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How to become an Occupational Therapist

a female occupational therapist assisting a patient

Occupational therapy may seem on the surface to be some kind of “workplace counseling” to someone who is unfamiliar with the profession. In reality, occupational therapy is a type of physical—and oftentimes mental—rehabilitation.

What is occupational therapy?

It may be easier to understand occupational therapy in contrast to physical therapy, with whom occupational therapists frequently work: while physical therapists are mostly focused on restoring full-body mobility and movement, occupational therapists help people to perform necessary tasks (or “occupations”) of daily life.

“We’re professionals who are dedicated to helping people, groups or populations do what they need and want to do, and identify what barriers in their way of doing that and then come alongside as a coach to help remove those barriers,” said Keri DeGroot, occupational therapist and assistant teaching professor with the University of Washington’s Division of Occupational Therapy.

Physical limitations aren’t the only thing that can prevent someone from executing activities of daily living (ADL), though. Akin to mental health counseling, occupational therapists also work with patients with an array of cognitive challenges as well. This dynamic healthcare profession is full of seemingly endless possibilities and consistently ranks as one of the most rewarding careers.

Is occupational therapy right for you?

Occupational therapy has been highly ranked on numerous job satisfaction metrics, making it an excellent choice for people who are drawn to service-oriented careers. Payscale ranks occupational therapists as #11 out of 454 on their list of most meaningful jobs. Meanwhile, U.S. News & World Report puts occupational therapy at #20 on their list of Best Health Care Jobs. If you want to jump into this exciting career, you’re in luck—employment is expected to grow 11.5% through 2032, much faster than the average across all occupations.

But just who should pursue this branch of the healthcare profession? First and foremost, it’s essential that they have an innate desire to help others since that’s what occupational therapy is all about. They must also be aware that occupational therapy requires years of schooling and graduation from a master’s or doctoral program on top of a baccalaureate education.

DeGroot said that one of her favorite parts of clinical practice is connecting with patients and their families and helping them on their journey to recovery and wellness.

“I had a client write me a handwritten thank you note saying, ‘I’ll never forget how that first shower in inpatient rehab felt after I had a stroke and hadn’t showered in five days. You made me feel like a person again.’”

But DeGroot said that occupational therapy can come with its fair share of challenges, too. These sometimes include inequality for access to resources (what if the patient can’t afford the tools you need to help them?) or being subject to insurance rules which dictate how long you can work with a patient.

6 steps to become an occupational therapist

Get a bachelor’s degree.

students in line to receive their bachelor's diploma

Occupational therapists must graduate from either an entry-level master’s or doctoral program in occupational therapy to get licensed. Both of these programs require applicants to have a bachelor’s degree already.

Occupational therapy attracts students from an array of baccalaureate majors, from English to psychology to kinesiology. It doesn’t matter what you major in as long as you complete the prerequisites for a particular graduate program, which typically include courses in anatomy and physiology, psychology, statistics, sociology, and more.

Graduate from an ACOTE-accredited occupational therapy program.

hand pointing to the word accredited

Occupational therapists in the United States must graduate from an occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). ACOTE accredits master’s and doctoral degree programs. Both programs are acceptable paths to licensure.

Complete fieldwork experience.

occupational therapy student tends to patient as her supervisor looks on

You must complete a certain amount of supervised fieldwork experience to obtain an occupational therapy license. Most states require at least six months of full-time fieldwork to qualify.

Pass the NBCOT exam.

person taking an exam on laptop with a holograph of questions at forefront

States require passing scores on the National Board for Certification in Occupational Therapy (NBCOT) certification exam to qualify for licensure. This exam tests you on four domains of occupational therapy: evaluation and assessment, analysis and interpretation, intervention management, and competency and practice management. Candidates get four hours to complete the test, which consists of three clinical simulation items and 170 single-response, multiple-choice items.

Apply for state licensure.

right hand filling out a state application for licensure

Once you’ve completed your education, fieldwork, and passed the NBCOT exam, you’re probably ready to apply for a license in your state. Applications are typically submitted online along with your transcripts, fieldwork evidence, passing NBCOT scores, and the appropriate fees. Some states may require that you submit and/or complete additional items such as a criminal background check or pass a state-specific exam.

Consider earning an advanced certification.

occupational therapist with glasses smiles and lab coat smiles at camera

Occupational therapists have the option to obtain additional certifications in certain specialty areas after gaining some experience. Specialty certifications are offered by numerous organizations. The American Occupational Therapy Association (AOTA) currently offers three certifications in the areas of gerontology, pediatrics, and physical rehabilitation.

