Occupational therapists are healthcare professionals who help people with physical, developmental, or cognitive challenges perform everyday activities more independently. By helping patients overcome their limitations, they play an important role in rehabilitation and supporting greater independence in daily life.
If you’re interested in pursuing a career in this profession and want to know how to become an occupational therapist, this article will walk you through the qualification process from the beginning of your education to professional licensure.
We will also take a closer look at the nature and responsibilities of the profession, explain how occupational therapists differ from similar healthcare professionals, and explore the opportunities available for further specialization after entering the field.
Understanding the Occupational Therapist Profession
Occupational therapists are healthcare professionals who work with people whose ability to carry out everyday activities has been affected by changes in their physical, cognitive, or emotional functioning.
Rather than focusing on treating the condition itself, these professionals examine how the resulting limitations affect a person’s ability to function independently and help them perform the activities that are important to their daily life.
This may include getting dressed, preparing meals, completing schoolwork, performing job-related tasks, or taking part in leisure activities.
When a patient begins occupational therapy, the first thing the OT will do is evaluate their current abilities and identify the activities they are struggling to perform. Then, based on the findings of that assessment, the therapist will develop an individualized treatment plan aimed at helping the patient improve their ability to complete those activities more independently.
As the treatment progresses, the therapist may modify certain activities, recommend adaptive equipment, or teach the patient alternative ways to complete tasks that have become difficult. These interventions can also change over time as the patient’s abilities improve.
Since limitations in everyday functioning can affect people at different stages of life, occupational therapists may work with patients of different ages and with different rehabilitation needs, including children with developmental challenges, adults recovering from injuries or neurological conditions, and older adults experiencing a decline in their ability to function independently.
This means that OTs can find work in a range of professional environments, such as hospitals, outpatient clinics, schools, skilled nursing facilities, home healthcare services, and community-based programs.
Occupational Therapists vs Physical Therapists
While occupational therapists play an important role in helping patients become more independent in their everyday lives, they are not the only rehabilitation professionals who help people overcome functional limitations. Among the other rehabilitation professionals who commonly help many of this group of patients are physical therapists.
Just like OTs, PTs also work with people whose ability to function has been affected by an injury or health condition. What’s more, both of these professions may be involved in the same patient’s rehabilitation and work toward improving their ability to function more independently.
However, the main area where occupational and physical therapy differ is the focus of the treatment they provide. While OTs concentrate on pain management and helping patients perform the activities that are important to their everyday lives, PTs focus more directly on improving the movement and physical function needed to perform those activities.
In practice, a physical therapist may help a patient regain the mobility needed to move around more effectively, while an occupational therapist may help that same patient apply those improvements when completing everyday activities independently.
Occupational Therapists vs Occupational Therapy Assistants
In addition to physical therapists, another related role that aspiring OTs are likely to encounter when learning about the field is the role of the occupational therapy assistant. Even though both OTs and OTAs provide occupational therapy services and may work with the same patients, these two professions come with different levels of responsibility.
Namely, OTs hold the primary responsibility for evaluating patients and determining how their occupational therapy should proceed. Based on the findings of their assessments, they establish treatment goals and develop the intervention plans used to guide the patient’s care.
OTAs, on the other hand, work under the direction of occupational therapists and help carry out the interventions included in those plans. As they work with patients, they also observe their progress and communicate relevant changes to the supervising therapist, who remains responsible for evaluating the patient’s needs and directing the overall course of treatment.
These differences between these two roles are also reflected in the education requirements aspiring professionals need to meet to become eligible for practicing them.
While becoming an occupational therapist requires earning a graduate degree in occupational therapy, becoming a certified occupational therapy assistant requires earning only an associate’s degree from an accredited occupational therapy assistant program.
Becoming an Occupational Therapist: Qualifications Breakdown
Now that we have a better understanding of the occupational therapist profession and how it differs from related rehabilitation roles, we can turn our attention to outlining the qualifications aspiring professionals need to meet to become eligible for practicing occupational therapy professionally.
To qualify for entry in this strongly regulated field, candidates need to:
- Complete the undergraduate education and prerequisite coursework required for admission to an occupational therapy graduate program
- Earn a master’s degree or entry-level Doctor of Occupational Therapy degree from an ACOTE-accredited program
- Complete the supervised fieldwork required as part of their professional education
- Pass the National Board for Certification in Occupational Therapy examination
- Obtain an occupational therapy license from the state in which they intend to practice
These requirements are set in place to make sure that aspiring occupational therapists complete the appropriate academic and clinical preparation and demonstrate the professional competency needed to provide occupational therapy services safely and effectively.
How to Become an Occupational Therapist: Step-by-Step Guide
Having outlined the main qualifications required to enter the profession, we can now take a closer look at how aspiring occupational therapists can meet them in practice.
Complete Your Undergraduate Education
The first step toward becoming an occupational therapist is enrolling in a bachelor’s degree program in any field related to healthcare. The occupational therapy profession does not require aspiring OTs to complete their undergraduate education in one specific major, so they have the liberty to choose any field they like.
