The Value of Occupational Therapy and Lobbying for the Profession

Who is this for?

This page is intended for those who may be unfamiliar with occupational therapy and was sent to this page by someone advocating for the profession. This includes other advocates, lobbyists, legislators, politicians, representatives, policy makers, insurers, employers, and elected officials at the state and federal levels.

Goal of this page

The goal of is page is to provide a quick overview of the value of occupational therapy as an allied health profession in the American healthcare system and for the society based on the published studies and the latest best practices.

What is Occupational Therapy?

Occupational therapy is a profession that is client-centered, evidence-based, and science-driven.((Lamb, A. J., & Metzler, C. A. (2014). Defining the value of occupational therapy: A health policy lens on research and practice. The American Journal of Occupational Therapy, 68(1), 9-14.))

Occupational therapists work with clients across the lifespan to help them do the things that they want to do that are meaningful to them. As an allied health profession, occupational therapists and occupational therapy assistants work alongside physicians, nurses, physical therapists, speech-language pathologists, psychiatrists, educators, and more.

Occupational therapy practitioners help people of all ages participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Unlike other similar professions, occupational therapy helps people function in all of their environments (home, work, school, community) and addresses the physical, psychological, and cognitive aspects of their well-being through engagement in meaningful activities.((North Carolina Occupational Therapy Association. (n.d.). Advocacy Toolkit. Retrieved from https://www.ncota.org/assets/docs/AdvocacyDay/ncotatoolkitnov2020MG%20%283%29.pdf))

“Occupational therapy professionals are broadly trained in human development, health promotion, disease process intervention, activity analysis, behavior modification, lifestyle interventions, and the use of adaptive equipment, all of which are fundamental in addressing the needs of patients, especially those who have more than one problem or condition. Involving occupational therapy and other services in primary care can reduce fragmentation in health care.”((Muir, S. (2012). Occupational therapy in primary health care: We should be there. The American Journal of Occupational Therapy, 66(5), 506-510.))

Is Occupational Therapy Effective?

Systematic reviews in the research shows occupational to be effective for pediatrics with disabilities((Novak, I., & Honan, I. (2019). Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review. Australian occupational therapy journal66(3), 258-273.)) to adults with disabilities,((D’Amico, M. L., Jaffe, L. E., & Gardner, J. A. (2018). Evidence for interventions to improve and maintain occupational performance and participation for people with serious mental illness: A systematic review. The American Journal of Occupational Therapy, 72(5), 7205190020p1-7205190020p11.)) as well as for mental health.((Gibson, R. W., D’Amico, M., Jaffe, L., & Arbesman, M. (2011). Occupational therapy interventions for recovery in the areas of community integration and normative life roles for adults with serious mental illness: A systematic review. The American Journal of Occupational Therapy, 65(3), 247-256.))

Positive Economic Impacts of Occupational Therapy

Occupational therapy not only impacts the lives of Americans’ physical health and mental illness but its services can have positive economic impacts including potential cost savings from shortened hospital stays,((Lindström, I. B., & Ohlsson, J. (2001). Occupational Therapy—What’s It Worth to Society?. World Federation of Occupational Therapists Bulletin, 44(1), 23-25.)) better healthcare outcomes, and improved quality of life, which is in line with the IHI Triple Aim objectives.((Mery, G., Majumder, S., Brown, A., & Dobrow, M. J. (2017). What do we mean when we talk about the Triple Aim? A systematic review of evolving definitions and adaptations of the framework at the health system level. Health Policy, 121(6), 629-636.)) Structured occupational therapy interventions comprised of multiple consultations and engaged caregivers have delivered better functional and economic outcomes.((Rahja, M., Comans, T., Clemson, L., Crotty, M., & Laver, K. (2018). Economic evaluations of occupational therapy approaches for people with cognitive and/or functional decline: A systematic review. Health & social care in the community, 26(5), 635-653.))

