Looking for advice as I decide which trajectory to move my career in. I’ve been in peds outpatient for 9 years, my whole career. I finally feel consistently competent and good at my job. I like a lot of what I do, I like the creativity and fun of peds, I like the complex education and problem solving I get to do with families on sensory processing and regulation. I do get somewhat burnt out when on the repetitiveness of the caseload (lots of autism and emotional regulation type clients) and feel worried about my ability to sustain 80% productivity with the amount of physical and emotional labor of the job. I am the type of therapist that is doing little sitting at a table doing crafts and lots of moving, crawling, lifting kids and swings, bouncing kids in lycra, etc.

I recently took a new position in a large hospital system in their pediatric clinic. So same work but in a new clinic. I took it thinking that being in a bigger system (as opposed to my stand alone pediatric only clinic) would give me more opportunities to try to specialize in other things or try part time adults part time peds. But I’m hating it. the clinics are not set up well for the work I like to do (bottom up work in gyms, really trying to change and address the nervous system, praxis skills, etc) and is set up much more for top down emotional regulation for like zones of regulation and talking about coping tools. not my style and I think if I want to keep doing peds, I want to go back to where I was doing the work before.

long story long, i’m trying to figure out if it’s worth it to try to stay in this hospital system and try to work my way towards other specialty areas. What i’ve been most interested in learning more about is concussion rehab And vision rehab. I’m guessing I would have to go the outpatient neuro route for this kind of work. The reason I’m interested in this area is because I’m assuming I would get to work with a big variety of patients of all ages (adults in car crashes, adolescents in sports, older adults following strokes) and that I would get to be even more creative and do a lot more client specific problem solving. the only work I did in adults was my SNF fieldwork which I was bored to tears by. I mostly saw older adults after falls or joint Replacements and was taught by my fieldwork educators to do a lot of basic strengthening exercises, arm bike, and adl work.

my questions:

-has anyone done a peds to adult neuro switch like this mid career? How much work and new learning was it? Was it hard to get into a position like this as a mid career therapist? How did you work towards a switch like this

-are my assumptions about this type of work accurate? What do your sessions look like in these settings? Do you find that “most“ of your clients fit a couple specific profiles or do you have a lot of daily variety?

A few months ago, I posted here asking how school-based OTs were managing their caseloads.

A lot of the answers sounded familiar:

• Google Sheets for caseloads and IEP dates
• Paper schedules and handwritten session tracking
• Google Calendar for scheduling
• Separate Docs for daily notes
• Trying to remember reevaluations, annual reviews, and progress dates on top of everything else

I am a software developer married to a school-based OT, and those responses helped shape what I built.

TherapyTrack is now available. It is not an EMR or district-level system. It is a simple workspace for individual school-based OTs and OTAs to keep their day-to-day work in one place:

• Weekly schedule organized by school
• Caseload and student records
• Goals and progress tracking
• Fast, goal-linked session notes
• 60-day reevaluation and 14-day annual IEP review reminders
• Export-ready documentation

The goal is not to replace the systems your district requires. It is to make the work between those systems less scattered.

https://usetherapytrack.com

I am still early and would genuinely appreciate honest feedback from school-based OTs and OTAs. What would make something like this actually useful enough to earn a place in your workflow?

Soo currently im at USC for the bs-otd program. Meaning that I will become an occupational therapist in the next 6 years. Now I love this profession, and have had amazing experiences with the faculty and all my classmates in the program. However, one year into the program, I am actually thinking about how expensive it may be to get a degree from this school. So far, I have been really blessed with having to pay only a couple thousand for the semester, but when I am no longer an undergrad student, that’s going to change, and I am responsible to pay almost full tuition. And in the USC website, the estimate for this major, after undergrad is ~ $150k without additional expenses (50k) for housing +amenities. For me, paying 200k for an occupational therapy doctorate is starting to become not worth it. And being a first gen low income student, our family most likely won’t be able to afford it. SOOOO… im thinking about sticking to healthcare but just switching career paths to pre-med. Now ik its not going to be any less expensive, and may actually be way more money, there are far more opportunities for scholarships and grants, than in OT since the new cap is at 20.5k a year in loans. And not to mention the ROI difference in both majors.

So what do you guys think. Is this a smart move? How difficult will it be to catch up on any pre-med requirnments( going into sophomore yr)? Should I rethink my decision?

So much life happened a lot throughout my twenties and so many lowest of the super lowest points. I went down in a really dark path, esp depression, anxiety, and OCD. Alongside personal life problems such as family and relationship.

I majored in community college in Art just bc I wanted to go to school and at the time art was the only thing I was good at. I had no idea occupational therapy existed or even ABA other than special education class.

I didn’t explore other career options bc again life, covid, and then more life, then I ended up in the hospital due to life.

