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The American Journal of Occupational Therapy 663

Standards of Practice for Occupational Therapy

Preface This document defines minimum standards for the practice of occupational therapy. The Standards of Practice for Occupational Therapy are requirements for occupational therapists and occupational therapy assistants for the deliv- ery of occupational therapy services. The Reference Manual of Official Documents contains documents that clarify and support occupational therapy practice (American Occupa- tional Therapy Association [AOTA, 2004]). These docu- ments are reviewed and updated on an ongoing basis for their applicability.

Education, Examination, and Licensure Requirements All occupational therapists and occupational therapy assis- tants must practice under federal and state law.

To practice as an occupational therapist, the individual trained in the United States

• has graduated from an occupational therapy program accredited by the Accreditation Council for Occupa- tional Therapy Education (ACOTE®) or predecessor organizations;

• has successfully completed a period of supervised fieldwork experience required by the recognized educational institution where the applicant met the academic requirements of an educational program for occupational therapists that is accredited by ACOTE® or predecessor organizations;

• has passed a nationally recognized entry-level exami- nation for occupational therapists; and

• fulfills state requirements for licensure, certification, or registration.

To practice as an occupational therapy assistant, the individual trained in the United States

• has graduated from an associate- or certificate-level occupational therapy assistant program accredited by ACOTE® or predecessor organizations;

• has successfully completed a period of supervised fieldwork experience required by the recognized edu- cational institution where the applicant met the aca-

demic requirements of an educational program for occupational therapy assistants that is accredited by ACOTE® or predecessor organizations;

• has passed a nationally recognized entry-level exami- nation for occupational therapy assistants; and

• fulfills state requirements for licensure, certification, or registration.

Definitions Assessment. Specific tools or instruments that are used dur- ing the evaluation process.

Client. A person, group, program, organization, or commu- nity for whom the occupational therapy practitioner is pro- viding services.

Evaluation. The process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results.

Screening. Obtaining and reviewing data relevant to a potential client to determine the need for further evaluation and intervention.

Standard I: Professional Standing and Responsibility 1. An occupational therapy practitioner (occupational ther-

apist or occupational therapy assistant) delivers occupa- tional therapy services that reflect the philosophical base of occupational therapy and are consistent with the estab- lished principles and concepts of theory and practice.

2. An occupational therapy practitioner is knowledgeable about and delivers occupational therapy services in accordance with AOTA standards, policies, and guide- lines, and state and federal requirements relevant to prac- tice and service delivery.

3. An occupational therapy practitioner maintains current licensure, registration, or certification as required by law or regulation.

4. An occupational therapy practitioner abides by the AOTA Occupational Therapy Code of Ethics (AOTA, 2000).

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5. An occupational therapy practitioner abides by the AOTA Standards for Continuing Competence (AOTA, 1999) by establishing, maintaining, and updating pro- fessional performance, knowledge, and skills.

6. An occupational therapist is responsible for all aspects of occupational therapy service delivery and is accountable for the safety and effectiveness of the occupational ther- apy service delivery process.

7. An occupational therapy assistant is responsible for pro- viding safe and effective occupational therapy services under the supervision of and in partnership with the occupational therapist and in accordance with laws or regulations and AOTA documents.

8. An occupational therapy practitioner maintains current knowledge of legislative, political, social, cultural, and reimbursement issues that affect clients and the practice of occupational therapy.

9. An occupational therapy practitioner is knowledgeable about evidence-based research and applies it ethically and appropriately to the occupational therapy process.

Standard II: Screening, Evaluation, and Re-evaluation 1. An occupational therapist accepts and responds to refer-

rals in compliance with state laws or other regulatory requirements.

2. An occupational therapist, in collaboration with the client, evaluates the client’s ability to participate in daily life activities by considering the client’s capacities, the activities, and the environments in which these activities occur.

3. An occupational therapist initiates and directs the screening, evaluation, and re-evaluation process and ana- lyzes and interprets the data in accordance with law, reg- ulatory requirements, and AOTA documents.

4. An occupational therapy assistant contributes to the screening, evaluation, and re-evaluation process by imple- menting delegated assessments and by providing verbal and written reports of observations and client capacities to the occupational therapist in accordance with law, reg- ulatory requirements, and AOTA documents.

5. An occupational therapy practitioner follows defined protocols when standardized assessments are used.

6. An occupational therapist completes and documents occupational therapy evaluation results. An occupation- al therapy assistant contributes to the documentation of evaluation results. An occupational therapy practitioner abides by the time frames, formats, and standards estab- lished by practice settings, government agencies, external accreditation programs, payers, and AOTA documents.

