Where Can I Work with an Occupational Therapy or Occupational Therapy Assistant License?

  • Renee Leuschke
  • |

Healthcare jobs are in demand, there’s no doubt about that, and Occupational Therapy is predicted to grow 24% (described as “much faster than average”) in the next ten years, according to the Bureau of Labor Statistics. That’s awesome!  There’s no doubt this fact will influence many current students to obtain an Occupational Therapy license in the hope that they can secure a well-paying job post-graduation. But what exactly does this mean?  What kind of options do Occupational Therapists have for work?  Your initial thought may be hospitals, schools, nursing homes—and you would be correct. But a much larger variety of positions exist within these three general types of facilities.

Hospitals

Hospitals are complicated places. A wide variety of healthcare providers work here, all playing their part to diagnose, treat, and improve a patient’s ability to return home. Where does Occupational Therapy fit in?  Most often, Occupational Therapists are working at four main branches of a hospital—acute care, inpatient rehabilitation, home health, and outpatient care.

Acute care Occupational Therapists primarily evaluate a patient’s functional abilities and assist with making recommendations for home to ensure safety and independence, or recommendations for further rehabilitation. They will often follow a patient through their acute care stay, but as length of stay may be rather short, they have limited hands-on time with each patient. Acute care Occupational Therapists typically work on a variety of medical floors—intensive care units (ICU), cardiac, neurology, oncology, orthopedic surgery, general medical/surgical, and burn units. Opportunities are high for learning a lot about a wide variety of diagnoses.

Occupational Therapists working on an inpatient rehabilitation floor (or rehabilitation hospital) are much more involved in patient care. In total, therapy provides three hours of skilled care to each patient every day, with occupational therapy making up at least one hour of that time. A strong focus is placed on improving independence in basic daily tasks (dressing, showering, cooking, etc.) as well as strengthening and improving balance following a new diagnosis or prolonged hospital admission. Occupational Therapists work hard in this setting, but it can be one of the most fun jobs as well as one of the best to learn basic skills.

Following a hospital stay, a patient may be referred to Home Health Occupational Therapy to continue to address functional needs. Occupational Therapists working home health (either for a hospital system or a private home health company) drive to each patient’s home to provide treatment related to self-care, home-making tasks, and strengthening. Therapists need to be able to work somewhat autonomously as they will not have fellow co-workers nearby. Documentation for home health visits is completed at the therapist’s home.

Occupational Therapists working in outpatient therapy (again, either hospital-based or private practice) enjoy several subsets of specialization. Many therapists work in outpatient therapy treating primarily hand injuries and surgeries. These therapists fabricate splints, provide exercises, and treat issues via a variety of modalities. Larger hospital systems often have several Occupational Therapists who only treat neurological diagnoses such as stroke, brain injury, and spinal cord injury. These therapists work with patients to obtain their individual goals which may range from strengthening a weak arm, improving coordination, improving independence in daily life tasks (dressing, cooking, paying bills), or improving visual impairments to return to driving. Driving rehabilitation specialists are also typically Occupational Therapists working at an outpatient clinic, but a specific certification is required to evaluate driving.

Specialty hospitals may not have as many openings for Occupational Therapists, but opportunities do exist to work in long term acute care hospitals (LTACH’s). These hospitals provide extended care to patients with complex medical needs (such as ventilators).

Pediatric hospitals are also an interesting option and employ many Occupational Therapists to work with children of all ages and abilities. Therapists may work with children following new serious diagnoses, injuries, or surgeries, but also provide treatment for newborn babies in neonatal units (NICU). Pediatric hospitals provide great opportunities to practice clinical skills relating to child development as well as physical disabilities.

Veteran’s hospitals also provide Occupational Therapy services, although if you are interested in working more closely with current military members, you may search for positions specifically on a military base.

Skilled Nursing Facilities

Skilled Nursing Facilities provide a large quantity of Occupational Therapy jobs. Occupational Therapy treatment at these facilities is similar to that provided in hospitals. Patients may reside in a facility short- term for rehabilitation prior to returning home or may reside long-term. Treatment also focuses on functional independence similar to hospitals.

Hospice care

Occupational Therapists working in hospice care help patients maintain an active role in desired activities. The focus in this setting is maintaining quality of life and comfort. Occupational Therapists may assist with caregiver training, positioning in bed, and gentle range of motion exercise to help maintain safety, comfort, and mobility. The American Occupational Therapy Association provides a great fact sheet further discussing this less-typical setting.

Mental Health

Occupational Therapy positions in mental health, whether hospital or community-based, are slim in comparison to hospital jobs. Therapists provide useful services to inpatient psychiatric hospitals, assisting with determining effectiveness of medication, guiding therapeutic groups, and assessing and treating specific functional needs. Community-based therapists work with patients to improve the ability to live independently. Mental health is very challenging yet rewarding and will challenge you be to a highly creative and flexible Occupational therapist.

Pediatric Clinics

Are you more interested in working with children?  Occupational Therapists working in pediatric clinics often provide specialized services such as sensory integration, feeding, visual impairments, fine motor coordination, and splinting. Patients are seen on an appointment schedule similar to other outpatient clinics. Typically, these facilities provide services to children less than 12 years of age.

Early Intervention

Early Intervention is a service provided by states to provide therapy to infants and toddlers who are experiencing developmental delay or disability. Services are typically only provided to children under three years old. Occupational Therapists evaluate children by testing their current developmental skills level. If a child qualifies for services, therapists provide treatment in the child’s home and work on reaching milestones related to motor skills, play, sensory processing, and parent education.

Schools

School systems are a very popular treatment “facility” for Occupational Therapists. Children identified as requiring Occupational Therapy receive a set number of minutes of treatment each week depending on their level of need. Treatment services are similar to a pediatric clinic, although a stronger focus may be on handwriting (fine motor coordination) as this is a required classroom occupation. Occupational Therapists in this setting also help develop Individualized Education Programs (IEPs) for each child they treat and attend meetings with other therapy providers, school staff, and parents as they work toward meeting IEP goals.

Are you surprised by the variety of job possibilities?  Although these are the most common placements for occupational therapists, careers also exist outside the clinical realm, truly providing opportunities to keep your chosen profession fresh. Learn how to become an occupational therapist, what online programs in occupational therapy entail, and get additional insight into career options and salary potential today.

Renee Leuschke

Meet The Author

Renee Leuschke is a Master of Science in Occupational Therapy Registered & Licensed with over 10 years of experience working in hospitals and outpatient clinicals. She obtained a Bachelor of Science in Psychology from Southeast Missouri State University and a Master of Science in Occupational Therapy from the University of Illinois at Chicago. She currently works with clients with neuro-related diagnoses such as stroke, traumatic brain injury, spinal cord injury, and multiple sclerosis.

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