the ability to complete tasks of daily living, such as washing theirfaces, and brushing their teeth and hair. Some PTs, however, may alsoaddress dysfunction of the upper extremities within the treatment session.

An OT may evaluate cognitive function and perceptual skills. OTs andPTs may work collaboratively to address the clients balance and trunkcontrol. In some settings, OTs address bed mobility; in other settings, bed

mobility is the responsibility of the PT.Typically, PTs do not use purposeful activities, such as crafts and

activities of daily living, to enhance recovery, nor do they work with clientsdiagnosed with mental illness, unless the client has a secondary physicallimitation. PTs focus more on the use of exercises or mechanical devices,such as electrostimulation machines, to help recovery. OTs, on the otherhand, use purposeful activities and crafts, which are considered to be thefoundation of the profession.

The most important point to remember, however, is that the twoprofessions typically work together to address the clients deficits.

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TYPICAL JOB OPENINGS FOR OTs

TO GIVE YOU AN IDEA OF THE JOB MARKET IN THIS FIELD, LOOK OVER THESE REAL

advertisements, placed by companies recruiting occupational therapists.They illustrate some of the skills and background employers seek.

OUT-OF-CLINIC SETTINGSWe are booming! Come join our family ofhigh quality therapists. We offer tremendous flexibility for part-time orfull-time positions, one to five days a week, working in early intervention,schools, or homes.

PEDIATRIC OTs IN HOME SETTINGS Minimum baccalaureate level,license or certification, three years experience (two years in a rehabilitationor hospital unit). Adult orthopedic, neurological, and spinal cord

background preferred. Strong interpersonal skills, computer skills.Independent worker. Overnight travel required.

NEUROLOGICAL CLINICFull-time position with benefits working inpost-acute care rehabilitation in a new clinic to serve a progressive urbanarea.

SCHOOL-BASED THERAPISTSeeking experienced and enthusiastictherapists to work with school-age children, utilizing an integrated model.

HISTORY OF THE CAREER

AN OLD ADAGE TELLS US THAT KEEPING BUSY IS GOOD FOR WHAT AILS US. WITHIN

that simple concept lies the key to the occupational therapy profession.

Using specific tasks or occupations to help someone who has beenill or injured is an idea as old as the concept of healthcare itself. The

Egyptians used activities to speed the recovery of people suffering frommelancholy, and Roman physicians spoke highly of treatment that involvedactivity or occupation.

In the mental institutions of 18th century Europe, the seeds weresown for what was to become a profession based upon the concept ofoccupation. Physicians in an asylum in Spain observed that charity patientswho were required to perform menial tasks recovered more quickly thantheir aristocratic counterparts who were inactive and idle during their

treatment.Occupation as a form of treatment grew in mental healthcare and,

during the 19th century, began to be employed in some asylums in theUnited States. By the early 1900s, a number of institutions were using

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productive activities and daily living tasks such as bathing, dressing, andeating as an effective form of treatment for a variety of mental healthproblems. A group of supporters of the evolving profession gathered inClifton Springs, New York in 1917 for a meeting of the Society for thePreservation of Occupational Therapy, later renamed the American

Occupational Therapy Association.

The new organization and its members quickly were challenged by theonset of World War I. Suddenly, a generation of servicemen, broken inmind and body, were in need of rehabilitation. Several thousand peoplewere given a six-week course in occupational therapy practice, mainly incrafts skills, and were sent to Europe to serve as reconstruction aides.

By the end of the war, thousands had received occupational therapy,

and the experience gained by the reconstruction aides laid the foundationfor the expansion of the profession into a variety of applications in bothmental and physical rehabilitation.

Following the Great War, occupational therapy training programswere established, and hundreds of practitioners graduated from them. Bythe start of World War II, occupational therapists were on hand to providea wide variety of rehabilitation services to the wounded. They trainedamputees to use artificial limbs and developed special programs to deal

with dislocations, burns, arthritis, and nerve injuries. Programs weredeveloped jointly with the armed services to train additional therapists. Bythe end of the war, almost a thousand occupational therapists were onduty in Army hospitals alone.

By 1945, there were more than 3,000 occupational therapists in theUnited States, and 26 schools existed to train and accredit them. Theprofession had become a well-developed discipline which required abachelors degree in order to be able to practice. As medicine moved into

new specialties, such as geriatrics, occupational therapy followed.

By 1960, professional specialization in occupational therapy hadbegun, with therapists concentrating on different areas, includingprosthetics training, constructing splints, training in activities of dailyliving, and the rehabilitation of clients with spinal cord injuries andprogressive neurological disorders.

Today, occupational therapy is keeping pace with the changes in

healthcare delivery. Occupational therapy personnel are actively involved incardiac rehabilitation, stress reduction, working with the elderly, andpromoting the healthy development of infants. In addition, occupationaltherapy practitioners are contributing to the development and use of

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innovative technological advances in rehabilitation, such as bioelectriclimbs and computerized communication systems.

Entering the new century, there are more than 50,000 occupationaltherapists in the US, employed in a wide variety of healthcare facilities,

schools, clinics, and businesses. Nearly 160 colleges and universities offertraining to prepare individuals for a career in occupational therapy.

WHERE THEY WORK

THE GREATEST NUMBER OF JOBS ARE IN HOSPITALS, INCLUDING ACUTE-CARE, GENERAL

or specialized rehabilitation units, pain management programs, neonatalintensive care units, outpatient rehabilitation, cardiac rehabilitation, and

skilled nursing units.

