With America's population aging and the applications of occupational therapy broadening, there is a need for new professionals. "U.S. News & World Report" ranked occupational therapy among the 10 best careers of 2012. Though many occupational therapists come into the field straight out of graduate school, it is possible to move from a certified occupational therapist assistant to an OTR position with additional education.
While other therapies focus on building strength or skills, occupational therapy focuses on applying skills. You'll spend your days as an OTR or a COTA working closely with patients to help them navigate physical, mental, developmental or emotional challenges with one simple goal: To improve their quality of life and make daily functioning easier. This could mean helping a stroke patient relearn to walk, talk or brush her teeth, or helping a child with learning disabilities use technology to work efficiently. The scope is enormous.
OTR vs. COTA
Both of these professionals assess ability and environment to determine what specific skills, strengths and modifications might help the patients. COTAs work under the direction of OTRs to administer treatment plans, and though they have much autonomy on the job and are often more directly involved with patients throughout therapy, they are not licensed to evaluate patients or write treatment plans. COTAs can begin working with a two-year associate degree and board certification, which is the quickest way into the field. OTRs must have at least a master's degree and many now have doctoral degrees.
COTA to OTR
The American Occupational Therapy Association has a full list of educational bridging programs for COTAs seeking OT degrees. Some programs require incoming students to have a bachelor's degree while others enable students to earn their undergraduate and graduate degrees simultaneously. Because most COTAs have two-year degrees, accelerated combined BS/MS programs are the best option. These full and part-time programs are designed for working adults. Most combine online distance learning with night or weekend sessions and fieldwork. Full-time students entering with a bachelor's degree can complete most programs in under three years; students starting with an associate degree can finish in less than four.
Job Outlook and Salary
Predicted job growth is slightly slower for OTRs than COTAs, though the former earned about $20,000 more annually in 2012, according to the Bureau of Labor Statistics. The agency projected 41 percent job growth for COTAs between 2010 and 2020, and 33 percent growth for OTRs in the same time period. Both remain substantially higher than the national average for all professions. In May 2010 the median wage for COTAs was $51,100 with the top earners making $70,790. Median wage for OTRs that year was $72,320. The top 10 percent made $102,520.
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