Occupational therapist salary

A big item you’d probably like to know is how much does an occupational therapist make? According to data from the U.S. Bureau of Labor Statistics (BLS), the median annual salary for occupational therapists is $93,180. Occupational therapists tend to have a competitive salary compared to other occupations, evidenced by the fact that even the 10th percentile of annual wages for OTs ($63,320) is higher than the annual mean wage across all occupations ($58,260).

Occupational Therapists

National data

Median Salary: $93,180

Projected job growth: 11.5%

10th Percentile: $63,320

25th Percentile: $77,700

75th Percentile: $104,730

90th Percentile: $123,870

Projected job growth: 11.5%

State data

State Median Salary Bottom 10% Top 10%
Alabama $83,770 $60,630 $110,240
Alaska $97,970 $70,160 $129,430
Arizona $84,250 $61,800 $120,240
Arkansas $79,980 $43,350 $121,180
California $104,380 $81,390 $136,490
Colorado $96,450 $73,190 $131,950
Connecticut $96,340 $71,410 $123,700
Delaware $87,360 $63,240 $114,980
District of Columbia $92,670 $64,320 $129,420
Florida $91,970 $64,600 $105,800
Georgia $95,200 $65,270 $119,130
Hawaii $95,890 $79,310 $146,250
Idaho $82,000 $62,260 $103,360
Illinois $93,290 $58,760 $113,440
Indiana $84,990 $62,220 $106,700
Iowa $80,960 $61,430 $102,740
Kansas $84,610 $62,920 $107,520
Kentucky $81,130 $60,270 $109,240
Louisiana $94,280 $61,270 $121,980
Maine $76,860 $60,750 $93,760
Maryland $98,280 $64,560 $121,980
Massachusetts $93,140 $61,620 $114,590
Michigan $82,450 $61,260 $104,320
Minnesota $81,370 $62,690 $101,070
Mississippi $91,800 $64,370 $109,100
Missouri $88,340 $59,240 $109,220
Montana $83,660 $64,260 $101,850
Nebraska $83,530 $66,080 $107,540
Nevada $102,130 $62,800 $136,440
New Hampshire $83,200 $58,700 $104,800
New Jersey $103,090 $65,310 $148,530
New Mexico $86,560 $61,350 $138,060
New York $86,370 $61,300 $131,900
North Carolina $83,560 $59,970 $109,210
North Dakota $75,640 $63,800 $100,540
Ohio $93,060 $63,170 $124,850
Oklahoma $92,230 $63,190 $122,250
Oregon $100,910 $72,280 $114,830
Pennsylvania $87,930 $62,910 $118,690
Rhode Island $93,600 $70,790 $110,370
South Carolina $84,390 $59,930 $114,400
South Dakota $76,400 $62,740 $97,300
Tennessee $95,560 $65,400 $107,900
Texas $96,260 $65,100 $131,580
Utah $85,260 $63,460 $120,270
Vermont $79,920 $63,680 $101,360
Virginia $97,080 $66,290 $134,200
Washington $94,900 $69,910 $120,730
West Virginia $79,620 $48,660 $107,390
Wisconsin $81,700 $59,550 $102,210
Wyoming $81,040 $50,940 $123,620

Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

Factors that can impact salary

The main factors that can influence an occupational therapist’s salary include their location, type of workplace, experience, and job scope. According to the BLS, the top paying industry for occupational therapists is home health care services with an annual mean wage of $102,640. However, this industry (and the other top-paying industries they list) only make up a small portion of the entire workforce.

Another influence on salary is whether you are self-employed at a private practice or you work as an employee for a larger institution. Self-employed healthcare professionals that work in private or group practices may be able to charge more for their services. However, they usually have more overhead costs.

Experience is probably the steadiest way to increase your earning potential. As with most careers, more jobs become available to you with more experience, and a higher salary tends to follow. This can be especially true if you have any specialty certifications. Having a particular skill set can make you a more valuable employee.  

Pay compared to similar professions

It’s natural to wonder how the salary of an OT compares to similar professions such as that of a speech-language pathologist for instance, however, it’s important to keep in mind that each profession has its own unique job responsibilities and your decision to become an OT should be based on more than just salary.

Career Median Annual Salary
Occupational Therapists $93,180
Physical Therapists $97,720
Speech-Language Pathologists $84,140
Occupational Therapy Assistants $64,250
Occupational Therapy Aides $37,060

Job outlook for occupational therapists

An expected growth rate of 11.5% through 2032 makes the occupational therapy profession poised to grow much faster than the average across all occupations. This translates to about 10,100 openings each year, on average, over the decade. The highest-paying occupational jobs are in California, while the New York-New Jersey area has the highest number of OTs employed.

