Occupational therapists encounter their share of clueless observations.

"Occupational therapy for kids? Do you help them get a job?”

“I don’t need therapy. I happen to like lying face down on the carpet.”

“Oh, that's a cool job! Can you recommend some good careers for a liberal arts degree?”

“Aren’t you basically just physical therapists?”

But never fear...Shmoop is here to shine a light on things. So what does an occupational therapist actually do? In a nutshell...they do way too many things to shoehorn into a nutshell. Occupational therapists work with all ages, from grownups to those who don't strictly HAVE a trade. (Get a job, baby!) But with the possible exception of infants and pampered reality show celebrities, most people need to be able to take care of themselves on a daily basis. And when that independence breaks down, because of illness, disability or injury, occupational therapists are the friendly tour guides who show their patients how to get from Point A to Point B, how to dress with one hand, and how to stay calm in crowds. In short, occupational therapists are walking, talking instruction manuals for life.

Occupational therapists (let's save some eye strain by calling them OTs) focus on three aspects of a person's life: work, self-care (dressing, grooming, taking care of bodily functions), and our personal favorite, play and leisure. Hey, grownups need recess, too! While similar to physical therapists (both professions want to see you out of bed and mobile), OTs focus on the whole person, including thoughts, feelings and all that mushy stuff. OTs also work on the day-to-day lives of patients after they leave the “nest” of a supervised setting, when no one is around to hand-feed them juicy worms.

OTs work their magic in a variety of locales, from hospitals to schools to private homes. That’s a lot to take in, right? Let's take a look at a few hypothetical career specialties. Warning: The names of these OTs have not been changed to protect their imaginary identities.

Hospital: Una works at a health center, where she treats “outpatients” who don’t require hospitalization. One of her duties is to coach stroke victims in feeding and dressing themselves. Una also handles lots of referrals from oncologists who need her to provide psychological support for patients who are going through chemotherapy.

School: Hannah specializes in early education, and helps children who are having trouble adjusting to the classroom setting. She often works with other specialists, such as speech language pathologists, and collaborates with parents and teachers to write an IEP (individualized education plan) for each of her students. Today she is customizing pencils for April, a second grader who can't master handwriting.

Senior Home: Rick works at Happy Home Assisted Living, where he finds solutions to help elderly residents live life to the fullest. His current challenge is to keep Nana Quimby in shape for her wheelchair racing league.

Sports Medicine: Anna is employed at a sports injury clinic, and has her hands full working with wrestler Jimmy "Brick Wall" Beckett, who must learn a safer way to head butt his opponents, post-concussion.

Military: Hong works at a veteran's hospital, where she helps injured soldiers transition back into society. One of her favorite patients, Kai, is learning to use his new prosthetic legs by recreating Michael Jackson dance moves. You should see his "Thriller."

Special needs/disabilities: Hamid owns his own occupational therapy business, and serves many clients whose children are on the autism spectrum. He has been known to answer his phone from the sensory ball pit, while he's hiding toys for his next patient.

As you can see, there are more OT specialties than you can shake a stick at. Still, some methods are consistent. The first meeting with a patient involves a bunch of questions about daily activities, work routines, and the effect the injury or disorder is having on his or her life. The OT gets really nosy, too...one word answers won't cut the mustard. OTs also ask lots of questions about recreation and time management, to see how the client splits his or her time. There will probably be some tests to size up the injury or disability; an insurance provider may need this information before it agrees to pay for the claim. Therapy usually takes the form of a series of goals to work on, spread out over several months or longer. If a particular activity is too challenging, the OT will find an alternate technique, or revise the goal itself. Success equals graduation from therapy, and a new life of self-suffiency!

How do OTs get matched up with a client? Doctors may refer patients to occupational therapy, and the OT gets paid by a health care provider. In a school, parents and teachers might make the request to send a student to an on-site therapist, or to a private OT’s office. (Fortunately, this is less serious than being sent to the principal's office.) Sometimes, an OT will do a free assessment to see whether a patient requires therapy–sort of like a test run with a new dentist, except nobody gets judged by the state of their gums. Or, an OT might even telecommute to provide therapy from a distance. Some OTs use this technique to go to prison. To treat patients, of course. OTs are usually employed on a full-time basis, and they may have to work evenings or weekends to fit into patient schedules.

OTs get their magical knowledge through careful study of anatomy, kinetics (how people move) and the human brain. And there's a healthy dose of psychiatry thrown in, to understand why humans do what they do. OTs need to have a good foundation in human development, especially when working with young people, and an understanding of assistive technology and prosthetics. Ethics are also a big deal...the whole "do no harm" thing applies to OTs, too, even with that jerk who keeps kicking you in the shins.

OT first sprang into being in the eighteenth century, when folks were getting all enlightened. Trouble was, the mentally ill were still being treated like it was the Dark Ages. Open-minded asylum directors like Philippe Pinel and William Tuke reformed institution life with wacky revolutionary ideas, like, “Hey, guys, how about we try NOT chaining patients to the wall, making them barf, or draining their blood?” Instead, Tuke and Pinel practiced "moral treatment," encouraging asylum inmates to perform cheerful activities like gardening, and fostering interaction with doctors and other patients. The moral treatment movement hung on for a while, but institutional practices went downhill again after the Civil War.

Let's skip forward to the twentieth century. A doctor named Adolf Meyer–this was before Hitler made that a really unpopular baby name–started a movement called "psychobiology," which treated both mind and body, not just whatever organ the doctors happened to be slicing into that day. From that moment on, health care professionals started turning to therapeutic activities to speed patient recovery. Coincidentally, it was around this time that everybody decided it was cooler to go by three names than two. George Edward Barton built one of the first rehab hospitals. Susan E. Tracy and William Rush Dunton figured out that their patients recovered better (and were less grouchy) when they had something to do. And Eleanor Clarke Slagle started the first occupational therapy school and became AOTA's first female president. Man, maybe we should pick out a third name, too....

OTs really came into their own during the First World War, when the home front faced an epidemic of traumatized soldiers suffering from "shell shock," now known as post-traumatic stress disorder (PTSD.) Armies of cheerful aides trooped into the sick wards with activities like basket-weaving, knitting and woodworking, and brainstormed ways to keep the men mentally and physically active. Professional OTs remained in high demand through WWII, and also began to tackle common old age conditions, like arthritis, cancer, and heart disease. When JFK signed a bill in the 1960s releasing the mentally ill from their asylum/prisons, OTs were on hand to help them find their place in society. The adoption of Medicare and Medicaid in the 70s led to a boom in occupational therapy specialties, and new generations learned that they couldn't live (or work) without these fabulous professionals.

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