Pocket Prep connected with a licensed and registered occupational therapist to explore the major differences between OTs and OTAs. If you’re on track to take the Occupational Therapist (OT) exam or Occuptational Therapy Assistant (OTA) exam, learn the similarities and differences between the two certifications.

Author: Brittany Ferri

Many people struggle with understanding the ins and outs of occupational therapy. Across many fields and specialties, the differences between the roles within this profession are even more nuanced for the general public.

When it comes to being in the field, understanding the differences between common certifications such as the OT and OTA is a must for studying professionals. Occupational therapists and occupational therapy assistants are similar in many ways, but there are some key aspects of their qualifications and daily responsibilities that set them apart.

If you are working in healthcare, studying to be a medical professional, or simply learning more about health professions, we’re here to help break down the differences between these two skilled providers.

Defining Occupational Therapists

Occupational therapists, abbreviated as OTR or OTR/L, are healthcare professionals who are licensed through their state of practice and nationally certified after passing a written exam. An occupational therapist’s national certification/registration is demarcated by the “R” after their title (OTR) and their state license is indicated by the “L” (OTR/L).

These credentials demonstrate to others that an occupational therapist (OT) is fully qualified to practice within the field of occupational therapy, including major duties such as administering evaluations/assessments; providing treatment through a range of activities; modifying treatment plans and goals; writing daily notes, evaluation reports, re-evaluation reports, and discharge notes; and discharging patients according to the progress they are demonstrating.

Defining Occupational Therapy Assistants

Occupational therapy assistants, abbreviated as OTA, perform many of the same duties that an OT performs, however, with some restrictions. The successful completion of a written exam gives individuals a national certification/registration, which is indicated by a “C” before their title (COTA). An OTA’s state license is noted using an “L” after its title (COTA/L).

These credentials allow OTAs to fully perform within their scope of practice in any clinical setting, which involves treating patients using a range of activities such as writing daily notes and creating preliminary discharge or re-assessment notes to be co-signed and finalized by OTs (only in some settings); relaying progress and the need for goal modification and/or discharge to the supervising OT; and completing evaluations/assessments (in settings and facilities that allow it).

The main difference between the role of an OT and an OTA is the OT’s ability to make final changes to treatment plans. No matter the variations in the scope of practice for each of these professionals, communication between these providers is integral to providing patients with the best and safest care possible.

Practice Settings & Colleagues

Both OTs and OTAs may work in clinical settings such as skilled nursing facilities (SNFs), acute rehabilitation hospitals, mental health hospitals, or acute inpatient hospitals. OTs and OTAs are also found in home health agencies, outpatient clinics, sensory integration clinics, schools, and community mental health settings. Both professionals work typical business hours, often from 9:00 am to 5:00 pm, with an hour or two of variation in their start and end time.

Those therapists and assistants who work in school systems have hours that mirror a typical school day as their role involves seeing children while they attend school. While occupational therapists may work with patients of various ages and with an array of diagnoses, their core responsibilities mentioned above remain largely the same.

A large part of an OT’s and OTA’s job involves working with other medical professionals. Therapists and assistants working in hospitals and nursing facilities may work with registered nurses (RNs), licensed practical nurses (LPNs), doctors (MDs, DOs), physician assistants (PAs), social workers (SWs), physical therapists (PTs), physical therapy assistants (PTAs), speech-language pathologists (SLPs), and/or speech-language pathology assistants.

Those working in mental health settings may interact with social workers, case managers, recreational therapists, behavioral therapists, licensed mental health counselors (LMHCs), licensed professional counselors (LPCs), and activity staff. Outpatient settings often require therapists and assistants to work alongside therapists of other disciplines.

Educational Requirements & Conditions

As of 2020, OTs who are currently in school or are about to enter school are required to have at least a Master’s degree in occupational therapy to practice within their field. There are still some practicing occupational therapists whose highest degree is a Bachelor’s in Occupational Therapy as that was previously the requirement.

There are some occupational therapists who hold a doctorate degree in occupational therapy (OTD), a doctor of philosophy (Ph.D.) in occupational science, or other doctoral-level degrees in related areas. While there has been some discussion of making the doctorate degree mandatory for all occupational therapists, this is not currently a requirement per the American Occupational Therapy Association (AOTA).

OTAs are currently required to hold at least an Associate’s degree in occupational therapy, however, some assistants have returned to school to receive a Bachelor’s degree in a related field to assist in their practice.

