What does an occupational therapist do? Inside a day in the life

Occupational therapy is one of Australia’s fastest-growing allied health professions, with over 32,000 practitioners nationwide. It’s also one of the happiest jobs in healthcare. Yet, despite this growth, what occupational therapists do on a day-to-day basis often remains a mystery to those outside the field.

In this article, we take you behind the scenes to explore what a typical day looks like through the eyes of an occupational therapist. From managing her caseload to what a client session looks like, learn about the different components that make up an occupational therapist’s day.

What is an occupational therapist?

An occupational therapist is an allied health professional who helps individuals of all ages who have functional limitations resulting from illness or disability live a more independent life.

Maja Mortensen, an occupational therapist currently working in Perth, Western Australia adds to this, stating that to her, being an occupational therapist consists of “looking at the whole person and supporting them to live the kind of life they want to live. This can be through a wide variety of ways, such as practising budgeting skills or life skills and having fun while doing it. Essentially, with occupational therapy, we’re focusing on how we can adapt the world to fit the person instead of trying to make the person fit into the world.”

To illustrate this, Maja shares a practical example. “Imagine someone with one arm who loves to cook. Instead of saying they can’t cook anymore, we would give them a chopping board that’s got spikes in it so they can secure the vegetables and still cut them, enabling them to live a more independent life.”

To figure out what the individual needs, Maja usually starts with a personalised assessment. “We are looking at what’s suitable, what level of skill they have and how much help they need. Do they need something complex or do they require something simpler, like say, a safety cutting knife?”

This assessment is part of a broader, holistic approach that occupational therapists take, where they look at individuals in their entirety. “We also look at the environment around them. We look at social aspects like their family life, what support they have and what their school or university life looks like. [We consider] what does work look like? What about accessing the community? It’s looking at the whole person’s life.”

How occupational therapists differ from physiotherapists

What sets occupational therapists apart from physiotherapists? Maja explains that “physios focus more on the musculoskeletal system, tendons and the physical body. Whereas as an occupational therapist, we look at the whole person. Physios would do that as well, but occupational therapists also look at the surroundings, like accessibility in the community and at home.”

Occupational therapist salary

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According to SEEK data, the average occupational therapist salary in Australia is $98,000.

Below is an overview of the average annual salary in each state and territory from highest to lowest:

• Northern Territory: $95,000 to $110,000
• Victoria: $95,000 to $100,000
• Tasmania: $90,000 to $100,000
• Western Australia: $90,000 to $105,000
• New South Wales: $90,000 to $105,000
• Queensland: $90,000 to $105,000
• South Australia: $85,000 to $100,000
• Australian Capital Territory: $80,000 to $105,000

A day in the life of an occupational therapist

Maja began her career as an occupational therapist in 2020, though it wasn’t always the plan. “I thought I wanted to be a physiotherapist,” she shares. “But then I had a gap year before I started university and I worked at a school for children with special needs and got to work with some of the occupational therapists. That’s when I realised that working in occupational therapy could be a suitable career for me. I also liked how it’s a creative role.”

Maja went on to pursue a Bachelor of Occupational Therapy at the University College Copenhagen before moving to Perth. For the first three years of her career as an occupational therapist, Maja worked in aged care, where she prescribed equipment such as wheelchairs and pressure care cushions to residents. She also conducted annual reviews where she assessed residents’ memory, mobility and fine motor skills.

In 2023, Maja transitioned into a role at a not-for-profit organisation in the disability sector where she now supports adults aged 16 and over to build the skills required to live more independently.

Morning routine

Maja works 38 hours a week, but her schedule is highly varied as her start and finish times, as well as where she begins her day, are flexible and tailored to her client’s needs. “Sometimes I will start at home, check my emails and make a rough plan for the day, which has to be very flexible as nothing ever goes 100 per cent according to plan.”

When she does start in the office, she states that her routine is quite similar. “I’ll have a chat with my co-workers, make a plan for the day and make sure my client files are ready.”

Working in a multidisciplinary team

Maja works in a multidisciplinary team which consists of speech therapists, psychologists and positive behaviour practitioners. While everyone has their own client allocation, collaboration is built into the way they work. “If there is something that my clients need from a speech therapy perspective, which I can’t provide, I can then refer them to a colleague and see if they can help with that.”