OTs also work at psychiatric hospitals and substance abuse centers,providing services for both inpatients and outpatients.

Other employers include:

Physicians offices

Orthopedic and hand therapy clinics

Public and private school systemsHome healthcare services

Nursing homes

Community mental health centers

Adult daycare programs

Businesses

Residential care facilities

A small number of occupational therapists are in private practice.Some are solo practitioners, while others are in group practices. They seeclients referred by physicians or other health professionals, or providecontract or consulting services to nursing homes, schools, adult daycareprograms, and home health agencies.

The fastest growing areas of OT are home health, private practice, andgerontology.

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THE WORK DUTIES

OCCUPATIONAL THERAPISTS WORK WITH PEOPLE OF ALL AGES FROM INFANTS TO

the elderly who have conditions that are mentally, physically,developmentally, or emotionally disabling. These conditions may include:

Arthritis, cancer, or other debilitating illnesses

Head or spinal cord injuries

Orthopedic, work or sports-related injuries

Amputation

Burns

Head trauma

Stroke or other neurological conditions

Mental illness

Developmental disabilities.

OTs help clients to develop, recover, or maintain daily living and workskills.

They not only help clients improve basic motor functions andreasoning abilities but also compensate for permanent loss of function.Their goal is to help clients have independent, productive, and satisfying

lives.

Occupational therapists assist clients in performing activities of alltypes, ranging from using a computer to caring for daily needs such asdressing, cooking, and eating. Physical exercises may be used to increasestrength and dexterity, while paper and pencil exercises may be chosen toimprove visual acuity and the ability to discern patterns.

A client with short-term memory loss, for instance, might be

encouraged to make lists to aid recall. One with coordination problemsmight be assigned exercises to improve hand-eye coordination.Occupational therapists also use computer programs to help clientsimprove decision-making, abstract reasoning, problem solving, andperceptual skills, as well as memory, sequencing, and coordination all ofwhich are important for independent living.

For those with permanent functional disabilities, such as spinal cordinjuries, cerebral palsy, or muscular dystrophy, therapists instruct in the use

of adaptive equipment such as wheelchairs, braces, and aids for eatingand dressing. They also design or make special equipment clients mayneed at home or at work. Therapists develop and teach clients with severe

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limitations to operate computer-aided adaptive equipment that helps themto communicate and control other aspects of their environment.

Industrial Therapists Some occupational therapists, called industrialtherapists, treat individuals whose ability to function in a work

environment has been impaired. They arrange employment, plan workactivities and evaluate the clients progress.

School Therapists Occupational therapists may work exclusively withindividuals in a particular age group or with particular disabilities. Inschools, for example, they evaluate childrens abilities, recommend andprovide therapy, modify classroom equipment, and, in general, helpchildren participate as fully as possible in school programs and activities.

Mental Health Cases Occupational therapists in mental healthsettings treat individuals who are mentally ill, mentally retarded, oremotionally disturbed. They may also work with individuals who aredealing with alcoholism, drug abuse, depression, eating disorders, or stressrelated disorders. To treat these problems, therapists choose activities thathelp people learn to cope with daily life. Activities include timemanagement skills, budgeting, shopping, homemaking, and use of public

transportation.Recording a clients activities and progress is an important part of an

occupational therapists job. Accurate records are essential for evaluatingclients, billing, and reporting to physicians and others.

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PERSONAL EXPERIENCE OF OTS

I Have a Lot of Variety I WorkWith School Children and Seniors When I was in

high school, I had average grades and I asked my guidancecounselor what field I should go into. She suggested that Ibecome a teacher. Because I always liked helping people, I got adegree in elementary education, with a specialization in specialeducation. For seven years, I worked as a special ed teacher until Idecided that I wanted to do something different.

At that point, I was trying to decide between becoming a

physical therapist or an occupational therapist. I decided on OTbecause I liked the functionality of it. What I mean is this: If aclient (we dont call them patients any more) needs to increase hisbicep strength, a physical therapist will teach him exercises to dothat. An occupational therapist uses skills from daily living to dothe same thing. I like to apply real-life tasks in helping recovery.

Occupational therapy also is what we call womb to tomb asfar as need. We help people at every age level. Its a holistic field.In treatment, we look at the whole patient their physical andemotional health, their family support and interaction, everything.We dont just say, Oh here comes the leg fracture today. We saythat were going to treat Mrs. Jones, who has a leg fracture.

And theres so much flexibility in the field. Therapists canspecialize in whatever area interests them.

I enrolled in an OT program and got a masters degree in OT.Because I already had a bachelors degree in a related field, Ididnt have to go back to square one and get a bachelors degreein occupational therapy.

Soon after I graduated, I went into private practice, which isunusual for new OT graduates. Most work in a clinical setting first,gaining skills and learning from more experienced therapists, but Ifelt I was ready to be on my own.

I was not interested in working with people with physicaldisabilities. I prefer to work with people with emotional andeducational needs so, in my private practice, I worked at a

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community-based residential center for adults with mentalretardation. I taught them how to use public transportation, shopat the mall, pay for things. It was nice because they were able tomeet their friends and relatives at the mall and get their hair doneor have lunch together.

Eventually, the facility closed because of an effort to integratethem more into the community. Thats when I moved East, and Igot a job in a large suburban school system, where I still worktoday.