Metro areas with the highest number of OTs employed

Metropolitan Areas Employment
New York-Newark-Jersey City, NY-NJ-PA 8,160
Los Angeles-Long Beach-Anaheim, CA 5,280
Chicago-Naperville-Elgin, IL-IN-WI 5,210
Boston-Cambridge-Nashua, MA-NH 3,890
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 3,880

California, Texas, New York, Florida, and Pennsylvania are the states that employ the most occupational therapists in the country. The states which have the highest annual mean wages are Nevada, California, New Jersey, Texas, and New Mexico. Furthermore, nine out of the top ten paying metropolitan areas in the country are in the state of California.

Requirements to become an occupational therapist

OTs must be licensed in every state to practice. Licensing requirements are nearly the same everywhere and consist of three major parts:

  • Graduate from an occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE), which can be either a master’s or doctoral degree
  • Complete fieldwork
  • Pass the National Board for Certification in Occupational Therapy (NBCOT) certification exam

Getting into an occupational therapy graduate program requires a bachelor’s degree first. You can major in anything (including a psychology bachelor’s) as long as you complete the course prerequisites for your particular grad program, which usually consists of introductory courses in subjects like anatomy and physiology, math, psychology, sociology, medical terminology, and more. Depending on your major, you may need to take additional classes if you didn’t take the prerequisites which are usually more science-heavy subjects.

“We tend to draw people from a wide variety of backgrounds,” DeGroot said. “I’ve got an English major right now, I’ve got people that majored in kinesiology, people that majored in abnormal psych and counseling.”

Students from psychology backgrounds can make excellent OTs because they are already attuned to the psychosocial nature of what occupational therapists do. On top of that, many patients that occupational therapists see may be struggling with conditions that psych students are more versed in, such as autism, mood disorders, or other mental or behavioral health issues.

“Experiencing a barrier in their life to being able to do what they need and want to be able to do have psychosocial concerns. Anytime I’m doing any therapy with anybody, whether we’re just working on one digit of the finger, there is a psychosocial impact for that person.”

Completing your occupational therapy school and getting licensed

Once you get your bachelor’s degree, it’s time to move on to graduate school and enroll in a master’s or doctoral occupational therapy program. These must be accredited by ACOTE to qualify for licensure.

“That’s typically then two to three years once you’re accepted into a program, plus 24 weeks of full-time fieldwork at a minimum, and if it’s a Doctor of Occupational Therapy (OTD) program, then it’s a little bit past that. And then you have to pass a standardized national board exam to be able to become an OT after that fieldwork,” DeGroot said.

Upon passing the NBCOT exam after completing your education and fieldwork, you are ready to apply for a state license. Be sure to check with your state’s licensing body to determine if there are any extra steps you must take, such as completing a criminal background check or a state-specific exam.

Occupational therapy licensure compact

As of August 2022, the Occupational Therapy Compact Commission (OTCC) is developing an occupational therapy licensure compact. A multistate licensure compact would allow practitioners in participating states to obtain a license more easily in other states, much in the same way that the Nurse Licensure Compact (NLC) functions for the nursing profession.

What being an occupational therapist is all about

At its core, the occupational therapy job is about helping others improve their quality of life. OTs can intervene when a person is struggling to execute activities of daily living, such as feeding and dressing oneself, bathing, writing, cleaning, cooking and so much more. People who are struggling with these sorts of tasks may have suffered an injury to their bodies and/or brains, have a disability or cognitive impairment, or they may be experiencing some other barrier such as homelessness.

“Whether the barrier is in the person with strength or balance or vision, whether it’s environmental or whether it’s in the task itself that we need to change—we can kind of work within any of those three spheres to address the issue,” DeGroot said.

What does an occupational therapist do?

The role of an occupational therapist typically involves working with patients one on one, but they can work in groups or with populations in more community-based settings as well. They work with patients of all ages from infants to the elderly and everything in between.

“Our OT process starts with evaluation and assessment. And part of that is an occupational profile: what does this person need and want to be able to do? What’s their life like? What’s their environment like? And then what are the barriers that they’re experiencing? Whether that’s mobility-related or motor function or something else, we assess those things.”

Following an assessment, an OT will create a customized intervention plan based on the goals established together with the patient. Treatment plans can vary immensely depending on the patient and may be conducted in the patient’s home, workplace, or at a medical facility.

Occupational therapist roles

The types of conditions that occupational therapists can help with are practically endless and can occur across the lifespan. Some of them include:

  • Traumatic brain or spinal cord injuries
  • Birth injuries or defects
  • Rehabilitation following a stroke or heart attack
  • Neurological conditions such as cerebral palsy or multiple sclerosis
  • Down syndrome
  • Chronic pain
  • Dementia
  • Autism
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Substance abuse
  • Other mental or behavioral health issues

Occupational therapists can also help people without any obvious condition or disability. For example, a grieving widow or widower whose spouse took care of certain things when they were alive (cooking, paying bills, etc.) may need some help learning how to manage these aspects of their life now that their loved one has passed away.  

