Occupational therapist & occupational therapy assistant Roles and Responsibilities

Key things to know  Educational differences OT/OTA  Credentials used  General scope of each role  Factors which affect who does what  Client issues  Setting issues  Payment issues  Regulatory issues

Occupational Therapists Credentials & Practice (USA) Master’s level education- ACOTE approved program  Theory, research & practice skills  24 weeks of Level II fieldwork  NBCOT exam- OTR (renewal required each 5 years)  Licensed in state In practice  Are autonomous practitioners who are able to deliver services independently.  Are responsible for assessing their need for supervision and seeking it if needed.  Should seek supervision and mentoring to develop best practice and promote professional growth.

Occupational Therapy Assistants Credentials & Practice (USA) Technical level education- Associate’s Degree ACOTE approved program  Basic occupational therapy skills  12 weeks of Level II fieldwork  NBCOT exam- COTA (renewal required each 5 years)  Licensed in some states, not in others In practice  Must be supervised  Are responsible for seeking supervision  Also expected to seek supervision and mentoring to develop best practice and promote continuing competency

Fieldwork Students  Level I students may or may not be supervised by credentialed OT personnel  Level II fieldwork students at both the therapist and assistant levels must be supervised by occupational therapy practitioners.  Fieldwork supervisors must have at least one year of experience after being initially certified by the National Board for Certification of Occupational Therapy.  OT students must be supervised by OT level  OTA students may be supervised by either an OT or an OTA.

Types of Supervision  Administrative supervision: Oversight over administrative job performance such as attendance, task completion etc. Ensures objectives and standards are met.  Clinical supervision or professional practice supervision: Supervision directed toward support, training and evaluation of professional discipline skills.  Functional supervision: Supervision providing oversight and training if directed toward a specific “function” or aspect of work for example wheelchair assessment and positioning.

Methods of Supervision  Supervisors should select methods that fit with supervisee’s needs and worksite demands.  Carefully select teaching methods that will be most effective in developing work skills.  Supervisors can utilize direct and indirect approaches to monitor and evaluate performance.  Direct supervision: The supervisor observes performance.  Indirect supervision: Information is gathered after performance through a variety of methods.

Frequency of Supervision  A supervisor must decide how frequently to have contact with the supervisee, based on:  His/her own supervisory skills.  The skills of the supervisee.  The nature of the work.  The expectations and requirements of the work setting and external regulatory or legislative agencies.  Frequency of supervision is generally viewed as occurring on a continuum, from continuous to “as needed.”

The OT/OTA Supervisory Relationship  The supervisory relationship between the OT and OTA is viewed as a partnership.  The OT is responsible for overall service provision and can carry out all facets of service provision.  The OTA’s primary role is in the implementation phase of service provision.

Service Competency  The process in which the OT determines that the OTA  performs tasks in the same way that the occupational therapist would, and  achieves the same outcomes.

Frequency & Type Supervision OT for OTA The frequency of supervision by an OT for the OTA will vary with practice setting and should be decided on the basis of:  Skills of the OTA: his/her service competency  Complexity of the task  Standard simple assessments (ie, grip strength) vs. assessment with complex theory base to do  Therapy activities that don’t have as much “inherent” evaluation in them.  Stable client situations  Requirements of the work setting  Requirements of external regulatory or legislative agencies (licensure, policies)  Payor requirements (ie, Medicare, insurance, school)

Occupational Therapy Aides  Occupational therapy aides have no formalized education in occupational therapy.  They are hired to provide supportive services to OT practitioners.  Aides can perform two types of tasks within the department:  Non-client-related tasks such as clerical work, clinic maintenance tasks, and preparation of work areas and equipment.  Assisting OT or OTA in client-related tasks that are routine and supervised by an OT or OTA.  Think of them as a “third arm”!