I support the teachers in dealing with children withdisabilities. For example, if a little kid comes to school using

crutches, I help decide where the best place would be to locatethe childs storage cubby. When children are moving fromelementary to middle school, I determine whether they are able toopen a combination lock on a locker or carry a tray in thecafeteria.

A lot of what I do is educating the teacher to see the childfirst and then the disability.

In addition to working in the schools, I also do homehealthcare for seniors. I teach them activities of daily living howto shower and dress and brush their teeth and cut their food. Ievaluate their environment to see how they might do things in away that will expend less energy.

The biggest drawback of the job for me is that an OT needs tobe patient and flexible. Thats not always easy, especially if youre

working with other professionals who arent doing the best job tohelp the client.

What I love most is the variety. I work with a three-year-oldwith autism and a 90-year-old man who has trouble bendingdown to tie his shoes. Im never bored. Im also able to make myown hours, and, while my job has structure, it also requires a lotof creativity.

My advice to people considering occupational therapy as aprofession is to plan on being a change agent. Youre there to helpchange peoples lives.

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Karen Jacobs, a former president of theAmerican Occupational Therapy Association,recently discussed with working therapists thepresent challenges of the profession. She

talked about creative, unique ways differenttherapists around the country are using theirskills.Together, we are creating the future of our

profession. Figuratively speaking, we are writing a book together one that could be titled, The Future of Occupational Therapy.

We probably all agree that, at present, our book is a realpage-turner. Some might even be tempted to compare it to a

work by Stephen King! Without a doubt, our profession facesgreater challenges today than ever before. In the past year, manyof us have seen some positions scaled back or eliminated.

I believe that the future of our profession has never beenbrighter. I believe that the current challenges will force us toreexamine the value of occupational therapy, re-evaluate thedirection of our profession, and identify and create new

opportunities to apply our skills. I believe the difficulties we nowface will make our profession stronger and each of us betteroccupational therapy practitioners.

Henry Kaiser, an author and columnist who also happens tohave a hearing impairment, put it another way. He said, Problemsare only opportunities in work clothes.

Healthcare is changing. If occupational therapy is to remain

relevant in this evolving climate, we must recreate ourselves. Wecan do this by becoming occupation F.A.N.A.T.I.C.s in otherwords, Forecasters, Advocators, Negotiators, Adventurers,Teachers, Innovators, and Collaborators. Each of these wordsrepresents a quality that will help us ensure the future of ourprofession.

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Forecasters

As members of the healthcare field, we must anticipate andguide the change. As forecasters, we must take stock of thechanges in healthcare and anticipate their direction, but we cant

stop there. We must also choose the future we desire forhealthcare and our profession, and work to bring that future intoreality.

It is useful, for example, to recognize that because Americansare leading increasingly fragmented lives they will inevitably havegreater mental healthcare needs. But it is much more useful torecognize that mental healthcare is an integral part of our

profession. I believe we are all mental health occupational therapypractitioners. We have come to the conclusion that mental healthrepresents one of our professions greatest opportunities forgrowth.

The Disease of Meaninglessness will reach epidemicproportions in the next decade. In my own opinion, it is alreadythe greatest healthcare crisis of our time. You see the ravages ofthis disease in all walks of life. Increasing levels of depression andaggression among adults indicate that fewer people are findingmeaning in their work. Teen suicides, substance abuse, eatingdisorders, shootings in schools all give evidence to the rise ofthis disease among our countrys youth.

Seniors, too, are particularly vulnerable to this disease. Afterdevoting years to their families and professions, many seniors findthemselves without meaningful occupation. As our population

ages, this problem will become even more pronounced.

The role of occupational therapy has never been moreimportant. We offer an antidote to the disease ofmeaninglessness. By helping people find occupations that theylove and by encouraging them to set and strive toward goals, wecan help them achieve happiness.

For example, Susan Stouffer, an assistant professor at the OT

Program at Barry University in Miami Shores, Florida, hasdeveloped a food service training program in a mental healthfacility.

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Susan says, It has been enjoyable work, being in anenvironment where there is so much potential and the clients areusually hardworking and good hearted.

Terrie McKamy, an OT in Deep East, Texas, has found an

innovative approach to providing mental health services. Terrieand her colleagues use a 50-acre farm to provide therapeuticservices for clients of all ages. Most of Terries adolescent andadult clients have chemical dependencies. She is helping theseindividuals overcome dependencies by learning new life skills andappropriate social behaviors. As they tend gardens and care foranimals, her clients gain a sense of achievement and discover newsources of enjoyment.

Terrie remarked, Many of these folks have never had funwithout drugs and alcohol. We had a 60-year-old man catch hisfirst fish ever, can you imagine?

Terrie recognized a growing problem in our society chemicaldependence among teens and adults and found a way to use herskills to address this problem.

Advocators

But it is not enough to anticipate changes. We must alsoinfluence them. There are many ways in which we can influencechange. We can influence potential clients and client groups. AsOT practitioners, we have always viewed ourselves as advocatesfor our clients. That should not, indeed, must not, change. But wemust also begin to see ourselves as advocates for our profession.

As I see it, these two roles have a kind of symbioticrelationship: By strengthening our profession we will be betterable to assist people who face challenges in their lives. And, witheach individual we assist, we demonstrate anew, the importanceand effectiveness of OT, making our profession stronger.

Negotiators

Better fundamental business skills are a long-term goal

toward which we must strive. In the meantime, however, we willeach need to hone our own negotiating skills. As individualpractitioners, these skills will aid us in our practices. As membersof the OT profession, these skills will enable us to educate

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potential partners and clients about the value of occupationaltherapy.

