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Working One-on-One in Occupational Therapy


Find out what working one-on-one with clients is like for occupational therapy assistants.Occupational therapists and occupational therapy assistants work closely with clients, often over long periods of time. OTAs in particular work one-on-one with clients, carrying out a plan of treatment and observing clients’ progress as they gain or regain the skills to perform activities of daily living. Working closely with clients is a challenge, but it also holds great rewards. Here are a few things to keep in mind while working one-on-one with clients as an OTA.

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Home customization

Occupational therapy assistants often work in client’s homes, helping them with activities of daily living. However, OTAs don’t just help clients with the skills they use in the home. They also help customize clients’ personal spaces to make them more livable, and have to develop up-close knowledge of both the client and their personal space.

Making recommendations to alter a client’s home could mean adding handrails or grab bars, ramps, elevators, or anything else that helps a client live in their space independently. But making the right alterations to a home depends on rigorous observation of the client in their personal space while doing activities of daily living. The OTA has to develop a rapport and baseline of trust with the client in order to effectively observe them. That trust is especially important because when people are observed, they change their behavior. That’s something OTAs have to keep in mind when working one-on-one with clients.

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Occupational therapy clients can often benefit from handrails and grab rails in their home.

Observing clients

It’s imperative for OTAs to observe their clients in their normal space while doing activities of daily living. In doing so, however, occupational therapy assistants have to contend with something that’s bedeviled researchers and healthcare providers for generations: Being observed can change people’s behavior.

When someone knows they’re being observed, they can match their behavior—even unconsciously—to what they think is the “right” way to do things. OTAs aren’t interested in seeing clients do things “right,” though. Instead they want good information about how clients move through their space and routine.

It takes more than just one session with a client for occupational therapy practitioners to get a good sense of how they perform given activities. Sustained, repeated observations are necessary, often in a client’s personal space. When working so closely with someone, occupational therapy assistants need to exercise empathy and patience.

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Working one-on-one requires empathy

Empathy is important in occupational therapy. Having someone watch and evaluate how you put on your shoes or make a sandwich is hard. Even if clients know they need the help occupational therapy offers, they can still be somewhat resistant to having a professional watch them repeatedly do what were previously personal or private activities. It can be frustrating, strange, or just slightly awkward to be watched and evaluated, so OTAs need to put themselves in clients’ shoes and think about things from their perspectives.

Working one-on-one with clients also has benefits. OTAs get to see progress up close, are usually the first to hear from clients about how a plan of treatment is working out, and are often the ones who clients will come to trust and appreciate most because of the bond developed over so many one-on-one sessions.

To learn more about Ameritech’s OTA program, check out our free e-book, “7 Fast Facts About Our OTA Program.”