The many roles of occupational therapists

Today, occupational therapists work with many kinds of clients, including wounded veterans of the Afghanistan and Iraqi wars.

Working in six practice areas (children and youth; health and wellness; mental health; productive aging; disability, rehabilitation and participation; and work and industry), occupational therapists touch the entire spectrum of life, from newborns to senior citizens. Their goal is always to help patients lead more independent, satisfying lives.

The field is strong and diverse and OTs are in demand. U.S. News & World Report named occupational therapist as one of the 50 best careers for 2011, while the Bureau of Labor Statistics predicts 26 percent employment growth through 2018.

“Today’s clinicians have so many choices and so many ways to think outside the box in where and how they practice. Creativity is a hallmark of our profession,” Hinerfeld said. “Because we bring solutions to make things better, our skills can be used in many areas.”

When Melinda Hodgson, OTR/L, HPOTII, graduated with a bachelor’s degree in psychology, she had no idea what she wanted to do with it. Fortunately, a career counselor at the University of Texas had a binder full of ideas.

“I read about occupational therapy and knew that was exactly what I wanted to do,” said Hodgson, a staff occupational therapist at Shepherd Center, a catastrophic care hospital in Atlanta. “I’ve never regretted it. I don’t know if it’s ever possible to outgrow this profession. I could live three lifetimes and not do it all.”

In 16 years as an OT, Hodgson has worked as a traveling contractor, in assisted-living facilities, school systems, acute care hospitals, home health, orthopedics clinics and in hippotherapy (an equine-assisted treatment strategy). She has developed many skills and has grown personally and professionally.

“There are so many different places and venues for helping people. Anywhere that someone can work or carry out daily activities, an occupational therapist can help,” she said.

Neurology is Hodgson’s special interest, and for the past five years she has worked at Shepherd Center with an inpatient neurological team of doctors, therapists and psychologists to help patients who have suffered traumatic brain or spinal cord injuries, strokes or other illnesses that have impaired their physical or cognitive function.

“We do what is relevant for each patient, with the goal of getting them to the highest level of independence and quality of life,” Hodgson said. “There isn’t a cookie-cutter approach. Everyone is an individual, and we involve the patient’s family as part of the team.”

Hodgson calls the work “intense,” yet totally engaging.

“It’s so gratifying to see patients make progress, to see them come back from a disaster, relearn skills, cope and get back to life. What could be more rewarding?” she said.

Play as therapy

“Getting to play every day,” is how Mili Cordero describes her job. Founder of ITT’S (Individual and Team Therapy Services) for Children, Cordero and her associates provide occupational, physical and speech and language therapy for children with developmental delays, cerebral palsy, ADD/ADHD, autism and other challenges.

“This job will control you, if you let it,” said Cordero, Ed.D., OTR/L. “You go home and you keep thinking, ‘What will I do to help this child eat or not be afraid?’ One of my favorite weekend activities is to look at Toys R Us or Target for something new that will engage a particular child.

“I love children and always wanted to work with them, but I didn’t know how until I discovered occupational therapy. I fell in love with it, because it combines all the things I love: children, arts and crafts, and science.”

Cordero has worked in pediatric occupational therapy for 42 years.

“When I went to school, sensory- integration theories were just being developed,” she said. “Therapists had to wear white uniforms and weren’t allowed to wear pants on my first job in Cleveland, Ohio. And, at that time, autism was considered a rare disease.”

Now, one in every 150 children is diagnosed with it.

“I’ve definitely seen changes, and it’s hard to keep up with all the OT sub- specialties,” she said.

Cordero’s private practice facility is an inviting indoor playground, but some serious work takes place there. She is certified in the cutting-edge Samonas and Tomatis sound therapies, which help children who have learning disabilities and other challenges increase their attention span and improve communication skills.

In all her interventions, Cordero uses the Developmental, Individual-Difference, Relationship-based (DIR) model developed by Drs. Stanley Greenspan and Serena Wieder. She evaluates children based on their developmental levels and what makes them different.

She also works in concert with parents.

“My interest is not only working with the child, but empowering the parent to help their child develop his full capability,” Cordero said. “I never thought I’d have my own practice, but I’ve been very, very happy doing what I do.”

Growth in the field

“Private pediatric practices are booming and begging for OTs, particularly in light of the rise in autism,” said Robin Underwood, day program coordinator and assistant professor at Brenau University’s School of Occupational Therapy.

Other growth practice areas are school systems, hand therapy centers, hospital inpatient and outpatient rehabilitation departments, and community-based programs that keep seniors functional.

“There are more jobs to help seniors with their driving, low vision and home modification, so that they can age in place,” Underwood said.

One of two accredited OT programs in Georgia (Georgia Health Sciences University is the other), Brenau added a weekend OT program in Atlanta to meet the high demand. The school plans to offer a clinical doctorate program featuring three advanced practice roles — clinical researcher, clinical educator and entrepreneur — starting in the fall of 2012.

“The profession is growing tremendously. We’re seeing students come from all over the country, and our graduates get two or three job offers even before they’ve finished their last field work,” Underwood said.

At 13, Underwood loved art, volunteering with mentally ill children and helping her grandparents stay active. She wanted to find an occupation that would combine those passions. Luckily, a friend told her about occupational therapy.

“OT was my beacon and I have loved working in geriatrics, mental health, education and community-based practice settings all my life,” she said.

In addition to her faculty duties, Underwood has practiced at the Gateway Domestic Violence Center in Gainesville for the past 11 years.

“Occupational therapists are considered an integral part of the team. Since our background is in function, I work with women who are survivors of domestic violence on anything that is a barrier to what they need and want to do. Most want to find a job, a place to live and to parent well,” Underwood said.

She teaches them how to manage money, make decisions and solve problems.

“Often, I’m a cheerleader,” she said. “The counselors deal with the emotional issues of their past. My emphasis is on helping them go forward.”

Underwood, who helped start Brenau’s OT program in 1996, recently achieved a life-long dream with the founding of The Center for Occupational Justice within the school. The ground-breaking program’s mission is to provide services to individuals, organizations and underserved populations in order to promote health and facilitate their engagement in purposeful and meaningful occupations.

The center, which will also prepare students to be creative and leader/practitioners, will provide services to those without access to occupational therapy.

“We’re using a barter system and allowing clients to give back to the department in ways that gives them dignity, such as assisting in labs or making things for the Gateway Center,” she said. “A lot of our former students have developed other community-based programs, and more are needed.

“There are so many different opportunities for practice today. It’s exciting to watch our students find their niche.”