The Case for COTAs: We’re Just As Important!

As you all know (and if you don’t know, now you know), I am a COTA: a Certified Occupational Therapy Assistant. In my opinion, having the word “assistant” in the job title has been a huge disservice to me and my colleagues.

When you hear the word “assistant”, you typically think Oh, okay. Your boss (the OT) tells you exactly what to do and how to do it and you go and do it and your job is done. Our profession is a little different.

Depending on the setting, occupational therapists and occupational therapy assistants often work side by side, collaborating with, and learning from one another. There are even times when the COTA has more years of experience than their OT colleague, and take on the role of “mentor” to them! The biggest difference between OTs and COTAs is that OTs can perform evaluations, and have the authority to discharge patients.

Unfortunately, there are some times when OTs are seen as “more important” than COTAs. I’ve witnessed this first hand.

A few years ago, I got a job working in a school district. The pay was great, the benefits were great, the schedule was great. Everything was great. Life was like this for two years, and then suddenly I got an email about a mandatory meeting with no further explanation. It wasn’t sent to all of my coworkers, just a few of us. I went to the meeting and was shocked to discover that several of the district’s COTAs were at risk of getting laid off due to budget cuts. I was stressed to say the least.

The more I asked around, the more I found out: COTAs were being let go because they were deemed unnecessary; That OTs could pick up our slack and do the same job without our support. This made me and my fellow practitioners furious. OTs and COTAs are a team, we support each other. Losing that support (on either end) would be devastating to the team (not to mention to the students we see). OTs would be spread too thin. We tried and tried to plead our case at several board meetings, but by then it was out of our control. They had already made up their minds and I along with 9 other COTAs were let go.

My next dilemma was finding where to go next.

I knew I wanted to continue working with the pediatric population, in a school if possible, but job openings were scarce. There were plenty of positions for OT, but rarely would I find that a pediatric clinic wanted a COTA. It became so disheartening that I started contemplating switching fields altogether. I applied for jobs with ABA (applied behavior analysis) companies, I even applied for some nanny positions. I interviewed with a company as a behavior interventionist, and when they read my resume they saw that I was a COTA. They had OTs working there, but no COTAs. A few days later, I got an offer for the behavior interventionist position. A few days after that, I got an offer to work full time as their first COTA.

We worked out my supervision requirements and I was given my own caseload. I did everything the OTs did, aside from evaluating incoming patients and discharging. We collaborated as a team. No one was superior. The only time I noticed that I would get looked down upon was when someone mentioned to a parent that I was an “OT assistant”. Every now and then, I would get word that a parent wanted their child to be seen by the “actual” therapist (AKA not a COTA). I was so grateful that the “actual” therapists had my back and would tactfully explain that I was an actual therapist and that their child was in good hands.

It’s unfortunate that we COTAs have to spend so much time justifying who we are and what we do, just because of one word.

After working in the clinic for two years, the school district I worked for realized that COTAs were indeed an important cog in the wheel of therapy. They began recalling us back to the district, to which I returned (I get summer breaks again!).

This whole experience made me realize just how misinformed many people are about the world of occupational therapy. I would love to petition to take the “assistant” out of occupational therapy assistant, and replace it with a more fitting word.

“Practitioner”? “Partner”? “Collaborator”?

 

What do you think? Leave a comment below!

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