Occupational therapist vs occupational therapy assistant
At a glance
Occupational therapist
Occupational therapists help people do the everyday activities they need and want to do, after injury, illness or disability.
Regulation: Certified nationally, regulated by states
Open the occupational therapist hubOccupational therapy assistant
Occupational therapy assistants deliver occupational therapy under the supervision of an occupational therapist.
Regulation: Certified nationally, regulated by states
Open the occupational therapy assistant hubTraining and regulation
| Occupational therapist | Occupational therapy assistant | |
|---|---|---|
| Credential | OTR | COTA |
| Regulation | National certification, then a state credential | National certification, then a state credential |
| Program accreditor | Accreditation Council for Occupational Therapy Education (ACOTE) (official site) | Accreditation Council for Occupational Therapy Education (ACOTE) (official site) |
| Entry exam | National Board for Certification in Occupational Therapy (NBCOT) (official site) | National Board for Certification in Occupational Therapy (NBCOT) (official site) |
| Typical time to qualify | Around 6–7 years from starting undergraduate study | Around 2 years |
| Licensure | Two layers. NBCOT certification is national and carries its own renewal requirement; the state license authorizes practice and carries a separate one. | Two layers, the same as the OTR: national certification plus a state license, each with its own renewal. |
| Interstate compact | OT Compact: Enacted, not yet issuing privileges | OT Compact: Enacted, not yet issuing privileges |
National certification, then a state credential
A national body sets the entry standard and certifies people who meet it. States then regulate practice on top of that, by license, certification or registration depending on the state. The two layers are separate obligations, each with its own renewal.
National certification, then a state credential
A national body sets the entry standard and certifies people who meet it. States then regulate practice on top of that, by license, certification or registration depending on the state. The two layers are separate obligations, each with its own renewal.
Scope, topic by topic
| Topic | Occupational therapist | Occupational therapy assistant | Difference |
|---|---|---|---|
| Spinal manipulation | Not typical | Not yet covered | Differs |
| Joint mobilization | Varies by state | Not yet covered | Differs |
| Instrument-assisted soft tissue mobilization | Varies by state | Not yet covered | Differs |
| Cupping | Varies by state | Not yet covered | Differs |
| Dry needling | Varies by state | Not yet covered | Differs |
| Ordering diagnostic imaging | Varies by state | Not yet covered | Differs |
| Therapeutic exercise | Within scope | Not yet covered | Differs |
| Blood flow restriction training | Varies by state | Not yet covered | Differs |
| Sport-related concussion | Varies by state | Not yet covered | Differs |
| Kinesiology taping | Within scope | Not yet covered | Differs |
| Electrical stimulation | Within scope | Not yet covered | Differs |
| Therapeutic ultrasound | Within scope | Not yet covered | Differs |
| Vestibular rehabilitation | Varies by state | Not yet covered | Differs |
| Aquatic therapy | Within scope | Not yet covered | Differs |
| Soft tissue mobilization | Within scope | Not yet covered | Differs |
| Traction | Varies by state | Not yet covered | Differs |
| Photobiomodulation (laser therapy) | Within scope | Not yet covered | Differs |
| Shockwave therapy | Varies by state | Not yet covered | Differs |
| Diagnostic musculoskeletal ultrasound | Varies by state | Not yet covered | Differs |
| Return to play clearance | Varies by state | Not yet covered | Differs |
| Direct access | Varies by state | Not yet covered | Differs |
| Telehealth | Within scope | Not yet covered | Differs |
| Topical and administered medications | Varies by state | Not yet covered | Differs |
| Ordering laboratory tests | Not typical | Not yet covered | Differs |
Shared and unique
Within scope for both
Generally occupational therapists only
Generally occupational therapy assistants only
24 of 24 topics are not yet covered for both professions.
How they divide the work
Occupational therapists and occupational therapy assistants deliver the same profession at two levels, and AOTA describes occupational therapy services as provided by both. State law defines the assistant by that relationship: Washington's act defines an assistant as licensed to assist under the supervision or regular consultation of an occupational therapist, and Texas's as assisting under the general supervision of an occupational therapist.
AOTA publishes guidelines that set out the separate roles and responsibilities of occupational therapists, assistants and aides, and how supervision works between them. States set the binding supervision rules, so the amount and form of supervision differs from one state to another.
Both credentials have two layers. Therapists enter through an accredited master's or doctoral program and assistants through an associate program, both accredited by ACOTE; each then passes its own NBCOT examination, earning the OTR or the COTA, and separately obtains a state license.
Sources
- What is occupational therapy? (official site)
- RCW 18.59.020, Definitions (occupational therapy) (official site)
- Texas Occupations Code Chapter 454, Occupational Therapists (official site)
- Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (2020). American Journal of Occupational Therapy. (official site)
- Find a School (official site)
- Get Certified (official site)
A general account. States name the techniques differently and draw the lines in different places; the topic pages hold the state-by-state detail.
Vocabulary
No shared vocabulary recorded yet
No topic yet records a term for both occupational therapists and occupational therapy assistants. Each topic page lists the names we have, across professions.
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