However, this doesn’t mean that every undergraduate path will prepare students equally well for the next stage of their education. Choosing fields related to human health and behavior, such as biology, psychology, or kinesiology, can provide a stronger academic foundation for later study and expose students to subjects that remain relevant throughout occupational therapy training.
It is also worth pointing out that while undergrad students have flexibility, they still need to complete the coursework required to satisfy the prerequisites for the occupational therapy programs they plan to apply to later in the process. The admission requirements for most OT graduate programs include anatomy, physiology, psychology, and statistics.
However, considering that every OT graduate program sets its own admission requirements, undergrads should research prospective OT programs ahead of time and make sure they strategically incorporate the necessary prerequisite courses into their bachelor’s studies.
Earn a Graduate Degree in Occupational Therapy
After earning their bachelor’s degree, aspiring occupational therapists can move on to graduate-level professional education. At this stage, they have two options: to earn a master’s degree in occupational therapy or to complete an entry-level Doctor of Occupational Therapy degree program.
While both of these pathways can provide the professional education needed to qualify for occupational therapy practice, their structures are notably distinct, which is why we will examine them in separate subsections below.
Master’s Degree in Occupational Therapy
The master’s degree in occupational therapy pathway is the shorter of the two graduate-level options available to aspiring OTs. These programs generally take around two years of full-time study and provide the entry-level professional education students need for professional OT practice.
Throughout their master’s education, OT students complete classroom coursework that focuses on the scientific and theoretical foundations of occupational therapy. At the same time, they also learn how those principles can be applied in patient care.
The curriculum of these programs is structured around human function, occupational performance, assessment, intervention planning, and evidence-based practice. In addition to classroom instruction, master’s degree programs in OT also include laboratory training where students can practice assessment and intervention techniques.
The one important consideration every occupational therapy student needs to keep in mind when starting their graduate studies is to make sure that the program they choose is accredited by the ACOTE, as only these programs are eligible for OT licensure.
Entry-Level Doctor of Occupational Therapy
The second option for students seeking graduate occupational therapy education is to enroll in an entry-level Doctor of Occupational Therapy (OTD) program, which provides broader professional preparation beyond the requirements of the master’s pathway.
Unlike the master’s degree program, this route includes additional doctoral-level coursework and a capstone component and can take up to three years of full-time study to complete.
While OTD students receive the same core clinical preparation needed for entry-level occupational therapy practice, their doctoral coursework also extends into areas such as research, leadership, program development, and advocacy.
What’s more, the capstone typically includes a 14-week experience in which students focus on developing advanced knowledge and skills in a particular area of occupational therapy practice.
Just like with the master’s degree, to qualify for OT licensure, OTD students need to choose a program that is offered by an occupational therapy school that is accredited by ACOTE.
Complete the Required Fieldwork
Regardless of which graduate degree students decide to pursue, their professional education will not be limited to classroom and laboratory instruction. As part of their graduate studies, all OT students must also complete supervised fieldwork that allows them to apply what they have learned in real practice environments.
The first part of this clinical preparation is Level I fieldwork, which introduces students to occupational therapy practice and gives them opportunities to observe how professional concepts are applied when working with patients.
After completing this introductory preparation, students move on to Level II fieldwork, where they take on a more active role in providing occupational therapy services under appropriate supervision. In total, this stage requires completing at least 24 weeks of full-time Level II fieldwork practice.
By the time they complete their practical assignments, occupational therapy students are expected to demonstrate greater competence in applying their clinical knowledge and performing the responsibilities associated with entry-level OT practice.
Pass the NBCOT Examination
With their graduate education and required fieldwork complete, aspiring occupational therapists can move on to the examination stage of the qualification process.
Their main challenge at this point of the process is to pass the national certification examination administered by the National Board for Certification in Occupational Therapy (NBCOT), commonly referred to as the NBCOT exam.
The NBCOT certification examination is designed to assess whether candidates can apply the knowledge and clinical reasoning developed during their occupational therapy education to situations they are likely to encounter in professional practice.
That said, in addition to passing the NBCOT exam, candidates in some states also need to pass a state law or jurisprudence examination before they can obtain licensure for OT practice.
Unlike the national certification exam, these state-specific assessments primarily focus on the laws, regulations, and professional rules governing occupational therapy within a particular jurisdiction rather than on clinical competency.
Secure a Professional Occupational Therapy License
Candidates who have passed the required exams can move on to the final stage of the qualification process and apply for an occupational therapy license.
To do so, they need to submit an application to the appropriate state licensing authority and provide documentation showing that they have completed an ACOTE-accredited occupational therapy program and passed the required exams.
Depending on the jurisdiction, they may also need to complete a background check, pay the required licensing fees, or satisfy other state-specific requirements.
Once the licensing authority verifies that the applicant has met all applicable requirements, it can issue the professional license needed to practice occupational therapy within that state.
Begin Practicing as a Licensed Occupational Therapist
The moment an occupational therapist candidate receives their professional license, they officially become qualified to enter the field professionally and begin their practice. At this point, they can start applying for positions in professional settings that align with their interests and the types of patients they would like to work with.
