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Occupational therapy--real help for real life.

Just living is an occupation. Young or old, people everywhere participate in daily activities that are the occupations of life. Growing, playing, learning, exercising, caring for the family and working make lives full and enjoyable. But when unexpected things happen to change that level of participation (i.e. injuries, depression, developmental disabilities), what can be done? Occupational therapy is there to restore the joys of living without pain or suffering.

Occupational therapy is one of the hottest growing professions around. The American Occupational Therapy Association (AOTA) cites on its website ( that "the U.S. Department of Labor's Bureau of Labor Statistics reveals that the job outlook for occupational therapists will improve substantially in the next several years and will continue to do so for the foreseeable future. Specifically, it states that 'Employment of occupational therapists is expected to increase faster than the average for all occupations through 2010,' meaning that employment is expected to increase by 21% to 35%."

Some significant points made by the Bureau of Labor Statistics regarding the occupational therapy profession are as follows:

Employment in this area is projected to increase faster than the average, as rapid growth in the number of middle aged and elderly individuals increases the demand for therapeutic services. Specifically, the large group known as the baby-boomers is now approaching the age where the occurrence of heart attack and stoke increases.

Occupational therapists are increasingly taking on supervisory roles. Due to rising health care costs, third-party payers are beginning to encourage occupational therapy assistants and aides to take more hands-on responsibility. By having assistants and aides work more closely with clients under the guidance of a therapist, the cost of therapy should be more manageable for those needing service.

More than one-third of occupational therapists work part time. The demand for this occupation has allowed more part-time openings, This is appealing for those professionals who, for various reasons, need to scale down the traditional 40-hour week.

AOTA staff writer Cynthia Johansson says in her article "Top 10 Emerging Practice Areas to Watch in the New Millennium" (which can be found on the AOTA website), "... current events, legislative changes and professional advocacy are reshaping the face of OT practice today, based on information gathered by the AOTA's Communication Department."

The 10 areas to watch Johansson lists are ergonomic consulting, driver rehabilitation and training, design and accessibility consulting and home modification, low vision services, private practice community health services, technology and assistive device development and consulting, welfare-to-work services, health and wellness consulting, ticket to work services, and addressing the psychosocial needs of children and youth. The emergence of more opportunities where occupational therapy is needed guarantees the future of the profession and creates a robust job market.

ACTE's Health Occupations Education Division Vice President Gina Doyle believes strongly in occupational therapy's valuable contribution to the health care team. "The focus is to assist the person in achieving maximum independence through individualized adaptation to health care challenges," Doyle says. "To do this, practitioners in the field must have the following strengths: high-level critical thinking, the ability to creatively adapt or design tools, astute observation of daily life skills, as well as the ability to recognize the unique needs of work requirements."

Helping people improve and restore their abilities to perform daily activities is the focus of the occupational therapist and occupational therapy assistants. This gratifying profession offers a diversity that makes it quite appealing to aspiring students. Their job is performed in varied settings such as hospitals, businesses, schools, clinics, private homes, community centers, rehabilitative institutions or nursing homes. Their patients range from newborns to geriatrics, and the mix of health issues they address are just as diverse. A wide variety of opportunities are there for the student who answers the call to occupational therapy.

The need for more occupational therapy assistants is in direct correlation with the increase in number of occupational therapists. Also, with the occupational therapist taking on more supervisory roles, the door has opened for more occupational therapy assistants to work with the supervision of registered occupational therapists in providing hands-on services to children and adults who are learning new ways to succeed in the occupations of life.

"Occupational therapy provides the bridge that allows the health client to cross the gap between decreased ability and living a full life," ACTE's Doyle remarks. "Occupational therapy represents the best of applied science in health care."

Career and technical education is there at the forefront of this growing profession, giving the occupational therapy assistant the knowledge and tools to do the job.

Durham Technical Community College

The two-year associate's degree program to train occupational therapy assistants (OTAs) at Durham Technical Community College (DTCC) in Durham, North Carolina, has been in place for 10 years. The curriculum prepares graduates to work under the supervision of a registered occupational therapist (OTR/L). Graduates completing this program take a national exam to become certified. The combination of completing the program and passing the exam makes them eligible to obtain a license to practice in North Carolina.

After obtaining their licenses, these graduates are ready to help registered therapists in all aspects of occupational therapy--from screening and assessment to treatment and documentation.

Durham's OTA Program Director, Susan Cheng, M.S., OTR/L, is glad to tell people what occupational therapy is and talk about the program and the graduates. She says, "Our graduates are employed in the public schools, where they might be helping the kids improve their gross motor skills, fine motor skills or social skills such as working in a group with others or managing their time better. Others may be employed in acute care hospitals, rehabilitation centers or nursing homes (which are now called long-term care facilities), where they help people recover skills after an injury or learn new ways to do things. Some graduates may work in assisted living facilities, where they might work as activities directors to provide enrichment and stimulation for the residents. Wherever our graduates work, their service enables people to live the best life they can live."

