Occupational therapy

Encyclopedia of Nursing and Allied Health, 20050229 by Meghan M. Gourley

Licensure

The profession of occupational therapy is regulated in every state; in 43 states, as well as the District of Columbia, Puerto Rico, and Guam, occupational therapists are required to be licensed. Licensure is important because it defines the scope of practice for therapists and provides guidance to facilities and health care providers on the appropriate application of occupational therapy services.

The field of occupational therapy has been playing catch-up with its allied health counterparts, such as physical therapy and speech-language pathology. More sophisticated and specialized education was necessary for occupational therapists to remain competitive and prove their worth when interacting with consumers and other medical professionals. In the 2001 market, practitioners must be able to employ critical reasoning and develop innovative practice models.

Advanced education and training

Continuing education courses and additional training is necessary for practitioners to remain competent within the field; this must be done on a regular basis. Practitioners can utilize AOTA's continuing education courses, online courses, and annual conference and exposition workshops, as well as educational sessions that are offered by leaders in occupational therapy.

In 2000, AOTA's Council on Continued Competence in Occupational Therapy (CCCOT) implemented the Continuing Competence Plan for Professional Development, a comprehensive plan that guides practitioners in developing and maintaining competent skills. The NBCOT, through which practitioners must become certified and eventually recertify, agreed to work in coordination with the AOTA to develop a recertification program that agrees with the principles set forth in the CCCOT's plan.

Future outlook

As health care delivery has changed dramatically with the advent of managed care, the roles of occupational therapists and occupational therapy assistants have expanded, due mostly in the United States to Medicare provider payment cutbacks mandated by the Balanced Budget Act (BBA) of 1997. Many jobs were cut in SNFs, leaving occupational therapists out of work. This change forced practitioners to consider other markets that might values their services.

The occupational therapy profession, however, was granted a reprieve when the U.S. Congress made several changes to the Balanced Budget Act. The Balanced Budget Refinement Act of 1999 called for a suspension of a capitation on rehabilitation services. Congress agreed to suspend the capitation because of the controversy surrounding combining occupational therapy, physical therapy, and speech-language pathology.

For occupational therapy to survive, new markets had to emerge. Practitioners proved their worth in less traditional roles and work settings. While therapists still have a place in LTC facilities, they are carving a niche in school systems-the most popular work setting, according to a 2000 survey conducted by AOTA-as well as business-to-business consulting firms that specialize in ergonomics, home modification, and/or assistive devices, wellness education programs, community-based mental health programs, and a variety of specialties in private practice.