The Value of Occupational Therapy

Effectiveness of OT in Mental Health and Employment

  • Studies found that occupational therapy practitioners through employment programs and interventions can help to support education and employment.((Arbesman, M., & Logsdon, D. W. (2011). Occupational therapy interventions for employment and education for adults with serious mental illness: A systematic review. The American Journal of Occupational Therapy, 65(3), 238-246.))((Noyes, S., Sokolow, H., & Arbesman, M. (2018). Evidence for occupational therapy intervention with employment and education for adults with serious mental illness: A systematic review. The American Journal of Occupational Therapy, 72(5), 7205190010p1-7205190010p10.))
  • Occupational therapy interventions can help with community integration and resuming normal life due to serious mental illness.((Gibson, R. W., D’Amico, M., Jaffe, L., & Arbesman, M. (2011). Occupational therapy interventions for recovery in the areas of community integration and normative life roles for adults with serious mental illness: A systematic review. The American Journal of Occupational Therapy, 65(3), 247-256.))
  • Occupational therapy using activity-based interventions can help children with intellectual impairments, developmental delays, and learning disabilities to participate in social situations, play, leisure, and self-managment.((Arbesman, M., Bazyk, S., & Nochajski, S. M. (2013). Systematic review of occupational therapy and mental health promotion, prevention, and intervention for children and youth. The American journal of occupational therapy, 67(6), e120-e130.)) This improved outcome decreases the burden on caregivers and can allow them to return to workforce.
  • Occupational therapy interventions for students with mental illness can help them to transition into higher education and ultimately to graduate and join the workforce.((Spencer, B., Sherman, L., Nielsen, S., & Thormodson, K. (2018). Effectiveness of occupational therapy interventions for students with mental illness transitioning to higher education: A systematic review. Occupational therapy in mental health, 34(2), 151-164.))
  • Occupational therapy practitioners are trained to provide interventions to homeless people to help them with transitions and increase their employment and education prospects.((Thomas, Y., Gray, M., & McGinty, S. (2011). A systematic review of occupational therapy interventions with homeless people. Occupational therapy in health care, 25(1), 38-53.))((Marshall, C. A., Boland, L., Westover, L. A., Isard, R., & Gutman, S. A. (2021). A systematic review of occupational therapy interventions in the transition from homelessness. Scandinavian Journal of Occupational Therapy, 28(3), 171-187.))

Effectiveness of OT in Community Living

  • Moderate to strong evidence suggests that occupational therapy interventions provided by occupational therapy practitioners improve driving performance and community mobility for older adults, enabling them to remain living in the community.((Stav, W. (in press). Occupational therapy practice guidelines for driving and community mobility for older adults (2nd ed.). Bethesda, MD: AOTA Press.))
  • Occupational therapy can provide home safety assessments before community discharge, which decreased 30-day hospital readmissions.((Johnston, K., Barras, S., & Grimmer‐Somers, K. (2010). Relationship between pre‐discharge occupational therapy home assessment and prevalence of post‐discharge falls. Journal of evaluation in clinical practice, 16(6), 1333-1339.))
  • Occupational therapy practitioners have a major role in enabling independent living and continued activity in older adults as a means to better health and reduced costs.((Knapp, M., Iemmi, V., & Romeo, R. (2013). Dementia care costs and outcomes: a systematic review. International journal of geriatric psychiatry, 28(6), 551-561.))
  • Moderate to strong evidence supports occupational therapy to help clients with Alzheimer’s disease and related disorders in their physical environment.((Schaber, P. (2010). Occupational therapy practice guidelines for adults with Alzheimer’s disease and related disorders. Bethesda, MD: AOTA Press.))
  • Occupational therapy can help patients to manage chronic conditions including Parkinson’s disease, stroke, and low vision.((Preissner, K. (2014). Occupational therapy practice guidelines for adults with neurodegenerative disorders. Bethesda, MD: AOTA Press.))((Kristensen, H. K., Persson, D., Nygren, C., Boll, M., & Matzen, P. (2011). Evaluation of evidence within occupational therapy in stroke rehabilitation. Scandinavian journal of occupational therapy, 18(1), 11-25.))
  • Occupational therapy practitioners’ can help to reduce readmissions and drive down expenses associated with multiple medical comorbidities.((Rogers, A. T., Bai, G., Lavin, R. A., & Anderson, G. F. (2017). Higher hospital spending on occupational therapy is associated with lower readmission rates. Medical Care Research and Review, 74(6), 668-686.))((Freburger, J. K., Li, D., & Fraher, E. P. (2018). Community use of physical and occupational therapy after stroke and risk of hospital readmission. Archives of Physical Medicine and Rehabilitation, 99(1), 26-34.))((Roberts, P., Robinson, M., Furniss, J., & Metzler, C. (2020). Occupational therapy’s value in provision of quality care to prevent readmissions. The American Journal of Occupational Therapy, 74(3), 7403090010p1-7403090010p9.))