Adventurers

It isnt enough to forecast our future, to advocate for ourprofession, and to be willing to negotiate. We also have to beadventurers! We have to be willing to stretch our boundaries, tostep outside our narrow sphere of comfort, and yes to take afew risks.

One of our colleagues exemplifies the ability to make anadventure of ones career. Jim is an OT who very modestlydescribes himself as having been in the right place at the right

time. I prefer to describe him as having had the right attitude atthe right time.

After serving in the army, Jim had the opportunity to workwith the United Nations as a staff counselor for Peace KeepingOperations from 1993-1995. He helped people prepare to go intorisky places. Recently, Jim left for The Hague, where he will workfor the International Criminal Tribunal for the Former Yugoslavia

(ICTY). He will be setting up an employee assistance program tohelp the 750 staff personnel of the ICTY, many of whom will beworking in Kosovo, deal with stress and stress management andto assist them in resilience building. Jim will focus on prevention,but also on cure and rehabilitation.

When I asked Jim to define his role, he explained, I think if aperson has a physical, psychosocial, educational, or social-skillsproblem, they can be a recipient of OT. We treat anyone who has aproblem. We are enablers.

Jims ability to think creatively about his career enabled himto seize a remarkable opportunity to help the people who areattempting to bring peace to one of our worlds most troubledregions. Jims definition of OT speaks to one of the fundamentalprecepts of our profession: As OT practitioners, we strive to healthe whole person.

Another OT Jeanne Lewin, was also willing to stretch her ideasabout what OT practitioners do. In 1983, Jeanne combined her OTskills with her entrepreneurial capabilities to found The Tramble

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Co. Today, Tramble creates equipment for occupational therapypractitioners and offers continuing education opportunities toOTs. Her company now sells products throughout the world.

You do not have to be an occupational therapy practitioner to

be an adventurer, either. There are plenty of adventures forstudents. Elaine Leone of Richmond, Kentucky, accompanied by sixOT students, went to Haiti to complete a fieldwork experience. Thegroup went as guests of the Northwest Haiti Christian Mission,which established the mission in St. Louis du Nord, in 1978.

The original program was a nutritional program. Since thattime, the mission has built a small medical clinic, a 6-10 bed

birthing center, a church, an orphanage (home to 45-50 children),a surgical unit, a school, a dental clinic. Elaine and her studentswere the first rehabilitation services of any kind to be offered onthe northwest coast.

Elaine said originally the mission director did not believe thatthere would be any work for us to do; he had not seen peoplewith disabilities. He was receptive to our coming but was fearfulthat we might be idle! We were on a radio program for about fiveminutes, describing occupational therapy. It was translated intoCreole. People started arriving for OT services that very afternoon!During our stay there, we evaluated and provided consultationand treatment to infants, children, adults and the elderly.

You dont always have to change the direction of your careerto embark on a professional adventure, however. We aresurrounded by opportunities for adventure, if we just open our

minds to them. A year ago, Angela Sallerson, took her backgroundin pediatrics to open a pediatric clinic called Occupational Therapyof Rochester, NY.

The clinic specializes in children of any age who are havingproblems with sensory processing disorders. Angela describes thatit was a dream of mine to open a clinic and after 27 years ofpracticing OT, I finally bit the bullet and did it!

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Teachers

Most of us recognize that teaching is a very big part of whatwe do as OT practitioners: We teach our clients new behaviors andnew skills. In addition to teaching individual clients, we need to

teach client populations. We need to teach them to set new,higher goals for wellness and to adopt new, healthier behaviorsthat will help them achieve this goal. Before we can teach themanything else, however, we need to teach them to view OTpractitioners as their allies in this effort.

We need, for example, to teach seniors that OT practitionerscan help them live more fulfilling lives and feel better, emotionally,

and physically. Once senior organizations become convinced ofthe importance of OT, they will insist upon its inclusion in assistedliving centers, homeless shelters, well senior centers, and senioraffordable housing.

We need to teach teens the meaning of self-worth and thevalue of contributing to a community. We need to teach them thatOT practitioners can help them develop tools to counter feelingsof isolation, confusion, and frustration. Before we can help the

teens, though, we have to educate the administrators within theschools, families, detention facilities, and youth organizationsabout OT.

We need to educate our nations workforce about thebenefits of ergonomically correct work environments both athome and at the workplace. We must teach employees that OTpractitioners can help them work without injury. We must teach

employers that OT practitioners can help them drastically reduceworkers compensation costs and absenteeism.

Rannell Dahl, an OT who works for NorthBay HealthcareSystems on the West Coast, is leading the charge to educatecorporate America. She has already helped several largecorporations, as well as a major university, develop ergonomicprograms. In addition, they have, as she puts it, infiltrated every

department within their own company.

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Innovators

We have to recreate occupational therapy to reflect all thechanges in healthcare and in societal demographics that we havebegun forecasting. In short, we have to become innovators. Who

decreed that OT practitioners had to be employed by hospitals,schools, or skilled nursing facilities? We are trained to help anyonewho is challenged or at risk. People have challenges in every walkof life and that is exactly where we belong.

Donna Cunningham is an OT who has used innovation andvirtual reality technologies to create a dynamic business calledVirtual Rehabilitation Works. VR is already used in many healthcare

arenas, such as surgical training, cognitive/perceptual retraining,and anatomy education. Donna believes that VR also can greatlyenhance rehabilitation for clients recovering from a variety ofillnesses including stroke, head injuries, arthritis, spinal cord injury,attention deficit disorder, Parkinsons disease, multiple sclerosis,orthopedic disorders and Alzheimers.

