In the medical field, OT stands for occupational therapy (or occupational therapist). It’s a healthcare profession focused on helping people perform the everyday activities that matter most to them, from getting dressed and cooking meals to returning to work after an injury. Unlike physical therapy, which centers on restoring movement and strength, occupational therapy takes a broader view: it addresses the physical, cognitive, emotional, and environmental factors that affect someone’s ability to function independently.
What Occupational Therapists Actually Do
The word “occupation” in occupational therapy doesn’t just mean your job. It refers to any activity that occupies your time and gives your life meaning, whether that’s brushing your teeth, driving to the grocery store, or playing with your kids. OTs work with people whose ability to do these things has been disrupted by injury, illness, disability, or aging.
The profession breaks everyday tasks into two categories. Basic activities of daily living (ADLs) are the fundamentals: bathing, dressing, feeding yourself, using the toilet, grooming, and moving between positions like sitting and standing. Instrumental activities of daily living (IADLs) are more complex tasks that require planning and problem-solving: managing medications, preparing meals, handling finances, shopping, housekeeping, arranging transportation, and communicating with others. An OT might work with a stroke survivor who needs to relearn how to button a shirt, or with an older adult who can no longer safely cook without supervision.
When these abilities decline, the consequences go beyond inconvenience. Difficulty dressing or toileting leads to poor hygiene. An inability to eat independently can cause malnutrition and dehydration. OTs step in specifically to prevent that kind of cascading decline.
How OT Differs From Physical Therapy
This is one of the most common points of confusion. Physical therapists (PTs) focus on improving physical function, mobility, and strength. They treat movement problems and musculoskeletal or neurological conditions resulting from injury, illness, or disability. Their goal is to get your body working better.
OTs use that physical foundation but zoom out to the bigger picture. As one UCLA clinician put it, occupational therapy focuses on improving the things you do day-to-day that have been impacted by a condition, disease, or injury. A PT might help you regain range of motion in your shoulder after surgery. An OT might then teach you strategies to get dressed, reach kitchen shelves, or return to your desk job using that recovering shoulder. The two professions frequently overlap and collaborate, but their end goals are distinct: PTs restore movement, OTs restore function in real life.
Who OTs Work With
Occupational therapy serves people across the entire lifespan. In pediatrics, OTs help children with developmental delays, autism, sensory processing difficulties, or physical disabilities build the skills they need for school and play. A pediatric OT might work on handwriting, social interaction, managing sensory overload in a classroom, or learning to use utensils.
In adult and geriatric settings, OTs commonly treat people recovering from strokes, traumatic brain injuries, spinal cord injuries, joint replacements, and hand injuries. They also work with people managing chronic conditions like arthritis, multiple sclerosis, or Parkinson’s disease. Mental health is another significant area: OTs help people with anxiety, depression, or serious mental illness develop routines and coping strategies that support independent living.
Services aren’t limited to people with disabilities. OTs also work in health promotion and wellness, helping people prevent injuries or adapt their environments before problems arise.
Tools and Techniques OTs Use
A big part of occupational therapy involves adaptive equipment: tools designed to make daily tasks possible when your body can’t do them the usual way. Examples include adaptive utensils with built-up handles for people with weak grip, dressing aids like button hooks and long-handled shoehorns, specialized handwriting tools for children with fine motor challenges, and sensory boards and pads for kids who need help regulating sensory input.
OTs also modify environments. This could mean recommending grab bars in a bathroom, rearranging a kitchen so someone in a wheelchair can cook safely, or adjusting a workstation to reduce strain. The approach is holistic: rather than just treating the body, OTs change the task or the environment to fit the person.
The OT Process
Occupational therapy follows three main stages. First is evaluation, where the therapist assesses what you can and can’t do, what activities matter to you, and what barriers are getting in the way. This includes observing you performing tasks and understanding your living situation, goals, and challenges.
Next comes intervention, the hands-on treatment phase. This might involve practicing specific tasks, learning new techniques, strengthening fine motor skills, using adaptive equipment, or making environmental modifications. Finally, the therapist tracks outcomes to measure whether you’re making progress toward your goals and adjusts the plan as needed.
Education and Credentials
Becoming an occupational therapist requires a graduate degree, either a master’s or a clinical doctorate in occupational therapy from an accredited program. After completing their degree, graduates must pass a national certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT). Those who pass earn the OTR credential, which stands for Occupational Therapist, Registered. State licensure is also required to practice.
There’s also a role called an occupational therapy assistant (OTA), which requires an associate degree and passing the COTA certification exam. OTAs carry out treatment plans under the supervision of an OTR but don’t perform evaluations or develop treatment plans independently. Both OTRs and COTAs must meet ongoing recertification requirements to maintain their credentials.
Where OTs Work
Occupational therapists work in a wide range of settings. The largest employers are hospitals (28% of all OT jobs in 2024), followed closely by outpatient health practitioner offices (27%). About 13% work in schools, helping children access education. Home health care employs around 8%, and skilled nursing facilities account for another 7%.
Pay varies by setting. OTs working in home health care earn among the highest wages, averaging around $105,700 per year, while those in schools tend to earn less, closer to $83,000. Hospital-based OTs fall in between at roughly $95,400. The field employed about 160,000 therapists across the U.S. as of 2024.