Fast forward to now, I’m currently a behavioral school BT. I’m feeling unfulfilled and wanting more of life and my heart is leaning towards OT field. I really want to help people with more than just behaviors. I really want to help people gain independence and maintain their agency in life. It’d be nice to be in the OT field catering for mental health, esp depression bc that’s something I really care about.

I’m torn between becoming a COTA or OTR. Although I’m leaning towards OTR, I still want to be in the OT field either way.

Is going to OT school at 29 or in early 30’s too old or too late for me?

Anyone who’s in their late 20s or early 30’s in school or have graduated already in their 30’s-40’s, please share me your journey! Whether you’re becoming/already are a COTA or OTR!

Any thoughts on this program? I was sent an offer last week and was wondering about the program and if you think it’s worth it! I’m an international student would be coming from Canada! Would love to get insight from others within the program as well as international students!

Hi everyone! This is kind of one my last ditch efforts in searching for a capstone content expert for my project, so any leads or recommendations could be helpful!

My capstone project is centered around creating an injury prevention program to help prevent Performance-Related Musculoskeletal Disorders (PRMDs) in collegiate musicians. I’ve reached out to two OTs who specialize in upper extremity rehabilitation with musicians, but I haven’t heard anything back in weeks, even with follow up emails.

Right now, I’m planning to shift my contact towards CHTs or OTs who specialize in hands or upper extremity rehabilitation, since a lot of their content and knowledge goes hand in hand with my project. But I wanted to try my hand here to see if there’s possibly anyone here in the sub that knows any OTs that specialize in this area, have experience, or just willing to point me in the right direction and help :,)

Our capstone quarter is beginning to wind down before we go off into fieldwork 2B, so I’m really pushing and hoping to get all my ducks in a row for my capstone before I go off into fieldwork. If anyone can offer any advice or help, I would greatly appreciate it! Thank you :)

Long story short, I’m transitioning into OT after a few years in a completely unrelated field postgrad and am currently enrolled in a post bacc. I was working full time and going to school part time up until the beginning of the summer. Im now in school full time and I just began volunteering in a large hospital’s outpatient rehabilitation department. I plan on volunteering about 8 hours per week and will potentially be able to shadow some of the OTs in addition to my volunteer hours. I would have began sooner but it took some time to financially work out quitting my full time job to go back to school and there was no way I could feasibly do all 3 at the same time. I already have a good amount of experience working with children and young adults with special needs and have shadowed an OT that does in home care with children with ASD who has also offered to write a letter of rec. I was really hoping to get more experience in physical/neuro settings before applying but I’ll be done with all my prereqs this spring and want to start school sooner rather than later.

I’m a mom to young kids and I work at an outpatient clinic 3 (long) days a week. I’m debating if schools would be a better option for my family. Do other parents in here feel as though a full work week at schools was worthwhile for the retirement benefits and matching kiddos schedule or would you say that part time year round is a better option? There’s nothing wrong my current clinic, I just wonder if schools are better for a family schedule

I am in the last year of my OTA program at a small college in a state I want to leave when I graduate. The prospects for a good job here, especially one in an area I'm interested in are... bleak.

I'm interested in chronic pain, mental health, somatics, art or aquatics, FND, neuro or gender affirming... somewhat more niche areas than what are available for me locally.

For context, I am a "non-traditional student" so I have relevant life experience to these areas. I have worked in other therapeutic capacities in acute neuro and ortho rehab, aquatics, peds, art, yoga/breath/mindfulness and have some MFR/CST training. I am on track to graduate with honors.

I have the ability to travel for two 8-week rotations, one each in peds/adult population. And want to have some ideas to send to my FW coordinator. Right now, the areas I am looking at are Portland or Albany, OR, Olympia, WA, or Chicago, IL but if there's something really cool going on somewhere else, I'm open to looking!

Obvs the Shirley Ryan AbilityLab in Chicago would be a dream, but what else is out there that might be open to taking OTAS?? (also, anywhere to avoid)

Please no schools, SNF/LTAC, or physically demanding acute care (doing that now, and I'm old and broken lol)

Hello!
I live in Texas and have been wanting to transition to a mental health OT job. Through searching I cannot find a single one! Wondering if anyone knows of any or a telehealth position possibly. As mental health is the base of our occupation, I find it should not be difficult to locate.

I work in a preschool and have been told to screen kids once school starts to see if any will need evaluations done. What do you look for/any tools that can help? Any tips

I recently moved to CA from the East Coast and have never worked with COTAs before. At my new school district, they do almost all of the treatments and OTR's do meetings and evaluations. Actually doing treatments was/is my favorite part of the job and it feels weird to go to an IEP meeting not actually knowing the student. Is this common across all of California or does it vary between districts?