As they continue to gain experience over time, occupational therapy practitioners can become increasingly familiar with managing patient evaluations, developing treatment plans, and adapting interventions according to the needs of the people they serve.
Working with different patients and treatment situations can also help them determine which areas of occupational therapy they are most interested in and eventually pursue more specialized practice.
Once they have established themselves in professional practice, licensed OTs can begin looking for ways to develop more advanced expertise in those areas. Depending on their career goals, this may involve completing additional training, pursuing a fellowship, or working toward an advanced professional certification.
Advanced Training and Specialization for Occupational Therapists
Among the postprofessional options available to occupational therapists who want to develop more specialized expertise are fellowship training and advanced certification. Although both can strengthen a professional’s knowledge in a particular area of practice, they do so in different ways and serve different purposes within an OT’s career.
Occupational Therapy Fellowships
One way licensed occupational therapists can develop more advanced expertise is by completing a postprofessional fellowship in a focused area of practice.
AOTA-accredited fellowship programs combine structured education with in-depth mentored practice, allowing OTs to build specialized clinical skills while continuing to work with patients in the area they want to pursue.
Depending on their professional interests, occupational therapists can pursue fellowship training in areas such as pediatrics, neurology, mental health, gerontology, physical rehabilitation, or hand therapy.
To enter an AOTA-accredited fellowship, applicants generally need to have graduated from an ACOTE- or WFOT-accredited occupational therapy program and hold, or be eligible to hold, a license in the jurisdiction where the fellowship takes place.
AOTA Board and Specialty Certification
Another way occupational therapists can formally demonstrate advanced expertise is through the Advanced Certification Program offered by the American Occupational Therapy Association.
The program currently offers exam-based board certification in gerontology, pediatrics, and physical rehabilitation, allowing experienced OTs to have their specialized knowledge and skills formally recognized at the national level.
To qualify for one of these credentials, occupational therapists generally need at least three years of professional experience, along with 3,000 hours of experience in the certification area during the previous five years.
OTs who complete an AOTA-approved fellowship can become eligible after two years of professional experience, provided they still satisfy the applicable experience-hour requirements.
Job Outlook and Salary for Occupational Therapists
Having looked at the qualification process required to become an occupational therapist, we can now take a look at the earning potential and employment outlook associated with this profession.
According to the Bureau of Labor Statistics, occupational therapists earn a median annual salary of $98,340. However, this figure represents the midpoint for the profession as a whole and does not reflect what every occupational therapist earns.
For example, occupational therapists working in skilled nursing facilities earn a median annual salary of $103,210, compared with $83,890 for those employed in educational services.
Furthermore, OTs working in California earn a notably higher average salary of $113,550, compared with those in Texas who earn $101,610. Meanwhile, OTs working in Florida earn an even lower average annual salary of $92,820 per year.
Looking beyond earnings, the job outlook for occupational therapists across the US is also positive. The BLS projects employment in the profession to grow by 14% between 2024 and 2034 and increase from approximately 160,000 jobs to 182,100.
This represents around 22,100 additional positions over the decade, while approximately 10,200 openings are expected each year on average when new positions and the need to replace workers leaving the occupation are taken into account. (BLS, BLS)
Final Words
Difficulties with everyday functioning can affect a person’s independence and ability to participate fully in daily life. In these situations, occupational therapists play an important role by helping patients overcome functional limitations and regain the skills they need to carry out meaningful activities more independently.
Becoming an occupational therapist requires years of education, clinical training, examination, and professional licensure. For those willing to commit to the process, however, the profession can offer a rewarding career centered on helping people improve their independence and quality of life.
Common Questions Answered
What degree do most occupational therapists need?
Occupational therapists need a graduate degree in occupational therapy, which can be either a master’s degree or an entry-level Doctor of Occupational Therapy degree. Both of these pathways can prepare graduates for entry-level OT practice, so aspiring professionals are not required to earn a doctorate to enter the field.
However, before they can begin either graduate program, students need to complete a bachelor’s degree and meet the graduate degree’s prerequisites. They also need to make sure their occupational therapy program is accredited by ACOTE, as graduating from an accredited program is necessary for continuing toward NBCOT certification and state licensure.
Is becoming an occupational therapist difficult?
Becoming an occupational therapist can be challenging because the profession requires several years of higher education, clinical preparation, and formal qualification before candidates can begin practicing.
Aspiring OTs first need to complete undergraduate education before moving on to a graduate occupational therapy program, where the academic workload becomes more specialized and is combined with supervised fieldwork.
After completing their degree, graduates must also pass the NBCOT exam and satisfy the licensing requirements of the state in which they intend to work.
How long does it take to become an occupational therapist?
Becoming an occupational therapist can take anywhere between six and seven years, depending on which graduate degree pathway a student chooses.
This timeframe accounts for around four years of undergraduate education followed by approximately two years in a master’s occupational therapy program or up to three years in an entry-level Doctor of Occupational Therapy program.
Considering that the required fieldwork is a part of the graduate program, it does not normally add another separate period to this timeline. However, after graduating, candidates must still pass the NBCOT exam and complete the state licensing process before they can begin practicing professionally.