Given the mobile nature of their work, the team doesn’t have regular morning huddles or briefings. Instead, they rely on monthly team meetings “where everyone shows up and we get an update of what’s going on in the organisation,” Maja explains.

These meetings also include a case study section where team members can brainstorm together. “We can be like, ‘I’ve got this client with this particular issue at the moment. Does anyone have any suggestions on how I could approach that? This is what I’ve tried so far.’” Between meetings, the team stays connected through email. “We email resources out, sending them between each other. We can also always just email and ask questions and people will get back to you with different suggestions.”

Managing her caseload

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Maja has a total of 30 clients and most of them have been with her since she started with the company. “My client roster is pretty set. I see most clients on a fortnightly basis and they usually have the same time slot and location for their sessions and then reports, additional meetings, supervision, training, all of that fits around it.”

The number of clients she sees each day, however, can differ. “I have an average of four clients a day, but some days are full of report writing, and other days, I might have five clients in the day. So in that way, I don’t have a set routine.”

Where sessions take place also varies depending on the client’s age and preferences. For clients under 18, she meets them either at home with a parent present or in the office where other therapists are around. For adults over 18, Maja can meet them in the community, whether that be a cafe, a park, their home or wherever they would like to meet up. “I did have a client who had their sessions at the cafe. So once a week, we would go and have coffee and then just have our sessions there,” she shares.

When Maja is away, her clients don’t get passed on to another occupational therapist. “They just take a break from therapy,” she explains. “No one takes over your caseload. There will be emergency contact information, of course, so there’s always someone they can reach out to, but they won’t have access to their one-on-one therapy while I’m away.”

Beyond temporary absences, more permanent client changes can also occur, though it’s not common. “There can be rotations due to the client’s preferences, if they move to be located closer to a different therapist or if they choose to discontinue services for different reasons,” Maja explains. “A client might discontinue services if they need a break from therapy due to therapy fatigue or feel that therapy is not working for them at the moment.”

Client sessions

Unlike short-term rehabilitation, Maja works with her clients on a long-term basis. “The clients I see have diagnoses that you can’t cure,” she explains. “So it’s not like they had a broken arm and now it’s not broken anymore. Instead, they have a long-term disability, so in that way, we can improve skills, but we can’t cure them.”

When it comes to her sessions, Maja’s client sessions run for 60 minutes, though there are circumstances where they might go longer. “There can be special occasions where the clinical reasoning is that I need to stay back for longer if I am able to. It depends on whether I have something straight after.”

Maja explains that much of her work involves helping individuals manage everyday tasks, also known as activities of daily living. This can include things like cooking in the kitchen, navigating public transport and developing time management or organisational skills.

Conversation therapy

With her client sessions, she explains that there are two main approaches that she uses: conversation therapy and hands-on activities. “With conversation therapy, we have a chat,” Maja shares. “So they might tell me about how they’ve been tracking since the last time I saw them, if anything major has been happening and whether there is something they’re dealing with at the moment and we go from there.”

Maja states that most clients will initially share that nothing has changed or happened and that everything is well. In those instances, she stresses that it’s important to dig deeper. “You have to ask follow-up questions such as, ‘How’s university going?’ or ‘How’s work going?’ instead of just a ‘Tell me how you’ve been’ because that’s a very big question.”

If everything is tracking well, Maja focuses on their therapy goals. “So that could be, for example, social skills. Then, we’ll talk about that, do some worksheets or do a bit of role-play to put it into practice.”

Maja shares that conversation therapy is usually used for clients who come into the office, as there aren’t many utilities available in that setting. “We might also do board games, which is a good way to break the ice or just change the topic. We sometimes also use board games to reflect on different things. An example would be emotional regulation. So say the client is having a really hard time losing a game, from there, we practise how we can manage those emotions and then try to use that in other scenarios in life.”

Other conversation-focused work includes practising how to initiate conversations or approach other people. In those instances, Maja works on body language and facial expressions with the client.

Hands-on activities

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The other approach involves hands-on activities. “I have clients where we spend the time cooking so that we can focus on improving their fine motor skills. For example, how to hold a knife or how to use a whisk. It can also be focused on improving their task planning, so their executive function.”