VR offers an opportunity for clients to engage in goal-directedmovement. In a typical session, the client steps in front of a large

screen television, where their life-size mirror image appears. Usingvideo-gesture-controlled technology, the client can move about totouch colored bouncing balls, kick soccer balls or play thedrums. Auditory and visual cues make the simulated experiencemore real. Clients have so much fun, that they forget they areworking on motion balance, eye/hand/body coordination andstrengthening.

Michele Ellis is an innovator. She created Accessible Vacationsto meet the needs of travelers with disabilities. Michele says,Although travel provides only supplemental income to my salaryas an occupational therapist, it has provided the opportunity tocreate my own business and visualize a business plan into reality.

Some of the interrelations between travel and occupationaltherapy have enabled an individual to complete a therapeutic goal

of going to a play out of town; assisted a man with a brain tumorto visit his sisters; created the opportunity for children withdisabilities to travel with their families; and aided a group of

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children with hearing impairments to attend a graduationceremony that was completely signed.

It is good to learn that some of the skills that we use everyday in therapy such as active listening, decision making and

problem solving make the difference in the business world.

Collaborators

As healthcare providers, it is time for us to recognize thebenefits of collaboration. First and foremost, by teaming up withothers, we gain additional opportunities to assist people who canbenefit from our services. Thats a very big positive. But it isnt theonly positive. We can also find new ways to apply our skills andnew markets for our skills.

When most of us think of collaboration, we think aboutworking with other healthcare providers. However, we also havenatural synergies with those who work in furniture or computerdesign, engineering, architecture, and the list is almost endless.

Remember, we are innovators. We are not content merely tobuild upon existing relationships; we want to create relationshipsthat havent existed in the past.

Michelle Ziegmann is an OT who has entered into a highlyproductive and profitable collaboration effort. Michelle works forthe Institute for Cognitive Prosthetics, where she works withcomputer programmers to develop and customize softwareprograms for clients. By combining her OT skills with those of theprogrammers, the Institute is able to offer clients highly effectiveprograms to meet their unique needs.

Michelle is an innovator, as well. She and her colleagues alsoengage in tele-rehabilitation. They use video conferencingtechnology to work with clients around the country. Because theycan observe the client working in his or her own environment,they are able to offer highly effective treatment at a reasonable

cost.

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F.A.N.A.T.I.C.s

This is what it means to be Forecasters, Advocators,Negotiators, Adventurers, Teachers, Innovators, and Collaborators.Now I would like to consider what happens when we combine

these traits. Taken together, they spell the word fanatic. I havechosen this word advisedly, because it represents the kind ofunflagging commitment and passion necessary to our greatendeavor the recreation of our profession.

You may have noticed that I have used the word passionrepeatedly. Passion is a priceless commodity. With passion, we canrecreate the face of the healthcare industry, giving occupational

therapy the importance it deserves in the healing process. Thefuture of occupational therapy is a bright one indeed!

PERSONAL QUALIFICATIONS

OCCUPATIONAL THERAPISTS NEED PATIENCE AND STRONG INTERPERSONAL SKILLS TO

inspire trust and respect in their clients.

OTs work with people from a wide variety of social, cultural,economic, and ethnic and religious backgrounds, so flexibility,open-mindedness, and the ability to communicate with a variety of clientsare important.

Ingenuity and imagination in adapting activities to individual needsalso are assets. Those working in home healthcare must be able to adaptsuccessfully to a variety of settings.

Because OTs work long hours in a job that is both emotionally andphysically demanding, a high energy level and an ability to handle stressare important.

ATTRACTIVE FEATURES

THE MOST COMPELLING FEATURE OF THE CAREER IS THE ABILITY TO MAKE A POSITIVE

difference in the lives of many people. There is always a sense that you and

your skills are needed and appreciated by the clients you serve.

In addition, occupational therapy is adaptable to so many differenttypes of settings, that OTs have their choice of working where they want

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and with the types of clients they prefer. Some settings, such as homehealthcare, allow a great deal of flexibility in scheduling.

In addition, occupational therapy is a job that challenges itspractitioners in a variety of ways physically, emotionally, creatively, and

spiritually each and every day. That challenge and the variety of the jobmake it difficult to leave. When occupational therapy gets into yourblood, its tough to walk away from.

UNATTRACTIVE FEATURES

BEING AN OCCUPATIONAL THERAPIST IS NOT FOR THE FAINT OF HEART. IT IS A

physically and emotionally demanding career that can have a way of

consuming other aspects of your life a problem that eventually can leadto job burn-out.

OTs work with patients who are recovering from an illness or injuryand are at their most vulnerable. They can demand a great deal ofpatience and understanding. The therapist also must deal with familymembers who can be anxious and demanding.

The job can be physically tiring because OTS may work long hours and

are on their feet much of the time. Therapists also face potential injury,such as back strain from lifting and moving clients and equipment.

Those providing home healthcare may spend several hours a daydriving from appointment to appointment.

In addition, OTs, like other healthcare professionals, must work in aclimate where the kind of services clients need and how long they can beprovided are being dictated by HMOs, insurance companies, and otherthird party payers, rather than the healthcare providers themselves. Thiscan lead to frustration on the part of both the therapist and the client.

