OTs have a unique client-centered approach to services and a distinct educational background focused on offering assistance to individuals with physical and mental challenges to increase their independence, improve their quality of life, and help them to participate in meaningful occupations through skills acquisition. They conduct comprehensive evaluations of client environments; recommend and train on adaptive equipment; provide support for physical, cognitive, and psychological aspects; teach how to modify an activity or task to facilitate participation; and provide education for clients and caregivers (AOTA, n.d.d.). OTs look at areas of occupation related to ADLs, IADLs, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2014). Client factors, performance skills, performance patterns, contexts, and environments are all taken into consideration (AOTA, 2014).
OTs are qualified to work in several roles. For instance, they can practice as a direct service provider, consultant, educator, advocate, researcher, and within leadership roles (AOTA, n.d.e.). They can also be policy developers and entrepreneurs. The combination of an OT's graduate-level degree, experience, and continuing professional development shows that the individual is competent to fulfill each of the roles mentioned above and related employment positions (AOTA, n.d.e.).
Direct Service Provider
As a direct service provider, an OT assesses all areas of occupational functioning, creates a treatment plan, provides intervention, and completes discharge when the time arrives (Heilfrich, 2019). An OT can also provide referrals to other services if needed. Specific treatments chosen by an OT are dependent upon the identified areas of need. Some examples include addressing basic self-care skills such as grooming, bathing, medication management, and nutrition. Skills that support independent living are also commonly addressed through job skills, house management skills, community integration, and money management. An OT may also address biomechanical deficits by assisting an individual in adapting to their limitations or by helping reduce the limitations in order to enable better participation in daily activities (Heilfrich, 2019).
There are numerous assessments that an OT can utilize as a direct service provider to evaluate a client holistically (Heilfrich, 2019). The purpose of assessments is to facilitate identifying a client's strengths and limitations regarding their independent functioning. Assessments also assist OTs in determining a client's needs in order to manage within various environments of choice. OTs' distinct value in assessment, when compared to other staff members, is that they are likely the only professionals with the skills to look at the functional, medical, social, and environmental aspects that influence a client's occupational performance. Furthermore, an OT is able to complete functional evaluations of clients. After interpreting the results of the evaluation, the OT can make recommendations for referrals or service plans as needed (Heilfrich, 2019).
The field of OT has an extensive history of activism and it is imperative that OTs have the qualities of an advocate (Kirsch, 2015). The role of an advocate entails representing others, pleading a cause, taking action, and/or providing support. OTs must advocate for their clients in a variety of ways (Stover, 2016). OTs can also be advocates for potential clients, students, co-workers, and more. The role of an advocate can be carried out in conjunction with all other OT related roles.
It is an imperative role for an OT interested in unconventional areas of OT. Advocacy has the power to bridge gaps between social forces, an individual's experience, policymakers, and the lives of clients (Kirsch, 2015). Advocation is at the heart of OT due to its client-centered foundation and without it, more clients would go without their needs being met, OT would likely disintegrate as a profession, opportunities for growth would be slim, many norms would go unchallenged, and more injustices would occur. Advocacy also embodies the principles of beneficence, veracity, and justice, which are included in the Occupational Therapy Code of Ethics (Stover, 2016).
An OT policy developer is concerned with legislation and how it impacts the OT profession, their clients, and potential members of society who may benefit from OT services. Participating in policy development enables an OT to have a voice, advocate for others, educate politicians, to enact or prevent change, and facilitate standards. Policy affects reimbursement rates, eligibility, limits, and professional acknowledgment. OT practitioners also benefit from understanding and engagement in policy in order to align policy with the values of the OT profession (Lencucha & Shikako-Thomas, 2019). Without OT policy developers, the field would unlikely be able to expand their reach of services, ensure continued support for specific groups of people, and maintain respect within healthcare.
An OT entrepreneur is typically considered a businessperson who designs, creates, and runs a business or program based on new, unique ideas often with considerable risk within the context of OT. Their goals often relate to generating financial gain, expanding opportunities to those in need, addressing unmet needs of society, and increased independence. Businesses and programs are essential for the implementation of OT services on an organizational level and without entrepreneurs, there would be less diversity in OT service implementation. Implementing new business/program ideas often comes with high risk and the field of OT benefits from those willing to take them. Competency in regards to entrepreneurship is also essential for enhancing OT's leadership within healthcare (Lachter & Szymanska, 2016).
As a consultant, an OT may provide consultation to an organization in general and its staff by offering recommendations regarding programming (Heilfrich, 2019). This may include assisting the staff with structuring routines to promote normative habits and routines (Heilfrich, 2019). Moreover, OTs can identify occupational risk factors for support staff associated with inappropriate boundaries with clients, poor stress management, and poor understanding of proper safety procedures when working with clients who have complex medical, substance abuse, and mental health concerns.
An OT can also give recommendations regarding environmental management (Heilfrich, 2019) by identifying and addressing barriers for all individuals within the organization in regards to accessibility. For instance, a building's design could pose challenges for an individual who uses a wheelchair or experiences sensory processing related issues, which could negatively impact their occupational performance. Support staff may also face challenges related to their facility's design that could contribute to extra time and effort in completing their daily work tasks. OTs are equipped with the knowledge and skillset required to manage the above concerns through task analysis, environmental analysis, and education.
An OT in a consulting role can also provide service to clients (Heilfrich, 2019). Often this takes place in the form of a group that focuses on developing a particular skill. These skills can be based on various life skills, such as community transportation, employment skills, leisure, and sexual education. A key difference between leading skill development in the consultant role versus in the direct service provider role is that the OT often lacks a complete picture of the clients that they are working with. This factor is contributed to the fact that each client has not been individually evaluated and that the OTs may only be on site a limited number of times to conduct the groups (Heilfrich, 2019).
Because the field of OT is broad and its main focus is regarding participation in activities, the role of a consultant is very flexible and will greatly be influenced based on who is receiving consultant services. OT consultants are important because they demonstrate expertise and allow for participation in less traditional environments.
Leader / Administrator
Strong, collaborative, and comprehensive leaders are
a necessity within healthcare (Sonnino, 2016). OTs can fulfill the role of a
leader in many different ways such as creating an environment where others
can contribute their maximum potential while supporting the mission of an organization.
The role of an OT administrator often entails being a leader of an organization, department, or within a university as staff. As a leader, they provide guidance, support, expectations, and structure to those within their environment. Usually, their goal is to promote the success of individuals within their workplace and fulfillment of their organizational/departmental objectives. Without administrators, there would be a lack of leadership, structure, and increased responsibilities for those who currently benefit from administrators.