She shares an example of making a plan with a client to cook a pot of pasta and working through all the steps involved, such as getting the pot, filling it with water, putting it on the stove, opening the pasta packet, adding it to the water and figuring out how long it needs to cook. “There’s a lot of steps we take for granted when we know what to do because we go on autopilot, but these steps don’t always come as easily to others,” she explains.

Other hands-on activities might include sensory experiences. “It can be bubbles or Lego, drawing mats or pen and paper. Anything that is a client’s interest is what we would use.”

Maja states that whether it’s playing a game or asking a question, she’s assessing them and in some ways, everything is therapy. She does state, however, that balance is important and sessions shouldn’t feel forced. “Sometimes you may just need to play a board game with the client to get them settled and then therapy is that we can take breaks or go for a walk because they can’t sit still anymore. You know, just to get that movement break. We always want therapy to be something that they’re looking forward to, we don’t want it to feel like a chore that they have to go to.”

Measuring progress

In Maja’s case, she states that she hasn’t had anyone she has identified who no longer needs therapy. “Sometimes you might be in a situation where it feels a bit stagnant. Like we just keep chugging along and nothing really happens. The progress can be very small, but it’s still there, which is very common and something that you just have to remember.”

Despite the gradual pace, Maja has witnessed meaningful benefits of occupational therapy in her clients. “I have seen them improve in their independent skills. So that could be implementing strategies that help them in their day-to-day life, like managing their workload at school better because they put it into their calendar, so it gives them a visual plan of what they need to do.”

She’s also observed an “increase in confidence through clients just realising what skills they already have in place and learning to believe in themselves through therapy.”

Maja states that at times, families may question the lack of progress. In those instances, she states that, “there can be the need to educate the family or the caregiver and to remind them I am on the client’s team. It’s all about supporting them and reminding them that we can only do what we can do and keeping at it can be just as helpful as any actual progress.”

When sessions don’t go as planned

In the case that sessions don’t go as planned, Maja emphasises that, “you just have to go with the flow. You have to be flexible and accommodating and just support clients in whatever’s happening. So, if for some reason, everything is just not going well that day, that’s not the day we’re going to talk about communication skills. Then that’s the day that we do what they like to do the most. If that’s watching YouTube clips of their favourite skateboarder or whatever that is, you pivot and you go with that.” The goal, Maja explains, is to ensure that clients “feel, if possible, better than they did when they came in. So if that means we’re playing UNO for 45 minutes, then that’s what we’ll do.”

She also states that preparation is key to managing these unpredictable moments. “I never go into a session thinking, ‘Oh, the session will be just like this.’ That’s obviously my aim, but I always have at least one backup.” While not common, there have been times when sessions need to be cancelled altogether. “It has happened [that] the client has come in and it hasn’t been the right day to attend therapy. If that is the case, then we can always cancel. It’s not a weekly occurrence, it’s very rare, but it can happen.”

New clients

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Maja states that with new clients, if they have a previous therapist within the same organisation, even if they’re from a different section of the service, they would typically have a handover session where both therapists are present with the new client.

When working with a new client, Maja highlights the importance of building trust first. “You don’t go straight into the tough questions when you meet someone new, you really take it at their pace. So we might play an adapted version of UNO where it consists of “about me” questions. So if you have a green card, you choose a green question. The questions are generic things like ‘Tell me about yourself’ or ‘What are your interests?’ and it’s all about getting them to feel comfortable and safe. Then we do baseline assessments after that.”

Beyond client sessions

Other than client sessions, Maja spends at least two to three hours on administrative work daily. “We’ve got mandatory reports for all clients. So there is a mandatory progress report or progress note after each client session and then we have annual therapy reports to provide updates on how therapy is progressing and things like that. Then there’s communication with external providers and with families, which is also a bit admin-heavy and rescheduling of sessions as clients would quite often reach out directly to me to say, ‘I’m not available’ or ask, ‘Can we move it to another time’. When that happens, I’d have to reach out to my client liaison officer to help me with finalising those things.”

Maja notes that organisation is crucial given the administrative load. “I use my Outlook calendar all the time as I need to be organised. For example, I have set days or half a day during the week where I will have my calendar blocked out to focus on report writing only.”

Winding down

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When her day ends, Maja usually spends the rest of her evening unwinding. “I go to the gym and come home and give my cat a big cuddle. Then, my partner and I make dinner and probably watch whatever brain-numbing TV show, have some quiet time, check in with each other and go to bed.”