Durham also has links to the local high schools through their health occupations classes. "Some of the area schools come to DTCC and tour the labs of multiple health technologies programs here, and some of them request that we come to the school and speak to the students there," Cheng says. "We also participate in the annual meeting of the Health Occupations Student Association in Greensboro [North Carolina] each spring."

The interaction between Durham and the local schools provides the opportunity for students to learn about the challenging and rewarding career of occupational therapy. They learn that the work of an OTA uses many skills-creativity, problem solving, logic, communication, teaching, motivating others, time management/multitasking and humor.

Humor? Yes, laughter can be the best medicine when trying to keep a patient optimistic and relaxed during the rehabilitative process.

"I think the best thing about the profession is that we help people who are medically stable and ready to focus on their future. They aren't expending all of their energy just on surviving, so they have more energy to focus on how to live again," explains Cheng. "We form a team with them to come up with solutions for the specific challenges they face. It is a very rewarding career where you know that your work is having an impact on improving file quality of life for your clients. The occupational therapy slogan is 'Skills for the Job of Living,' and that's what we provide our patients."

Although the changes that Congress made to what Medicare would pay for rehabilitation for the elderly created a tough job market from 2000-2002, the employment outlook for OTAs is quite promising. Today's Durham OTA graduates have a bright future. As Cheng notes, "All of our graduates have found jobs within six weeks of graduation for the past several years."

Greenville Technical College

Greenville Technical College in Greenville, South Carolina, has had an Occupational Therapy Assistant Program in place since 1996. The program continued to be successful, despite the downward trend that took place several years ago in allied health care.

Today's enrollment in the program remains stable, averaging around 14 students each year, and the demand is great for OTAs in the northwestern part of the state where Greenville is located.

The program is designed as a "One Plus One" program. Phase I includes all of the general education and related course work. This part of the program may be completed at Greenville Tech or any articulating college, or any accredited college. Articulation agreements are in place with several technical and community colleges in the area, such as Midlands Tech, Piedmont Tech and Blue Ridge Community College. Students successfully completing Phase I enter Phase II of the program on a first-qualified, first-admitted basis. It is in Phase Two that the student receives his/her first introduction to occupational therapy and the hands-on experience of clinical application.

"I feel very good about the program," says Janice Robinson, MS OTR/L, the program's director. "Success on the national board exam has been very positive. Last year's graduating class had a 90 percent pass rate, and those testing June 19, 2003, through December 18, 2003, had a 100 percent pass rate. Also, our graduates are having no problems finding jobs."

Robinson entered into the OT field after working 10 years in the business world. (She has a BS in business administration.) She spent four years in full-time work with a women's Christian ministry, during which time one of her friends experienced an automobile accident. She observed her friend's rehabilitation firsthand, and that was the impetus for her pursuit of a career in occupational therapy. This profession offered her the two things she had been looking for--a flexible career for life and the opportunity to help those in need.

Besides the young high-school graduates who enroll into Greenville's OTA program each year, there are those like Robinson who need a career change that is fulfilling and gives back to the community.

"Like many states across the nation, we have seen a rise in displaced workers," explains Robinson. "One of Greenville Technical College's missions is to provide education to meet the changing needs of the community."

In keeping up with the times and this mission, Greenville Tech's OTA program is on the verge of launching a pilot online course in occupational therapy. Also, a part-time track layered on top of the traditional study format is being considered. But as in any career and technical education, hands-on is required at some point. Participants in this part-time track will eventually have to attend the 18 weeks of full-time clinical work.

"We also visit high schools whenever we are asked, and we participate in career days hosted by the college for high school and middle school students," Robinson notes. "Monthly 'Career Talks' for potential students of all ages who are interested in attending the program are provided as well. Information on the field of OT is covered, as well as specifics of the OTA curriculum."

Greenville is a sister program with Trident Technical College in Charleston, South Carolina, which has been in existence for close to 20 years and covers the southeast part of the state. Robinson believes that the success of the OTA program in the Greenville area is for several reasons.

"Because Greenville Tech is located in the northwest part of the state, services of well-educated and certified OTAs are now more accessible in that area," says Robinson. "Also, the population is aging, and people are learning about the benefits of using occupational therapy."

Like many professionals in the health services field, Robinson keeps a close watch on advancements and trends. She says happily, "The Bureau of Labor Statistics says the increase in health care occupations is on the rise. I believe the growth in the occupational therapy field is projected around 35 percent. So, things continue to look bright and hopeful for Greenville!"

New England Institute of Technology

The New England Institute of Technology (NEIT) in Warwick, Rhode Island, offered the first occupational therapy assistant education program in the state. NEIT says on its website that it invests heavily in "world class" technical resources and utilizes faculty members who are, or have been, top professionals in their respective fields. Many NEIT faculty members serve on national, regional and statewide occupational therapy organizations and accrediting bodies. This great source of leadership and knowledge keeps the program vital and progressive.