7. An occupational therapy practitioner communicates screening, evaluation, and re-evaluation results within the boundaries of client confidentiality to the appropri- ate person, group, or organization.

8. An occupational therapist recommends additional con- sultations or refers clients to appropriate resources when the needs of the client can best be served by the expertise of other professionals or services.

9. An occupational therapy practitioner educates current and potential referral sources about the scope of occupa- tional therapy services and the process of initiating occu- pational therapy services.

Standard III: Intervention 1. An occupational therapist has overall responsibility for

the development, documentation, and implementation of the occupational therapy intervention based on the evaluation, client goals, current best evidence, and clini- cal reasoning.

2. An occupational therapist ensures that the intervention plan is documented within the time frames, formats, and standards established by the practice settings, agencies, external accreditation programs, and payers.

3. An occupational therapy assistant selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with the occupational therapy assistant’s demonstrated competency and dele- gated responsibilities, the intervention plan, and require- ments of the practice setting.

4. An occupational therapy practitioner reviews the inter- vention plan with the client and appropriate others regarding the rationale, safety issues, and relative benefits and risks of the planned interventions.

5. An occupational therapist modifies the intervention plan throughout the intervention process and documents changes in the client’s needs, goals, and performance.

6. An occupational therapy assistant contributes to the modification of the intervention plan by exchanging information with and providing documentation to the occupational therapist about the client’s responses to and communications throughout the intervention.

7. An occupational therapy practitioner documents the occupational therapy services provided within the time frames, formats, and standards established by the prac- tice settings, agencies, external accreditation programs, payers, and AOTA documents.

Standard IV: Outcomes 1. An occupational therapist is responsible for selecting,

measuring, documenting, and interpreting expected or

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The American Journal of Occupational Therapy 665

achieved outcomes that are related to the client’s ability to engage in occupations.

2. An occupational therapist is responsible for document- ing changes in the client’s performance and capacities and for discontinuing services when the client has achieved identified goals, reached maximum benefit, or does not desire to continue services.

3. An occupational therapist prepares and implements a discontinuation plan or transition plan based on the client’s needs, goals, performance, and appropriate fol- low-up resources.

4. An occupational therapy assistant contributes to the dis- continuation or transition plan by providing informa- tion and documentation to the supervising occupational therapist related to the client’s needs, goals, performance, and appropriate follow-up resources.

5. An occupational therapy practitioner facilitates the tran- sition process in collaboration with the client, family members, significant others, team, and community resources and individuals, when appropriate.

6. An occupational therapist is responsible for evaluating the safety and effectiveness of the occupational therapy processes and interventions within the practice setting.

7. An occupational therapy assistant contributes to evaluat- ing the safety and effectiveness of the occupational ther- apy processes and interventions within the practice setting.

References American Occupational Therapy Association. (1999). Standards

for continuing competence. American Journal of Occupa- tional Therapy, 53, 599–600.

American Occupational Therapy Association. (2000). Occupa- tional therapy code of ethics (2000). American Journal of Occupational Therapy, 54, 614–616.

American Occupational Therapy Association. (2004). The refer- ence manual of the official documents of the American Occupational Therapy Association (10th ed.). Bethesda, MD: Author.

Authors The Commission on Practice:

Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson

Susanne Smith Roley, MS, OTR/L, FAOTA, Chairperson-Elect

Gloria Frolek Clark, MS, OTR/L, FAOTA Janet V. DeLany, DEd, MSA, OTR/L, FAOTA Eileen R. Garza, PhD, OTR, ATP Mary V. Radomski, MA, OTR/L, FAOTA Ruth Ramsey, MS, OTR/L Carol Siebert, MS, OTR/L Kristi Voelkerding, BS, COTA/L Lenna Aird, COTA/L, ASD Liaison Patricia D. LaVesser, PhD, OTR/L, SIS Liaison Deborah Lieberman, MHSA, OTR/L, FAOTA, AOTA

Headquarters Liaison

for

The Commission on Practice Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson

Adopted by the Representative Assembly 2005C218

NOTE: This document replaces the 1994 Standards of Practice for Occupational Therapy. These standards are intended as recommended guidelines to assist occupational therapy practitioners in the provision of occupational ther- apy services. These standards serve as a minimum standard for occupational therapy practice and are applicable to all individual populations and the programs in which these individuals are served.

Previously published and copyrighted in 1998 by the American Occupational Therapy Association in the American Journal of Occupational Therapy, 52, 866–869.

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