WORKING CONDITIONS

OCCUPATIONAL THERAPISTS IN HOSPITALS AND OTHER HEALTHCARE AND COMMUNITY

settings generally work a 40-hour week. Those in schools may alsoparticipate in meetings and other activities, during and after the school

day. Almost one-third of occupational therapists work part time.

In large rehabilitation centers, therapists may work in spacious roomsequipped with machines, tools, and other devices.

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Therapists are increasingly taking on supervisory roles. Due to risinghealthcare costs, third party payers are beginning to encourageoccupational therapy assistants and aides to take more hands-onresponsibility. By having assistants and aides work more closely with clientsunder the guidance of a therapist, the cost of therapy should be more

modest.

EDUCATION AND TRAINING

THE FIRST STEP IN BECOMING AN OCCUPATIONAL THERAPIST IS TO DO A CAREER

investigation and learn as much as possible about the field. A good placeto start is with the career planning and placement offices of colleges and

universities that offer occupational therapy programs. The staff there istrained to administer tests that determine individual preferences and needsrelating to careers.

Another important part of assessment is to gather information from avariety of sources. Many people think they know what occupationaltherapy involves, but they may never have observed an OT or received OTservices. Search the World Wide Web for occupational therapy oroccupational therapist. Interested individuals may also want to contact

state and national occupational therapy associations to receive printedmaterials.

When you have learned more about the profession and your ownprofessional preferences, you are ready to do a self assessment. Askyourself how well you receive feedback, how well you relate to a variety ofindividuals from different backgrounds and cultures and what you feel areyour strengths and weaknesses. Also, consider what your salary goals are,where you would like to live, and the kind of work schedule you would like

to have.

Try to be as objective as possible. Gain additional insights fromteachers, friends, family members, current and past employers, andmentors. If possible, contact a local acute care hospital or rehabilitationcenter and ask to interview an occupational therapist to learn first-handabout the job.

When you have done all of this and you are convinced that

occupational therapy might be a good career fit for you, evaluate a varietyof programs at colleges and universities.

A bachelors degree in occupational therapy is the minimumrequirement for entry into the field. You may enroll in an accredited

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four-year college program leading to a degree in occupational therapy, oryou may be able to transfer to an occupational therapy program after twoyears in a liberal arts program. Course work includes physical, biological,and behavioral sciences, and the application of occupational theory andskills. After the four-year program, students also must complete a

supervised clinical internship of at least six months. Specific requirementsfor admission or transfer are set by the individual educational program.

All states, as well as Puerto Rico and the District of Columbia, regulateoccupational therapy. Although requirements vary from state to state, toobtain a license, all applicants must have graduated from an accreditededucational program and pass a national certification examination. Thosewho pass the test are awarded the title of registered occupationaltherapist.

College graduates who already hold a degree in another field maychoose an entry level masters degree program or a post-baccalaureatecertificate program. A certificate program is one that, upon completion ofacademic course work and fieldwork, awards a certificate rather than adegree. The certificate enables the graduate to take the nationalcertification exam. There are a few states that require a degree in theprofession for licensing. Therefore, a certificate might not be as marketableor transportable to other jobs as a degree. Students who are consideringentering the field should check with the regulatory board in the stateswhere they intend to work.

During their careers, occupational therapists are expected to regularlyparticipate in continuing education programs. The American OccupationalTherapy Association offers hundreds of workshops, courses, and otheropportunities for new and experienced practitioners. The events alsoprovide an opportunity for networking and sharing new practice strategies

and techniques.The AOTA has established standards for the profession that have been

adopted by many states in their laws and regulations. The association alsohas accredited the nations 300 programs and colleges throughout theUnited States.

Leading undergraduate programs in this field are offered at theseinstitutions:

New York UniversityBoston University

Wayne State University

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Temple University

University of Minnesota

State University of New York College at Buffalo

Colorado State UniversityUniversity of Florida

University of Oklahoma

University of Southern California

University of Wisconsin - Madison

JOB OUTLOOK

THE CAREER OUTLOOK FOR OCCUPATIONAL THERAPY APPEARS TO BE IN A STATE OF

transition. The shortage of OT practitioners that marked the 1980s andearly 1990s seems now to have been replaced by a balance in the overallsupply and demand.

Shortages and vacancies are being reported in rural areas and in

several practice settings, for example, in school systems needing pediatricpractitioners. These shifts in demand for OT practitioners reflect some ofthe changes affecting healthcare delivery, with its increased reliance onmanaged care. But while payment and reimbursement for OT service areundergoing changes, the need for those services can only increase, giventhe demographic trends in the US.

In general, the demand for OTs is expected to increase by over 50percent by 2006 more than for almost any other profession. The fastest

growing segment of the population is the elderly, and their need for OTservices is clear. Advances in medical care contribute to the growth ofother populations who will need the special skills of the occupationaltherapy practitioner.

For example, sophisticated neonatal intensive care assures the survivalof premature infants, many of whom face developmental difficultiesthroughout their childhood. Advanced trauma services in emergencyrooms means more lives saved. But survivors of spinal cord, traumatic

brain, and severe orthopedic injuries require extensive occupationaltherapy.

Finally, new ways in which occupational therapy practitioners mayflourish are becoming evident. Most prominently, the prevalence of the

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computer in all areas of todays life employment, leisure, and learning means that the special skills of task analysis and ergonomics will be calledupon. Preventing and treating the symptoms of repetitive strain injuries isa growing field into which OT practitioners are naturally qualified to move.