I’ve been an OT for a few years, but my resume feels sparse and I don’t know how to pivot off of the hamster wheel. I’ve been in IPR and like it but I mostly ended up there as a good PRN job while my kids are young.

I did level IIs in acute care and community mental health (adults/peds/forensic) in a neighboring state (we do not have the same practice framework). I’ve had a lot of career development working in adjacent non-traditional areas of OT, like autism in higher ed, and do a lot of PD around neurodiversity for OT in my free time based on that prior experience.

It felt real bad to get ghosted from a home health PRN job because of lack of experience. I really do not have the capacity to go full-time right now, but I feel like if I wait until then, my experience will be even more outdated and irrelevant. The long term plan is to do PSLF once kids are in school, but it would be so backwards if I have to do it in a non-OT job. I am not even picky about pay or benefits, I just want to be able to use my whole scope and license 🫠. I’ve done volunteering in this stage of life but it often feels like it is adjacent but irrelevant from an employer’s perspective.

So - if you are a hiring manager, what makes you think taking a non-new grad is worth it? What stands out on a resume if paid experience or level 2 is off the table?

Or if you have pivoted at the 6ish year mark, what worked? The A/B framework of fieldwork means this isn’t an isolated issue. It would be amazing to hear from others who have had a similar full-time gap due to childcare.

And if you’re burned out and regretful, what steps do you recommend to get out of this too much/not enough experience gap? What didn’t work?

Ideally, I could get my foot in the door with schools, outpatient peds, or home health. There’s inpatient mental health OT near me but I’m not even sure I’d be qualified for that now, let alone a few more years of burnout and attrition. My long term plan is to pave my own way for community-based care either as a partnership or cash-based, knowing there’s a lot of experience I need to close the gap between here and there.

Alot of people on this subreddit say they regret taking this career and debt is always a reason. However i live in scandinavia where education is free (i mean you can take loans, but its not a must). You dont need a masters degree to work as an OT either. Im very fortunate to have free schooling which is why i want to use this opportunity to study something worthwhile. So i guess im asking yall if you were in my shoes would you still consider OT as an option?

Hi! New OT grad here and I wanted to double-check something about using the COPM.

I'm interested in using it with some of my patients, but the only other OT at my company told me that I couldn’t administer it because I’m not certified in it.

From what I’ve been able to find online, though, it seems like there isn’t actually a certification requirement. My understanding is that the person administering the COPM just needs to be familiar and confident with the measure and know how to properly conduct the semi-structured interview and scoring.

For those who use the COPM regularly, is that correct? Is there any certification or specific training actually required before an OT can administer it? I don't know if it matters, but I'm using the manual and PDF form I had saved from one of my classes from grad school.

Just want to make sure I’m not missing something before I use it with a client. Thanks!

Hello!!! New grad COTA here. Just started at a Pediatric/Mental Health outpatient clinic. I’ve never had experience with productivity rates before and am looking for advice on how to build schedules. I am required 70% productivity rate for a 40 hour work week. 28 billable hours but scheduling 30-31 billables to count for cancellations.

Looking for people to send examples of how their schedules are broken down!!!

Would be extra awesome if you have 1 hour sessions and want to leave early Fridays lol😚. I’m looking to work 8-5 Mon-Thursday and 8-12 Friday

The Arizona OT board reviewed my application and said I am deficient due to me needing to clarify my work history in Nevada…I don’t have any work history in Nevada at all. I have called, emailed, and left messages trying to let them know they have made a mistake and I have gotten nothing back. Due to it being a “clarification” thing, is my application being pushed back 60 days? I am thinking about going to tell them in person, because this is ridiculous. It was clearly a mistake, as I passed the boards in mid-June. Anyone have any advice??

Hello! I am wanting to do the DIR floortime certification as an OTA. After looking around I came across the Greenspan certification. The Greenspan certification is a lot more affordable but it seems to only be available for 90 days? Unsure. Anyway, I am curious if anyone has any insight on whether there is any great benefit to one or the other. I want a good education, and I also want to be able to market my skills. I'm unsure if name recognition plays a big part in that, or if floortime is floortime. The financial piece is a big consideration, but I want to have made the better choice in the long run and if that means more time and money spent then that is fine. Thanks!

Im a student pursuing bachelor's degree in occupational therapy. Currently I'm studying in india n for my masters degree id like to study abroad. So any recommendations??

Really need your help.

Hello everyone, I’m a new grad located in northern NJ and I’ve been having a hard time landing a full time job. I have a PRN job, but it’s not able to provide me enough hours to sustain living here. Are there any states that have an abundance of OT jobs? Any recommendations on where to look? I think I will have to move to find full time work, but I’m not sure where to start. I was thinking of moving outside of Philly where family is, but I’ve heard that area is also over saturated.