How to Become an Occupational Therapy Assistant


By Michael Sapko, M.D.
OT assistant helping a man out of his chair

Occupational therapy assistants enjoy a greatly satisfying career working directly with patients of all ages to help them grow and develop positive skills, rehabilitate after injury, manage a multitude of chronic illnesses and conditions, and improve their quality of life dramatically in many other ways.

An occupational therapy (OT) assistant works under the direction of an occupational therapist to guide patients in prescribed therapeutic activities and exercises, often using specialized equipment, in order to help them achieve or recover their full, independent and healthy lifestyles in spite of injury or disability.

While an occupational therapist may diagnose and prescribe certain treatments, occupational therapy assistants are mostly responsible for directly working with the patient to achieve the treatment goals. It’s important to note, OT assistants (or OTAs) are different than OT aides—aides generally do not assist with exercises or treatment.

Work Environment

Since occupational therapy assistants work under the direction of the therapists, they work wherever the OTs work. And since there are many different specialties in occupational therapy, the assistants enjoy a variety of potential workplace environments. Traditionally OTAs worked in hospital but increasingly they are employed in private practice offices (approximately one third of all assistants). Other venues include schools and nursing care facilities. Ten percent of OTAs provide direct in-home care to patients.

The assistants work a 40+ hour work week, which may involve weekends, early morning and/or early evening schedules. The work can be physically demanding since assistants help patients perform exercises throughout the day. This may involve supporting patient weight, bending, stooping and lifting.



The minimum education requirement for an occupational therapy assistant is a two-year associate’s degree. The degree should be from a program accredited by the American Occupational Therapy Association. Courses vary by school, but will generally include coursework in biology, psychology, kinesiology (the science of movement) and a variety of occupational therapy courses.


Most often, a school that grants associate degrees will provide a formal practicum in which students work under the supervision of a licensed occupational therapist. When it is not part of the formal curriculum, students must arrange to obtain this supervised training separately. The required length of this field work varies by state, but is at least eight weeks in duration. The practicum offered in most schools may last longer than minimum requirements.

Licensing and/or Certification

Graduates must pass the National Board for Certification in Occupational Therapy (NBCOT) certification examination. OTAs take the Certified Occupational Therapist Assistant (COTA) exam. Once candidates have their associate degree, documented fieldwork experience, and passing COTA exam grade in hand, they may apply to their state for licensure, which is essentially a verification process for the above qualifications.

Necessary Skills and Qualities

Occupational therapy assistants need good physical fitness because they will be physically active for an entire work shift. The job also requires a great deal of patience and compassion. These professionals are in almost constant patient contact; they must love working with people and be able to communicate clearly and with appropriate tact and sensitivity.

Opportunities for Advancement

Because licensure allows occupational therapy assistants to work for OTs only, career advancement depends greatly on solid job performance in support of the therapist. Assistants who demonstrate that they can be trusted, follow treatment instructions and provide excellent care are rewarded with job security, promotions and higher pay.

If you would like to gain the necessary education to become an OTA, we highly recommend that you check out our free School Finder Tool located HERE.


The Bureau of Labor Statistics states that the median income for occupational therapy assistants was $55,270 as of May 2013. Those who work in nursing facilities, private offices and as home health workers earn more than those who work in hospitals or schools. 

Job Outlook

Job growth is projected to increase at a much higher rate than average. The Bureau of Labor Statistics estimates a 43% increase in jobs from 2012 to 2022. As such, there will be 43,200 occupational therapy assistant jobs in 2020 compared to 30,300 in 2012.

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