Other practice areas with potential for occupational therapy relate tothe American consumers embracing of a more holistic approach to health.Here, issues of lifestyle management and wellness are ones in which OTpractitioners already have applicable skills.

EARNINGS

ACCORDING TO RECENT SURVEYS, FULL-TIME SALARIED OCCUPATIONAL THERAPISTS

earn between $800 and $1000 a week. According to one survey of acutecare hospitals, the median annual base salary of full-time OTs is about$45,000. Those at the top of the pay scale earn about $50,000.

Salaries vary widely, of course, depending on location, the type offacility, and skill or experience level. Therapists who work in specificpractice areas may be compensated for advanced skills or training.Therapists who work in private practice tend to earn more than thoseholding staff positions.

When considering whether to accept a position, determine not onlythe base salary but benefits offered, including medical and dentalinsurance, malpractice insurance, continuing education, and travelbenefits. Also consider the number of work hours, what time of day thosehours will be and the conditions under which you will work.

GETTING STARTED-GAINING COMPETENCIES

HIGH SCHOOL STUDENTS WHO ARE INTERESTED IN BECOMING OCCUPATIONAL

therapists should take college preparatory courses. The following coursesin high school may be helpful to prepare you for your college career:

Biology

Chemistry and physics

English and other writing coursesHistory or social studies

Foreign languages

Mathematics

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Computer science

Psychology and/or sociology

Choose course electives to compliment your career goals. These mightinclude art, sewing, cooking, and other industrial arts courses. Many of the

activities learned in these classes involve activities of daily living or activitiesthat can be used in treating patients.

Here are some other things you can do right now to help gain theskills and information you need to become an occupational therapist.

Complete a co-op, intern, or volunteer experiencein ahealthcare or human-services setting. This will provide you with on-siteexperience and help you to learn good work habits early.

Joinart, music, and theater extracurricular activities to helpexpand your creativity.

Conductinformational interviewswith people in the occupationaltherapy field.

Attendcareer and job fairsthat feature job opportunities in OT andtalk to recruiters about what they like to see in potential candidates.

Attendrelevant conferencesand seminars about OT and thehealthcare profession as a whole.

Participate in a student exchangeor study abroad program to learnabout other cultures.

Becomefamiliar with work settingsand job descriptions by visitingclinics, hospitals, schools, and businesses where OTs work.

Joinsports activitiesto help you maintain or improve your wellness

and learn about your muscles and body.Practicemaking decisionsby supervising a group of people.

Actas a leaderin a student or civic organization.

Practicepublic speakingin classes or in organizations.

Tutorstudentsin various subjects. This will give you experience ininstructing others.

Developa new campus organization.

Joina professional organizationsuch as the American OccupationalTherapy Association.

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COMPUTERS AND OTs

COMPUTERS ARE BECOMING AN IMPORTANT TOOL IN OCCUPATIONAL THERAPY AND

will continue to play a growing role. Those considering a career in the fieldwill want to gain proficiency in computer and Internet use as early as

possible.

When I became an occupational therapist more than a decade ago,only a few clinicians had used a computer, one OT says. Now, just ageneration later, few therapists have not used a computer. Increasingly,occupational therapists around the world are using computers to fill avariety of functions in and out of the clinic.

Computer users are generally quick to point out that, good as

computers are, they do have their down side. Finding the right mix ofhardware and software to meet the need and the budget is the first issue.Then, there are the extra hours spent learning to use the hardware andsoftware.

Finding the right connection to the Internet is not always easy orwithin budgetary constraints. Even after one finds and pays for theconnection, time is required to learn how to connect to and function onthe Internet. Several Internet users warn that surfing the net can take up

quite a bit of time if one is not careful, especially at first when the softwareneeds to be configured and the user needs to learn how to use it. Otherscaution about the possibility of becoming lost in an alluring, new,electronic world.

Nevertheless, computer users identify many benefits. Many users ofelectronic, internationally-based discussion groups, comment on theirbroadened understanding across specialties, cultures, and geographicalboundaries. Therapists who are geographically isolated delight in the sense

of community and collegiality they have gained from their contact withother therapists on electronic discussion groups. Several therapists praisethe efficiency in time, cost, and natural resources which e-mail hasbrought to communications whether for a few team members in onesclinical setting, or hundreds of colleagues on an electronic mailing list.Most therapists appreciate the educational and professional growthopportunities the Internet affords them.

Occupational therapists who use computers as treatment tools withtheir patients are outspoken in their praise for the role of the computer asa playing field leveler for individuals with disabilities.

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How are occupational therapy practitioners usingcomputers in the clinic? Computers are used by clinicians asstand-alone tools for creating, processing, and displaying information, andthey are used as links to other computers (linked computers are called anetwork). On another dimension, computer use can be seen as supporting

the roles and functions of a therapist, including administering/managing,planning and documenting patient programs, communicating, conductingresearch, growing as a professional, and direct patient training.

A manager of 20 pediatric OTs in a large hospital finds e-mail to be afantastic tool for increasing communication and making everythinghappen a little faster. I download and print-out a variety of messages froman electronic discussion group and distribute them to my staff. I also usethe Internet for this purpose, by regularly checking out the OT related sites.I have templates I have created for my client-related reports, which havesaved a lot of time.

Other therapists note that they use Lotus, Excel and invoicingprograms and other spreadsheet or database programs for billing and forcase management. Faxing reports directly from the computer is also afavorite efficiency of some managers.

