OT ExplainedOTR Guest Blogger

OT vs OTA and How They Work Together

When you are trying to decide between occupational therapy career options, it’s important to look at what you will be doing in certain roles and compare: OT vs OTA. You will want to learn about your day-to-day tasks, the people you will work with and the education you will need before you can begin your career. If you are looking at the OTA outlook and considering an occupational therapy assistant career, you will want to learn more about who you will work with, including the different patients you’ll work with and coworkers. 

Working as an occupational therapy assistant requires the ability to work with a team. Not only do you work with your patient, but you will work closely with an occupational therapist to develop and carry out treatment plans (also known as OT intervention plans). Our guest blogger shares some information on the relationship between an occupational therapist and an occupational therapy assistant.

OT vs OTA and How They Work Together

Many occupational therapists, upon graduating from occupational therapy school, have to supervise a certified occupational therapy assistant (COTA) working at their facility. This experience can be daunting to some, however, if built on communication and realistic expectations it can be a less stressful situation. First, let’s start with the legal and professional differences in the expectations at an OT vs. OTA.

OT vs OTA: The Main Difference

Occupational therapists spend four years completing a masters-level education, whereas you can become a COTA by completing a two-year associate’s degree. Occupational therapists are involved in all of the evaluation and setting goals for patients, and certified occupational therapy assistants use the information gleaned from the evaluation and goals of the treatment plan. At some facilities, the certified OTA may have a greater caseload than the OT due to the extra paperwork required of the occupational therapist. A COTA has to have their daily notes signed by an OT, whereas OTs do not have to have a cosigner.

COTAs and OTs Working Together

Despite differences in the professional and legal roles between COTAs and OTs, the most important aspect of the COTA/OT relationship is communication. Both the COTA and OT needs to be strong communicators to allow each professional to treat their patients to the best of their ability.

For example, after an occupational therapist completes an evaluation on a patient to be seen by the COTA, the OT needs to make sure the COTA is aware of the identified deficits and the goals for the patients. The COTA then can make treatment plans as appropriate to address the identified deficits. Along the way during treatment, if the COTA or OT feels like the treatment plan or goals need to be updated, they work together to make those adjustments. The COTA is allowed to spearhead this, however, the OT is responsible for the changes and has to document the changes made.


Communication is also important if the COTA and OT are in disagreement with parts of the treatment and discharge planning process. As therapists, we all come from different backgrounds and have participated in different continuing education courses, all of which afford us different levels of expertise in a variety of areas. It is important to capitalize on your areas of expertise. At times the COTA and OT may be in disagreement with what needs to happen during the progression of treatment.

For example, the COTA may have greater knowledge in a certain area. The supervising OT needs to respect that and get an understanding of why the COTA feels the treatment should go in a certain direction.

My Experience with a Certified OTA

When I first graduated from occupational therapy school, I began supervising a COTA. It was hard to remember to do everything I needed to do at first, such as co-signing notes, writing progress reports and communicating with the COTA about the evaluation and treatment plan. As time went on, you develop a routine and a strong relationship with the COTA, which makes it easier to be more productive. It is was especially nerve-wracking when you are supervising a COTA who has more experience than you, as it makes you have to have more of an open mind since they have worked in the field longer than you have.

The professional and legal difference for a COTA and an OT vary from state to state, so it is important you take the time to look up what your requirements are in your state to make sure you are doing everything you are supposed to. Overall, having good communication between the OTA and OT and other members of the team is imperative to being able to do what’s best for the patients.

Want to learn more about St. Catherine University’s online OTA program? Speak with an advisor today.

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