Effectiveness of OT in Preventative Health

A large part of reducing healthcare costs and the impact of adverse health outcomes is preventative health which leads to a decreased utilization and cost burden on the healthcare system.((Hildenbrand, W. C., & Lamb, A. J. (2013). Occupational therapy in prevention and wellness: Retaining relevance in a new health care world. The American Journal of Occupational Therapy, 67(3), 266-271.))

Barriers to Achieving Healthcare Goals

Although the core mission and values of occupational therapy have numerous benefits for American society, current limitations in billing and practices pose a barrier to occupational therapy practitioners achieving the best outcomes for our communities.

For example, “The participants frequently referred to the belief that occupational therapists were very much concerned with patient
well-being … . Yet there were many examples of where the
occupational therapists claimed that these client-centered
interventions were compromised when business-oriented
health service managers kept the attention on the “product”
and “process” of healthcare.”((Lencucha, R., & Shikako-Thomas, K. (2019). Examining the intersection of policy and occupational therapy: A scoping review. Canadian Journal of Occupational Therapy, 86(3), 185-195.))

  • Limitations in the scope of practice of occupational therapy practitioners also pose a barrier to the implementation and practice of research-backed interventions.((American Occupational Therapy Association. (2021). Occupational therapy scope of practice. The American Journal of Occupational Therapy, 75(Supplement_3).))
  • According to the AOTA, “the ability of occupational therapists and occupational therapy assistants to compete in the marketplace, and the integrity of the occupational therapy profession’s domain, are only as strong as the legal structures that are in place in all 50 states and other jurisdictions.”
  • Occupational therapy remains to be a relevant and appropriate service across many areas, but needs advocacy to defend its licensure and scope of practice.((American Occupational Therapy Association. (n.d.). Scope of practice. Retrieved from https://www.aota.org/advocacy/issues/scope-of-practice-advocacy))
  • There continues to be a lack of public awareness and knowledge among the healthcare team of the role and value that occupational therapy provides. This may be due to barriers in its licensing, scope of practice, and research to support its positive outcomes.((Darawsheh, W. B. (2018). Awareness and knowledge about occupational therapy in Jordan. Occupational therapy international, 2018.))((Mu, K., Royeen, C., Paschal, K. A., & Zardetto-Smith, A. M. (2002). Promoting awareness and understanding of occupational therapy and physical therapy in young school aged children: An interdisciplinary approach. Occupational Therapy in Health Care, 15(3-4), 89-99.))((McAvoy, E. (1992). Occupational who? Never heard of them! An audit of patient awareness of occupational therapists. British Journal of Occupational Therapy, 55(6), 229-232.))((Meny, A. H., Hayat, A. A., Ain, Q. U., Tariah, H. S. A., Almarhoon, A. J., Eldigire, M. H. A., & Ahmed, S. (2021). Knowledge about Occupational Therapy among People in Saudi Arabia. Journal of Evolution of Medical and Dental Sciences, 10(22), 1703-1708.))

Additional Resources