The skills you’ll need

While the hard skills that you’ll use day-to-day are nurtured in the classroom and over time with experience, occupational therapists should also have several innate qualities and skills that are essential to their success.


“Creativity is a must. I tell my students, go in with your plan A through F, and then you might get to plan G or J.” People that are able to come up with creative ways to approach a problem will likely have more success with their patients.


“You can’t come in with a predictable plan when you’re working with people, it just doesn’t work well. You need to be able to adapt on the fly.”


Clients are typically struggling with something or perhaps are recovering from a traumatic event. Occupational therapists need to be able to recognize the severity of the situation and emotionally support the patient through a journey that they may not want to be on in the first place. “People are going through a lot when they’re seeing us. Most people don’t want to need our services for anything.”


Like other healthcare professionals, OTs need to maintain thorough documentation on their patients and know when and how to follow up. “The process of documenting everything we do and keeping on track of where people are and their progress all takes quite a bit of organization.”

Tools and technology you may use

Occupational therapists use many tools and modern technology to do what they do. A major part of their job is utilizing tools to help their patients, from repurposing everyday objects to modify someone’s environment to helping them use adaptive technology like a wheelchair.

“Our students take an entire class on assistive technology,” DeGroot said.

The Assistive Technology Industry Association describes assistive technology as “any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities” and provides some examples:

  • Low-tech: communication boards made of cardboard or fuzzy felt
  • High-tech: special-purpose computers
  • Hardware: prosthetics, mounting systems, and positioning devices
  • Computer hardware: special switches, keyboards, and pointing devices
  • Computer software: screen readers and communication programs
  • Inclusive or specialized learning materials and curriculum aids
  • Specialized curricular software
  • And much more—electronic devices, wheelchairs, walkers, braces, educational software, power lifts, pencil holders, eye-gaze and head trackers, and more

“Lots and lots of accessibility apps are out there now,” said DeGroot. “There’s vision, magnification, hearing, speech-to-text—there are all kinds of accessibility at peoples’ fingertips.”

Where you’ll work

Because the application of occupational therapists is so broad, you’ll find them working in numerous different settings, including but not limited to:

  • Hospitals
  • Outpatient clinics
  • Nursing care facilities and long-term care settings
  • Home health
  • Mental health and other social service settings
  • Schools

Occupational therapists in many of these environments collaborate with other professionals on a daily basis. Depending on where they work, OTs may work alongside or in tandem with physical therapists, mental health counselors, social workers, substance abuse counselors, speech-language pathologists, school psychologists, and much more.  

Frequently asked questions (FAQs)

Can occupational therapists work from home?

Especially since the inception of the COVID-19 pandemic, occupational therapists have been able to work in telehealth settings and provide treatment to patients virtually. Whether an occupational therapist can work from home depends on their particular employer and job scope, but it may be possible in some cases to provide virtual services to patients.

Can an occupational therapist become a doctor?

Yes, occupational therapists can go on to be medical doctors if they decide to make a career change. This would require an allopathic or osteopathic medical school to earn a doctoral degree. You cannot earn the MD or DO designation without going through their respective medical schools.

How much traveling does an occupational therapist do?

OTs travel just as much as any other healthcare professional. They typically work in a consistent location that they commute to such as a hospital, medical office, or school. OTs that work in home health settings may have to do more traveling since they have to commute to different clients’ homes.

Who refers people to occupational therapists?

Other healthcare professionals, social workers, and more may refer patients to occupational therapists. Some people may seek out occupational therapy services on their own as well.

Do societal factors and culture influence the work of occupational therapists?

Absolutely. Successful OTs should be attuned to their client’s unique cultural circumstances so that they can cater their treatment in a way that aligns with their patients’ values.

Getting started

Becoming an occupational therapist can be a rewarding and fulfilling career choice that can make a positive impact on people’s lives. Researching various educational programs is your first step in pursuing the profession, and ultimately choosing one that fits your needs and goals.

With the help of our school search widget on this page, you can find and compare a list of relevant occupational therapy programs in your area (or online). So start your journey today and take the first step toward becoming an occupational therapist.

Published: February 20, 2023


Written and reported by:

Kendall Upton
Staff Writer


With professional insight from:

Keri DeGroot, OTD, OTR/L, Assistant Teaching Professor

University of Washington Division of Occupational Therapy