How to Become an Occupational Therapist

Occupational therapy, the saying goes, adds life to days. Find out how you can pursue a rewarding career helping people, the degree needed, and your salary expectations.
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  • Occupational therapists need a master's or a doctoral degree and a state license.
  • Hospitals, nursing homes, schools, and home health services need licensed occupational therapists.
  • Home health services and long-term care facilities may pay occupational therapists higher salaries.
  • Occupational therapists help people with injuries or disabilities improve their ability to do daily tasks and care for themselves.

Want to begin a fast-growing career devoted to helping people to heal physically and mentally? You may consider becoming an occupational therapist (OT).

OTs work in a variety of industries, not just hospitals. They can work in speech therapy offices, home health services, elementary or secondary schools, and nursing care facilities. Learn how to become an occupational therapist, common responsibilities, licensing criteria, and earning potential.

What Is Occupational Therapy?

Occupational therapy focuses on the pain and mobility challenges patients experience while doing everyday tasks. Instead of helping patients regain movement, like in physical therapy, an OT helps them perform their daily activities independently. Occupational therapists focus on helping patients build fine motor skills, allowing them to perform tasks such as feeding and dressing themselves.

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What Does an Occupational Therapist Do?

OTs treat patients who may struggle with daily activities, such as bathing, eating, walking, or dressing. Some of their patients live with a long-term disability, while others may need occupational therapy while recovering from an injury. Occupational therapists evaluate patients and develop therapy plans based on their needs. They can work in hospitals, schools, mental health settings, home health services, and nursing homes.

A minimum of a master's degree and state licensure is required to become an occupational therapist. Most OTs begin their careers at the master's level. Although some earn a doctoral degree.

Occupational Therapist Responsibilities

  • Assess Patients and Their Environments: Occupational therapists evaluate new patients to plan therapy treatments. Patient evaluations include observing gross or fine motor skills and cognitive abilities. Assessments include continually monitoring caseloads and amending short- and long-term goals.
  • Help Patients Perform Their Activities of Daily Living (ADLs): Occupational therapists introduce techniques to address ADLs, activities for basic well-being and survival. Occupational therapists assist in nine areas: bathing, toileting, dressing, swallowing and eating, feeding, mobility, personal device maintenance, and hygiene.
  • Educate Patients, Families, and Employers: OTs educate patients, families, and caregivers in how to help manage the patient’s conditions. They also teach patients how to increase their independence with ADLs and provide support group information and other resources.
  • Suggest Adaptive Equipment and Accommodations: Occupational therapists suggest adaptive equipment patients need to perform daily activities.Common adaptive equipment helps patients with dexterity issues and includes utensils with grips or button hooks to help patients dress.
  • Assess Patient Progress and Help Patients Gain Independence: Occupation therapy requires ongoing assessments to help patients meet goals. Documentation of a patient's progress helps occupational therapists modify the plan of care as needed to better meet the patient's needs, improve their function, adjust at-home programs and make referrals if needed.

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What are the Steps to Becoming an Occupational Therapist?

To become an occupational therapist, you must complete a bachelor's degree, earn a master's degree, and become licensed in your state. Some occupational therapists go on to complete a doctorate program.

Step 1: Earn a Bachelor's Degree

The first step in becoming an occupational therapist is to earn a bachelor's degree in a related healthcare or STEM field. It typically takes four years to complete a bachelor's degree.

Becoming an OT requires communication skills and an understanding of the physical and psychological challenges patients may experience in therapy. A bachelor's in psychology is a popular choice for OTs. However, with a bachelor's degree in occupational therapy, you can become an occupational therapy assistant to gain experience.

Step 2: Complete Observation Hours and Grad Exams

Some graduate programs require you to take the GRE. Programs may require you to earn a minimum GRE score as well as possible observation hours to gain admission.

As a prerequisite for a graduate degree, you usually need proof of 20-100 hours of experience working under a licensed occupational therapist. Required hours vary by each program.

Observation hours can be completed at schools, skilled nursing facilities, home health services, and hospitals. Some programs offer on-the-job training.

Step 3: Earn an Advanced Degree in Occupational Therapy

You need at least a master's degree to qualify for OT certification and state licensure.

To earn a graduate degree requires that you complete 60-70 credits. However, credits vary by school. Over 2-3 years, you'll study occupational therapy theory, neuroscience, functional anatomy, clinical reasoning, environmental adaptations and home modification. The required fieldwork lets you gain clinical experience by delivering occupational therapy to patients under the supervision of your clinical instructor.