Nancy R. Dooley, Ph.D., OTR/L, assistant professor and department chair of the Occupational Therapy Assistant Program, is one such faculty member.

"One thing that makes NEIT's OTA program unique is that students can earn an associate's degree in only 18 months," says Dooley. "We constantly have employers looking for graduates to hire, so it is great for students to earn their degrees so quickly."

According to NEIT, the OTA program encourages students to value an individual's need to live a productive lifestyle, despite disability or illness, in a holistic way. Like DTCC and Greenville Tech, NEIT's program allows students to focus specifically on the study of occupational therapy. Aware that OT practitioners treat the whole person, including physical, emotional, cognitive, sensory and perceptual needs, the NEIT program training includes all aspects of life skills development from infancy to adulthood. This is an important feature to the training because today's OTA assists a diverse group of individual in all shapes, sizes and ages.

NEIT's OTA students attend two levels of field study. After completion of all classroom training, and the Level I fieldwork off campus, the student crosses the threshold into the community for Level II fieldwork. It is at Level II that the student actually has the opportunity to apply his/her classroom training to real-life situations.

Successful completion of all degree requirements allows the student to sit for the National Certification Examination for Occupational Therapy Assistants.

"We are very proud of the quality of our program, graduates and faculty," Dooley states. "One-hundred percent of our recent graduates passed the national certification examination. Nationally, the pass rate is 84 percent, so it is quite unusual to be able to boast of a 100 percent pass rate!"

A strong tie to the community is a win-win situation for both NEIT graduates and the people they help. "We know that many area employers go directly to our Career Office whenever they need to hire someone," explains Dooley. "Some have told us that they only hire New England Tech graduates."

Another impressive fact about NEIT is that the Career Office offers lifetime employment assistance, showing a deep commitment and belief in their graduates.

Why OT?

Two OTAs tell about their career

Marie-Claude Flynn was a stay-at-home morn for 13 years. Like many Working: mothers, once she felt secure fin the children's independence, she decided to go back to work.

"I took some temp jobs as a secretary (my former profession), and realized I really did not like to work with computers and consequently was not interested in learning about them," explains Flynn, "I like to work with people."

Flynn attended an orientation at DTCC where her answers to a questionnaire pointed her toward health care professions. She read about OT and realized that it was something she wanted to explore. She was fascinated by how occupational therapy aided disabled individuals' independence. She was also drawn to the flexibility that an occupation in this field afforded her.

"I think the sky is the limit for OT, because it affects every aspect of peoples' daily life--at home, at work, even driving," says Flynn. "It addresses vision; cognitive abilities and physical abilities."

One of Flynn's most rewarding experiences was with a 13-year-old patient, Flynn was able to assist this young girl to full independence in getting dressed in the morning. "I would come early in the morning to make it very purposeful and would work on her taking her shower, then dressing herself," says Flynn. "Donning her bra was the biggest challenge for her, due to decreased fine motor skills and decreased vision. After six sessions, she did master her morning care. To her great pleasure (and her mother's) she did not need her mom to be involved in that part of her daily life. She could have privacy. That was very rewarding for me, as I could really relate as the teenager who wanted to be 'free,' and I helped her get there."

As Flynn says, not every experience is as moving as this particular one, but working with patients and watching their progress, no matter how slowly it comes, is always very gratifying. "It gives so much pleasure to the patient when they can do one thing by themselves again!"

Darlene Labine, another DTCC graduate, says, "When I finally learned about OT, I was hooked! It's what I've been looking for my whole life. I love practically everything about it!"

Labine, who holds a degree in physical education and taught at One time, works at Murdoch Center, a state-run facility for mentally retarded adults. Many of the patients live at the center permanently and endure disabilities like severe spasticity, cerebral palsy, spinal misalignments and various other neurological impairments.

"Much of what is done here revolves around prevention of further injury and/or maintenance of skills, explains Labine. "Splints are made more for contracture management vs. increasing functional ability. The [Certified Occupational Therapy Assistants] COTAs here make all the custom-made splints. The COTAs are also involved in recommending the most appropriate adaptive feeding equipment such as cups, spoons, dishes and elevated plate stands. More recently they have had the opportunity to assist in the ordering, customizing and adjusting Of wheelchairs, and that has been an educational experience."

Labine enthusiastically says, "Even though we often end up compensating for residents' abilities, hope springs eternal! Improvements can and are made, but here you really learn to appreciate the small things ... a smile or a laugh, an individual learning to independently move their wheelchair two feet instead of one, someone learning to feed themselves more independently, or someone learning to tolerate tooth brushing better."

Creativity and flexibility are key says Labine. "You really need to be creative here. OTs are fairly obsessive about things being functional, but what's functional to us may not necessarily make sense to the folks here."

Labine says that she has experienced that "stuck" feeling--knowing that she didn't like the situation she was in, but not knowing how to do anything different. She describes her career simply when she says, "OTs teach people how to 'unstick' themselves."
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Author:Gibbs, Hope J.
Article Type:Cover Story
Date:Apr 1, 2004
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