Since there is no Bachelor’s degree available in occupational therapy (only an Associate’s, Master’s, and doctorate in occupational therapy), some OTAs may hold a Bachelor’s degree in public health, healthcare administration, or similar degrees to assist in endeavors such as management or owning a private practice.

Despite all of the requirements for practice, there are ample opportunities for both OTs and OTAs to expand their knowledge by receiving additional degrees and certifications in occupational therapy or a closely related field.

Occupational therapists and assistants alike have the ability to obtain industry-specific certifications in areas such as neurodevelopmental therapy (NDT), driving rehabilitation, and low vision specialist to assist in their treatment of certain populations and diagnoses.

Occupational Therapist Salary Expectations

While salary can vary between practice settings and geographic locations, the U.S. Bureau of Labor Statistics estimates that occupational therapists make an estimated $40 per hour or between $80,000 to $85,000 yearly. Additional numbers from U.S. News note that occupational therapists make an average of $84,000.

Similar differences between location and practice settings also apply for occupational therapy assistants. The U.S. Bureau of Labor Statistics estimates OTA salaries to be $28 per hour or roughly $55,000 per year.

Some of the highest paying practice settings for both occupational therapists and occupational therapy assistants are home health agencies and skilled nursing facilities. Therapists and assistants working in hospitals and outpatient also benefit from competitive pay, but not as high as nursing facilities and home health.

Some of the lowest paying practice settings for therapists are school-based settings, mental health settings, and nonprofit organizations/community agencies.

Occupational therapists and assistants who work their way up to positions such as therapy manager, clinic director, CEO, founder, and other management-level titles typically receive higher salaries due to their additional responsibilities.

Who Is Cut Out to Be An Occupational Therapist?

One of the most important aspects of these jobs is the total time commitment involved. The schooling to receive a Master’s degree and become an occupational therapist is roughly 5.5 years from the point of starting a Bachelor’s degree to the end of a Master’s degree program.

Individuals who wish to become occupational therapists must consider if they have the time and resources to cover other life responsibilities such as childcare, pet care, additional income needs, or even household tasks during this stretch of time. They also must consider their financial ability to take on debt or bills for that length of schooling.

Due to the complexities involved with planning your life around going to school to become an OT, I have found that occupational therapists are often creative and excellent at critical thinking. These traits not only assist them in completing OT school but translate wonderfully into the field when they begin treating patients.

Who Is Cut Out to Be An Occupational Therapy Assistant?

Currently, OTAs require about two years of schooling for an Associate’s degree, state licensure, and national certification. Despite OTAs having a shorter time requirement to complete their schooling, these professionals must demonstrate similar levels of critical thinking and creativity to excel in their role. Additionally, the OTAs that I’ve known are also incredibly driven and immediately jump into the field once graduating to begin making an impact in healthcare.

OTAs also use skills such as adaptiveness and flexibility to provide patients with the best care possible. Each of these traits sets the field of occupational therapy apart from other professions and allows our providers to make a unique and lasting impact in the lives of others.

While there are some differences in pay between an OTA and OT, both professionals have similar daily responsibilities. Those duties include treating patients, communicating with other healthcare professionals, and documenting patient progress to modify goals or determine the need for discharge.

Which One Is Right For You?

Individuals who are looking to enter the field sooner than later should consider pursuing an OTA certification due to its lesser time commitment. One of the benefits of taking this route is the ability to re-enter school and become an OT at a later time if you change your mind.

Individuals who can swing a longer upfront commitment or have longer-term income goals are oftentimes better suited to pursue an OT designation. Getting on-the-job experience and learning the ins and outs of the industry at the ground level is the best way to make an educated decision on if this is the best pathway for you.

Both occupational therapists and occupational therapy assistants make significant differences in the world. Each of these professions allows individuals great career mobility, work opportunities, and the development of specialties. Both professions provide excellent opportunities to help others and make a positive difference in healthcare and beyond. hue

Author Bio:
Brittany is a licensed and registered occupational therapist specializing in cognitive and psychiatric rehabilitation. She is also a certified trauma provider. She is the founder of Simplicity of Health, LLC where she provides health writing, consulting, and community wellness education. She has her Bachelor’s in health science studies, a Master’s in occupational therapy, and is actively pursuing her Ph.D. in integrative medicine.