The cost of a master's degree depends on the program you choose. Before you take on the student debt associated with an advanced degree, consider your expected salary as an occupational therapist.

Occupational therapists earn a median annual salary of $96,370, according to the Bureau of Labor Statistics (BLS). If you earn your doctoral degree in occupational therapy, you can pursue a management or directorial position after several years of experience in the field, which could lead to a higher salary.

Step 4: Obtain State Licensure

After earning a degree from a program approved by the Accreditation Council for Occupational Therapy, you must pass the National Board for Certification in Occupational Therapy (NBCOT) exam to become a certified OT. After passing the exam, you must fulfill your state's requirements, which vary by state.

Common requirements to become a licensed OT in your state may include

  • A clean background check
  • Official transcripts from your graduate program
  • A passing score on your state's regulation exam

Step 5: Get a Job as an Occupational Therapist

You must have a state license to work in occupational therapy. Most employers hire occupational therapists to work in hospitals. In fact, the BLS reports that about 29% of 139,600 occupational therapists in the United States work in state, local, and private hospitals.

You can also work in schools, home health, hospitals, or nursing facilities. In each setting, you'll conduct evaluations and assessments to address the needs of each patient. Your work will also include completing progress reports and other documentation and consulting with other medical professionals.

Step 6: Maintain Licensure

Each state has its own requirements for maintaining OT licensure. Along with submitting an application and paying any required fees, many states require continuing education or competency hours. If you don't renew your license on time, you must pay late fees to renew it. Practicing with an expired license may result in a fine or a criminal charge.

Additional certifications you can get to show your expertise include:

  • Geriatrics
  • Pediatrics
  • Physical rehabilitation

What to Know Before Becoming an Occupational Therapist


College accreditation is one of the most important aspects of your education. You will not be allowed to take the NBCOT exam, become certified, or become licensed in your state without proof that you have completed an accredited program. After passing the exam and becoming certified, you can then apply for state licensure. You will not be able to find a job or legally practice in your state without licensure and certification. Each state has its own rules for licensure.


The average cost of a master's program varies depending on the school. According to the National Center for Education Statistics, graduate tuition and required fees cost an average of $19,750 per year as of 2020-2021. Be aware of hidden college costs not listed on program websites. This average cost does not include books, technology, housing, and transportation.

After graduation, you must also pay for costs associated with becoming a licensed occupational therapist. For example, the fee to fill out the NBCOT exam application online is $515, and states have different licensure renewal costs.


Early in your career as an occupational therapist, you can make about $56,800 a year or $27.31 an hour, according to the BLS. The 90th percentile of occupational therapists can earn an average of $121,490 annually, or $58.41 an hour.

Experienced occupational therapists tend to earn more, as do professionals in specific settings. The top pay industries for occupational therapists include management companies, home health care, and outpatient care centers, which pay between $102,840-$117,710.

The career offers relative stability. The BLS projects jobs for occupational therapists to increase by 12% from 2022-2032, which is much faster than average.

Frequently Asked Questions About Becoming an Occupational Therapist

What degree do you need to be an occupational therapist?

You'll need at least a master's degree and a bachelor's degree in a related field to be a practicing occupational therapist. Some graduate programs require you to pass the GRE, complete observation hours, write an essay, and sit for an admissions interview.

Some students choose to earn their doctorate or Ph.D. While this is not a requirement to practice, an advanced degree may open up opportunities for you to pursue research, teaching, or advanced employment.

Is it hard to learn occupational therapy?

Occupational therapy programs can be hard as they require 2-3 years of intensive classroom study beyond a bachelor's degree. As a part of the curriculum, you must also complete clinical rotations where you work in different settings or clinics throughout your schooling.

How long does it take to become an occupational therapist?

You'll spend at least 6-7 years becoming a licensed occupational therapist. It takes about four years to complete a bachelor's degree. After that, completing a master's program takes two or three years. If you go on to earn your Ph.D., you could spend up to an additional six years in school.

What is the difference between an OTA and an OT?

Occupational therapists, or OTs, need at least a master's degree, a passing score on the national exam, and a state license to practice. Each state sets the educational requirements for OT licensure. Occupational therapist aides work under the supervision of a licensed OT.

How much do occupational therapists make?

Specific work settings in occupational therapy pay more than others. Occupational therapists make a median annual salary of $93,180. Working in home health services and outpatient care centers pays the most, with occupational therapists making over $100,000 annually.

Page last reviewed on September 8, 2023 is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

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