Occupational therapist

Occupational therapists help people who have problems with their physical or mental health or learning disabilities. Their aim is to maximise their clients’ independence and quality of life, at home and in their working and social lives. They assess needs, and plan and carry out practical arrangements and activities to help people deal with and overcome problems.

Work activities

Occupational therapists (OTs) help people to deal with and overcome physical, mental and social problems connected to illness or disability. “Occupational” here means any way in which people spend their time, including personal care (such as getting dressed, washed and going shopping), work or school, housework and leisure time.

OTs work with a very wide range of clients, including:

People who have had accidents.
People recovering from an operation.
Older adults, for example, if they are frail, recovering from a stroke or have arthritis.
People with physical or learning disabilities.
People with mental health problems such as stress, anxiety and depression.

Occupational therapists look not just at the client’s physical health but also their mental and emotional well-being. This assessment helps the OT to understand what the client can and cannot do, their feelings, level of independence and potential ambitions and abilities. The OT concentrates on what the client can achieve rather than what they are unable to do. The OT builds up a general picture of the client’s needs by working with the client, their family or carers, and professionals such as physiotherapists, social workers and doctors. Then, the OT and the client work together to decide which skills or abilities the client needs to develop to reach their full potential. The OT writes an intervention plan based on the client’s needs and expectations. Because occupational therapy is all about meeting clients’ needs, it can take place anywhere where people need help, for example, at home, in hospital or at work.

OTs might also arrange for extra support for clients (for example, district nurse visits and home help services). If someone has had an accident or stroke, they might need to re-learn life skills such as washing themselves and cooking. Helping the client to feed themselves could include training them to use adapted cutlery that has been designed to be used with one hand or planning meals together to get the client interested in cooking again. OTs help people return to work, for example, after an operation or period of stress-related absence. They might plan a role play to improve their client’s ability to deal with work situations.

Occupational therapists often support people with mental health problems in their own homes. The client might need therapy for acute anxiety or depression, which could be preventing them from going out to work. OTs help clients to draw up a list of everyday goals, making achievement realistic. The therapy could involve practising work-related skills or developing assertiveness.

Occupational therapy can be one-on-one or with groups. Activities in groups can be good for building communication skills, confidence and social skills. The OT takes overall responsibility for planning, organising and delivering therapy programmes. They might supervise occupational therapy assistants in supporting the client and arranging activities. Occupational therapists work in many areas, including social care, mental health, education and learning disabilities. They can specialise in areas such as substance misuse, hand therapy, eating disorders, children and older people. Apart from the NHS, they work in charities, residential care homes, government and voluntary agencies, schools, colleges and equipment manufacturers. Employers include the NHS and local authority social services departments, schools, residential care homes, voluntary organisations, charities, private healthcare companies and equipment manufacturers.

Personal qualities and skills

To be an occupational therapist, you’ll need:

To enjoy working with people, enabling them to reach their full potential.
The ability to inspire confidence, to encourage and persuade.
Patience and determination – this can be slow work, and results often don’t come easily or quickly.
Observational skills, for example, to make initial assessments and to monitor the client’s progress.
Creativity and adaptability, to plan individual therapy programmes.
Sensitivity and tact to work with clients who are nervous, embarrassed or frustrated.
Teamwork skills to work alongside other health professionals and people such as parents and teachers.

Pay and opportunities

NHS employees are paid on a rising scale within defined pay bands of the Agenda for Change payscale, according to their skills and responsibilities. In the NHS, occupational therapists (OTs) start on band 5, earning £28,407 and upwards. They may earn slightly more or less with other employers.

OTs usually work 37.5 hours a week, Monday to Friday, and might be required to be on-call or work in the evening or at weekends. There might be opportunities to work part-time.

Employers include the NHS, local authority social services departments, schools, residential care homes, voluntary organisations, charities, private healthcare companies and equipment manufacturers. Opportunities occur in towns, cities and rural areas throughout the UK.

There are opportunities for OTs to work independently in private practice.

Where are vacancies advertised?

Vacancies are advertised on the NHS Jobs website, in local/national newspapers and on job boards, as well as the Government’s Find a Job and Find an Apprenticeship services.

Entry routes and training

The usual route to becoming an occupational therapist is through a BSc degree in occupational therapy. Courses usually take three years to complete full-time (four in Scotland). All courses must be approved by the Health and Care Professions Council (HCPC). This allows you to apply for registration with the HCPC; registration is essential. Please see the HCPC website for a list of approved courses. Courses that are also accredited by the College of Occupational Therapists (COT) are recognised by the World Federation of Occupational Therapists (WFOT), meaning that they are accepted in over 60 countries. You can find a list of accredited courses on the COT website.

You can also qualify through an approved two-year pre-registration postgraduate course. Entry requirements vary between universities. Some specify that you should have at least a 2:1 in your first degree, which might need to be in a subject that is related to occupational therapy, such as biology, psychology or sociology. Some universities accept graduates with a 2:2 and/or any degree subject. You might also need to demonstrate skills and knowledge gained through some relevant work experience. Please check prospectuses carefully.

Another pathway is the level 6 (degree) apprenticeship programme. On this route, you will spend much of your time learning in the workplace, while also undertaking university study on block or day release to gain your degree.

As an occupational therapist, you could choose to specialise, for example, in mental health, paediatrics or stroke recovery. You could also go into a research, management or teaching post.

Rehabilitation of Offenders Act: This career is an exception to the Rehabilitation of Offenders Act 1974. This means that you must supply information to an employer about any spent or unspent convictions, cautions, reprimands or warnings, if they ask you to. This is different from other careers, where you only have to reveal information on unspent convictions if you are asked to.

Qualifications

For entry to a degree course in occupational therapy, the usual minimum requirement is three A-levels. Some universities specify biology, while others ask for any science subject. Psychology and Sociology can be other preferred subjects. Some universities don’t specify subjects at A level. You’ll also need GCSEs at grades 9-4 in your A-level subjects plus a further two to three GCSEs (9-4), including English and maths. You might also need science subjects. Equivalent qualifications, such as Edexcel (BTEC) level 3 Nationals and the International Baccalaureate (IB) diploma, might be acceptable for entry.

To begin a degree apprenticeship, you will need two A-levels plus GCSEs in maths and English.

Adult opportunities

Age limits: It is illegal for any organisation to set age limits for entry to employment, education or training, unless they can show there is a real need to have these limits.

If you don’t have the qualifications you need to enter a degree in occupational therapy, you might be able to start one after completing a college or university Access course, for example, Access to Science. You don’t usually need any qualifications to start an Access course, although you should check this with the course provider. A number of two-year accelerated postgraduate courses are also available. There are also a number of four-year part-time degree courses. Some of these are in-service courses, for example, for people already working as occupational therapy assistants/assistant practitioners or technical instructors. For others, it doesn’t matter if applicants are employed or not.

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