Elisheva Jacobson on Occupational Therapy

What is your job title, what do you do, and how long have you been working in this field? What is the path that led you to this job?

I have been an occupational therapist for more than 20 years. I like to say that OT chose me more than I chose it. From a young age, I gravitated toward a profession in the medical field that involved helping others, but I knew I didn’t want to be a doctor or nurse. I sought an occupation that offered flexibility and in which I could eventually work for myself rather than under the licensure of someone else. I considered becoming a physician’s assistant, but PAs always work under a licensed medical doctor whereas occupational therapy does not have that limitation. I began my career working in hospitals full time, and after having my first child, I moved to per diem work in homecare, schools, and early intervention. I currently own an outpatient pediatric OT clinic that services approximately 300 clients weekly.

Can you explain what a professional in your field does?

Occupational therapists facilitate the highest level of functioning in their patients in the areas of cognition, emotional regulation, motor skills, and daily living activities. We work with people across their lifespan, including preemies in the NICU, babies and toddlers in early intervention, school-age students, adults in rehabs, and the elderly in hospitals. Our focus is always on function and our goal is to help our clients achieve independence. We work with people who were born with disabilities, developmental delays, and acquired injuries.

Our work is predominantly physical and even OTs who are in the mental health space utilize movement to elicit change. We don't work “magic”; we employ all the tools available to help our patients progress to the best of their abilities. We typically work individually with clients and use physical movement and hands-on assistance to facilitate their progress. Some of the therapies we perform include helping patients progress through developmental movement patterns; playing with toys, using scissors, and learning to write; engaging in self-care tasks and higher-level home and food management; and basic strengthening and coordination.

In what area of study did you obtain a degree and how does it inform what you currently do? Can you offer insight into the variety of ways in which your degree can be used?

I have a Bachelor of Science and a Master of Science in occupational therapy with a certificate of specialty in pediatrics. I attended a dual-degree program where I was able to obtain both degrees concurrently. There are also other routes to becoming an OT. One option is to take science prerequisites while acquiring an undergraduate degree and then apply to graduate school for occupational therapy. OT doctorate programs are now also available as is the COTA program which grants an associate degree to become a Certified Occupational Therapy Assistant. OTs and COTAs sit for a national licensing exam to be able to work in the US. Occupational therapists can be self-employed or work for someone else and may specialize in areas including mental health, pediatrics, geriatrics, orthopedic and neurologic rehabs, schools, homes, clinics, and private practice. COTAs carry out treatment plans set by the OT who performed the initial client evaluation.

Why is a career in this industry valuable?

Occupational therapy affords flexibility, a respectable salary, meaningful work, a sense of accomplishment, job opportunities across a variety of settings, and the opportunity to work full time, part time, salaried, per diem, or self-employed. OT’s are needed across the US in hospitals, schools, and rehabs. The national licensing test is taken prior to acquiring state licensure, which is obtained with fees and document submission and not additional exams.

What does a day-in-the-life look like?

An OTs day can vary tremendously. Full-time salaried hospital positions tend to have earlier work hours like 8am-4pm. This includes treatment hours, documentation time, a lunch break, and some team meetings. Treatment can be individually or in groups. School jobs generally run on the same schedule as the school's hours and include preparation, treatment, and lunch time. Younger students are picked up from their classrooms, while older ones will find their therapist on their own. Per diem homecare and early intervention are extremely flexible since therapists may choose their own hours to visit each family's home and sessions generally last between 30-60 minutes.

My personal schedule involves dropping off my preschooler and working approximately the same hours as the school day so that I’m able to finish by pickup. When I did homecare and early intervention, I would schedule in some open slots for grocery shopping and errands. Per diem work generally means coming home with paperwork; some therapists do this in the evenings after their children are asleep and others leave time during the workday to complete documentation.

What are the skills necessary for success in this career and what type of characteristics would be a good fit for positions in this field?

Firstly, it’s important to have commitment and determination to complete the schooling and manage the heavy science course load. You need to enjoy interacting with people and working with your hands since some aspects of the job are physical. Organization and flexibility are helpful when managing your schedule and paperwork, and decent writing skills are important for reports and evaluations. Networking with other professionals in complementary fields is valuable for referrals when clients may need something more than OT. Intuition and problem-solving are helpful traits, as is a dose of humility to admit when one doesn’t have all the answers.

What is the most rewarding part of the job and the most challenging aspect?

I truly enjoy what I do and therefore never feel like I’m working. I like to say that I play with children for a living! It is gratifying to know that I put a smile on someone’s face or brought out the best in them that day. I help people be as independent and functional as possible, all while having fun.

It can be challenging when schedules don't go as planned, and they often don't. When working per diem, client cancellations result in not getting paid. Factor that in when budgeting so the frustration decreases.

What is the job market like? Are jobs easy to obtain, flexible, and well-paying?

The job market is hopping! Jobs in New York appear to be easy to obtain, flexible, and well-paying. It is typical for OT students to be offered jobs at the fieldwork sites where they intern. When I interview and hire staff, I am not necessarily looking for the "best" therapist. I am looking for someone who has a positive attitude and flexible personality, is easy to get along with, and has a desire to learn and grow in our field.

Can you give an idea of starting salaries in the industry and how one moves up? How is success defined in this field?

Starting salary for per diem work is $65-$70 an hour in New York. OTs can move up the career ladder in a hospital setting by being promoted from staff therapist to supervisor and further up the chain, which usually happens when there is an open position due to someone more senior leaving. Generally, success is perceived as being in private practice with self-pay clients.

Would you recommend this career to other women and men? Why or why not? What advice can you give to people interested in this field?

I absolutely love what I do and definitely recommend this career to frum women. I have yet to discover another profession that is as flexible, well-paying, and meaningful, and that fits with our lifestyle and calendar. I would not necessarily recommend this field for men as the salaries are good as secondary income, but most OTs would probably not be able to support a family with multiple children in the yeshiva system. Nevertheless, men with business acumen who are highly motivated to work long hours and eventually establish their own practice have potential to achieve more success and earn a higher income. My heartfelt advice to those interested in this field is to volunteer and spend time in a few different occupational therapy settings to ensure this is what you actually want to do as a profession.