At a clinical site where most of the clients are preschoolers, computers

are used to assess and treat the children, so the computer station at theclinic is part of introducing technology to children. Its use helps the familydecide what software and hardware will work at home.

At another site for children, the treatment teams use computers forassessment and evaluation, with appropriate software, for physical accessassessments, and for training and skill development in areas ranging fromcause and effect to literary skill development.

Several therapists note their appreciation for on-line courses they havetaken using their e-mail, while others appreciate the electronic newslettersand journals. Still others have exchanged articles with e-mail colleagues.One therapist put her experience this way: I find that surfing the Internetis very interesting as it exposes me to areas I wouldnt otherwise attend to.The discussions are a rich source of thought and interpretation. Thespontaneity is energizing as are the unique perspectives that come throughpersonal discussion as opposed to journal reading.

E-mail enhances professional communication. It fosters contact withother OTs even when geographical or other barriers prevent physicalcontact. E-mail affords therapists the opportunity to see themselves ashealthcare professionals who are members of a global community and

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who share concerns and responsibilities with other therapists around theworld. Therapists whose specialties are narrowly focused and unusual arelikely to find an international community of colleagues on the Internet.What most newcomers to e-mail and electronic discussion groups findremarkable is how easy and cost-effective e-mail can be. For someone who

has good software, many contacts can be made with very little effort.

One therapist said, E-mail permits me to communicate with persons Iwould not necessarily telephone or write to, for example, with an authorwho wrote a book of interest and who greatly inspired me because of herresearch and her publications. I found her e-mail address, sent her amessage in which I introduced myself and there began a wonderfulprofessional relationship.

Another clinician says, What I find fascinating about e-mail is theability to interact with people of similar interests, and perhaps differentopinions, from a whole variety of backgrounds. I find this interchange tobe very broadening.

As good as communication by e-mail is, one respondent notes that itwill get better as users learn new writing skills which are better suited toelectronic communication, such as breaking up blocks of text, usingmeaningful subject lines in e-mail communication, keeping messages

short, and selecting reply options more carefully when communicating vialists.

Some Examples of OTs Using Electronic Communicationin Their Practices

Consultant Gathers Data From the World Wide Web and E-mail

This year in my medical-legal consulting I was asked to comment on

the likelihood of a musician having an occupationally related injury. I didthe typical search on my universitys data bases and found a very smallamount related to occupational injuries in this type of musician; it wasquite general and therefore not too helpful.

I searched with two key words on the Internet to see what else Icould find. I found an article by someone doing her PhD on the exactsubject. It was quite an informative discussion and pointed out some ofthe issues. It was fascinating. I also found a bibliography, 198 pages long,

listing occupational injuries of performing artists. I saved this and searchedit by keywords to narrow it down to the particular type of musician I wasconcerned with. I was then able to select a few articles and have the libraryget them for me through regular inter-library loan. These articles were in a

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journal that was not in the regular databases. They were specificallyrelevant to my question.

I e-mailed the person who maintained the bibliography and asked fornames of relevant treatment centers and got a reply the next day. All this

from my desk at home!When I do go to the library I already know what I am looking for so

it really saves me time. I can do the search at home in the comfort of myown office.

Obtaining Information About Surgical Intervention for My

Client

I am an OT, living and working in a rural area. I have a young girl

client who has Charcot-Marie-Tooth (CMT) Disease, and last fall Idiscovered what a powerful tool the computer was to help me connectwith other persons who have this disorder.

I accompanied the girl to a hospital in another state. The doctorthere suggested she have bilateral plantar fasciotomies. The familys doctorat home was not positive about this surgery. That was a difficult positionfor me and the parents to be in whose judgment do we listen to?

I learned that there is a CMT electronic discussion newsgroup. Iwrote a message to the people on this list (at that time there were 40people; there are now 85) asking if any of them had experience with thissurgery and would they be willing to write to me. When I came home thatnight after work I found 18 messages! (from Norway, Holland and the US).Three of the respondents had experienced this surgery and shared with metheir views on it. The other messages were very supportive messages.

I was very touched by these replies. Living in a very rural area as I do,

there are no CMT support groups, and I didnt know how to help the girland her parents.

The end of the story is that my client had the surgery (she is 15) andis very glad she did so. She finds it easier to walk and can now wear shoes.Also, she can get her feet into ski boots and managed to ski at Christmas. Iam now on the Internet all the time and have found various supportnewsgroups very helpful in obtaining information for my clients and theirfamilies.

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Continuing Education on the Internet Many therapistsrecognize the educational value of the Internet for entry-level, continuing,and specialty education. Of particular interest is the potential of theInternet to broaden access to learning opportunities in other parts of theworld. One therapist who is currently teaching a course to two audiences

at the same time using closed televideo believes this sort of teaching willincrease in the future.

ASSOCIATIONS

To learn even more about this career, you may want to contact industry

trade associations and organizations and ask them to send informationabout careers in this field. Consult a directory of associations in your libraryfor current addresses and phone numbers.

American Occupational Therapy Association

American Occupational Therapy Foundation

National AMBUCS, Inc.

State Occupational Therapy Associations

Tri-Alliance

World Federation of Occupational Therapists

PERIODICALS

Advance Newsmagazines for Occupational Therapists

American Journal of Occupational Therapy

Journal of Occupational Therapy Students

OT Practice

OT Week

[institute for career research] career as an occup(bookzz.org)

Documents