Given the significant emotional load that comes with this role, Maja relies on her support systems. She speaks with her co-workers and her partner to share the burden, goes for walks and listens to podcasts that have “absolutely nothing to do with work so I can turn the brain off and focus on things outside of work.”

She also mentions the importance of establishing clear boundaries between work and personal time. “I think I experienced [burnout] in my previous role and that made me realise I had to put some strategies in place to avoid that. So I am very strict with my work laptop and my work phone. When I am off work, my laptop and phone are switched off. I don’t work outside of work hours and that’s a boundary you have to set up for yourself because otherwise it’s a slippery slope.”

Rewards and challenges of being an occupational therapist

For Maja, the major reward of being an occupational therapist is “when a client has a win, no matter how big or small it is. That’s the highlight, if they do something they thought they would never be able to. I feel like in this sector of work, it’s important to remember that the small wins are really big for the clients. So something that we might take for granted can be a huge step for them. Wearing a different fabric of a T-shirt, for example, can be a big win for a client.”

When it comes to challenges, Maja views bureaucracy as a significant hurdle because “there are many policies and restrictions within occupational therapy and you have to work within those frames and sometimes that can really restrict you in doing everything you want for the client.”

Working in aged care vs the disability sector

Occupational therapists can work in a variety of sectors and Maja has experience working in both aged care and the disability sector. She shares some key differences between the two:

“With aged care, it’s more about comfort care. When you get into an aged care facility, you’re sort of at that end stage in life. It’s probably the last place you’re going to live. So, the main focus is ensuring that residents feel comfortable and are enjoying the time they have there. We're not working on building skills, instead, it’s about maintaining the strength that they have, the balance they have and how far they can walk. We’re not necessarily looking at them being able to walk several kilometres, we just want to maintain what skills and what capacity they have. Whereas the role I’m in now is more about improving skills and developing skills to support a more independent life.”

She also notes that her current role is more dynamic in comparison to her previous role. “In aged care, there were just the same standardised tests that you would do for everyone. It’s the same equipment as well that individuals would have a need for and the same activities that we would be doing. Everything is very routine-based. My current role is more varied and you have to be more creative, flexible and accommodating.”

Advice for aspiring occupational therapists

Occupational therapists make a meaningful impact in people’s lives and the profession has an expected annual job growth of 7.4 per cent over the next five years. Maja also highlights the valuable role occupational therapists play within multidisciplinary teams, “We bring a lot of additional insight that other service providers might not notice because of the holistic view we take of our clients,” she explains. “That makes us very valuable because whether it’s [working] in a hospital or an office-based setting, our focus is always on the whole person and it often helps to tie things together.”

When it comes to advice for aspiring occupational therapists, Maja keeps it simple. “Just do it,” she says. “An occupational therapy degree is so versatile that you can pretty much get into any sector that you want. Whether that’s mining, aged care, early intervention for children or work health and safety, there are so many ways to go with it.” She also adds that, “the work-life balance is pretty good.”

Pursue a career in occupational therapy

If you’re looking to pursue a career as an occupational therapist, you’ll need to complete an accredited Bachelor of Occupational Therapy and register with the Occupational Therapy Board of Australia (OTBA). Have an undergraduate degree in another field? You can consider applying for a Master of Occupational Therapy course. Some courses to consider include:

Master of Occupational Therapy at Curtin University

This graduate entry master’s course will aid you in developing the knowledge required to excel as an occupational therapist. You’ll learn about human development, occupational health and management and the theory and practice of occupational therapy.

Master of Occupational Therapy at the University of Canberra

Fast-track your career to becoming an occupational therapist by studying this postgraduate course. In this course, you will gain hands-on experience and complete core units such as Occupational in Context and Occupational Therapy in Mental Health.

Master of Occupational Therapy at Flinders University

Prepare yourself for a career as an occupational therapist by completing this postgraduate degree. As part of this course, you’ll complete a total of three clinical practicums along with units such as Interprofessional Practice and Occupational Therapy from an Older Person’s Perspective.

Other than courses in occupational therapy, postgraduate courses are also offered on GlobalHealth Education in other disciplines such as counselling, mental health, nursing, psychology, public health and social work.