Work Environments for Occupational Therapists

You can find occupational therapists (OTs) working with people from the neonatal unit to hospice programs. OTs have the opportunity to specialize, leading to work ranging from inclusive design consultants to surfing therapy.

Occupational therapist working with a man's elbow
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OTs receive education in the basic components of health and healing (anatomy, neuroscience, psychology, group dynamics, etc.) and how this intersects with participation in the daily tasks of life (we use the old-school term “occupations” to describe these daily tasks).

This education equips OTs to help individuals participate more fully in their daily lives. Often an OT who is fresh out of school will go straight into one of the most common work settings. From there, they may specialize within that setting or perhaps transition to one of the specialized workplaces.​

The Most Common Settings Where OTs Work

salary and workforce survey by the American Occupational Therapy Association provides insight into where OTs work. 9664 responses were compiled from OTs, certified occupational therapy assistants (COTAs), and OT students. There are around 150,000 OT and COTA jobs in the US, so the survey is not fully representative of all OTs, but it does provide some of the best information available about their work. Here is the percentage breakdown of where OT respondents to the survey work:

  • Hospital Setting—27%
  • Long-term Care/Skilled Nursing Facilities—19%
  • Schools—20%
  • Freestanding outpatient clinics—11%
  • Home Health—7%
  • Academia—6%
  • Early Intervention—5%
  • Mental Health—2%
  • Community—2%
  • Other—1%

What the “Other” Category Entails

This is where things get interesting. Other somewhat common examples would be hospice programs and work hardening programs. There seems to be a growing number of OTs who are working “from home” and taking on business ventures, such as coordinating an outdoor play program, writing, and blogging, or working for a telehealth company.

Where Certified Occupational Therapy Assistants Work

The numbers varied for COTAs, with a much higher percentage working in long-term care/skilled nursing facilities (56%). From there, the numbers followed the trend of occupational therapists, but with a lower percentage in each category.

What These Numbers Don’t Capture

These numbers capture where the therapist is working, but not what they are doing in that setting. For example, an OT in a freestanding outpatient clinic might be a hand therapist, a lymphedema therapist, specialize in autism or sensory integration.

The numbers are skewed toward therapists who are involved in the national association and likely to answer surveys. For example, the percentage working in academia feels a little high, but these therapists are probably more likely to be involved in the national organization.

Why the Different Settings Are Good to Know

If you are an OT or aspiring OT, it is good to have a realistic understanding of where most OTs work. It is also helpful to be aware of which settings boast the highest salary for OTs. Here is the ranking of the best-paid settings, according to the AOTA survey:

  1. Academia
  2. Home Health
  3. Long-term Care/Skilled Nursing Facility
  4. Other
  5. Community
  6. Mental Health
  7. Hospital
  8. Free-Standing Outpatient
  9. Schools
  10. Early Intervention

For OT consumers, it is good to recognize the scope of an OTs education and the many points in life where occupational therapy can be beneficial. If you are seeking help participating more fully in your life in the midst of following a health incident and considering occupational therapy, it could also be beneficial to read about the many specialties that OTs pursue.

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