Occupational therapy: You shouldn’t need a degree for that
Last August, the Accreditation Council of Occupational Therapy Education introduced a mandate requiring entry-level occupational therapy assistants to obtain bachelor’s degrees. The mandate is being re-evaluated due to criticism from practitioners, and for good reason: The proposed change, which may not even produce substantive gain for patients or therapists, would close off valuable opportunities for those unable or unwilling to obtain a four-year degree.
Worst of all, this is part of a damaging trend toward raising degree requirements across the employment market.
Occupational therapists help individuals with illnesses or disabilities perform daily activities, such as dressing themselves, eating, and working. For their part, occupational therapy assistants provide critical support to occupational therapists working directly with patients in a variety of settings, including in homes, hospitals, and workplaces.
ACOTE’s new requirement, which would take effect in 2027, increases the credentials needed to become an occupational therapy assistant from an associate’s degree to a four-year bachelor degree; it also would require occupational therapists to obtain a doctorate instead of just a master’s degree. ACOTE is responsible for accrediting occupational therapists and occupational therapy assistants, and graduating from an accredited program is a prerequisite to taking the industry’s certification exam. Certification is also required to obtain an occupational therapy or occupational therapy assistant’s license in most states.
Unfortunately, despite its important gatekeeping role, the ACOTE’s decision to raise its credential requirements lacks any health or safety rationale — in fact, the ACOTE’s justification for the new degree requirements focuses solely on defining professional roles rather than identifying quantifiable health or safety issues.
In addition to lacking a legitimate rationale, the requirements also raise barriers for would-be workers hoping to pursue a career as an occupational therapy assistant, a currently in-demand profession. Career tracks like that of an occupational therapy assistant offer crucial opportunities for those seeking greater economic mobility without a four-year degree.
Even though only 17.5 percent of current occupational therapy assistants have bachelor’s or graduate degrees, the median income of occupational therapy assistants is about $56,000, which is 40 percent higher than the income of the average associate degree holder. The occupation is also expected to grow rapidly, as the Bureau of Labor Statistics estimates 29 percent growth in the profession from 2016 to 2026, compared to only 7 percent growth for occupations generally.
Occupational therapy is representative of the kind of middle-skill, middle-income jobs that have been slow to grow in the wake of rapid digitalization and globalized markets. These types of jobs are important because they help provide those at the middle and lower ends of the socioeconomic scale access to greater opportunity. By raising educational requirements, the ACOTE is making it harder for lower- and middle-income Americans — many of whom would find a four-year degree unobtainable or impractical — to successfully enter the occupational therapy profession and improve their lot in life.
This requirement reflects a trend occurring across America’s labor market. Occupations in which workers with an undergraduate degree constitute a minority are now regularly requesting college degrees in new job postings. This leads to credential inflation and creates a barrier to upward mobility. An egregious example comes from Washington, D.C., where the city recently mandated that childcare workers obtain associate’s degrees in early childhood education or childhood studies.
Policies that further restrict people’s ability to enter into high-demand, well-paying positions will only amplify America’s decline in broad-based economic opportunity. While greater credential and skill requirements are sometimes justified, the burden of proof for mandating those requirements should be high. Unless additional credentials are necessary for professionals to effectively perform their jobs, requiring enhanced degrees serves little purpose.
There are also less burdensome solutions available if positions such as occupational therapy assistants need more skills. For example, occupational therapy assistants are already required to enroll in continuing education programs. They also could be required to work with colleges and major employers to receive additional relevant training outside of a four-year degree.
Ultimately, increasing the credential requirements for occupational therapy assistants will reduce the number of people eligible to work in the profession and deprive people of opportunities to improve their lives. Rescinding ACOTE’s mandate would be better for workers, patients, and the economically disadvantaged.
