As an occupational therapist, you know how wide of a variety of jobs we have to choose from. From inpatient rehab, acute care, and geriatrics, to pediatrics, home health, neuro outpatient, and of course, hand therapy.

If you’re interested in pursuing a career in hand therapy, you will likely want to consider becoming a Certified Hand Therapist (CHT).

The path to become a Certified Hand Therapist is rigorous and requires additional steps above and beyond going to OT school and getting a job working with hands.

While there are jobs in hand therapy all over the world, keep in mind that the requirements in this article are for the United States. Your country may have different standards.

Here are the 5 steps you’ll need to follow:

1. Obtain your Master’s or Doctoral Degree in Occupational Therapy.

At this time, you cannot be a COTA and become a Certified Hand Therapist (CHT) unless you have completed a Master’s bridge program. You can have your master’s or doctorate in Physical Therapy and become a CHT, although the majority of CHT’s are occupational therapists.

2. Have a current OT license

The certification requires you to have an OT license in the state you will be practicing in. You’ll likely already have this as you start to build experience, so this one is easy.

3. Take continuing education courses related to hand therapy.

Self-studying is important in this expertise. Before you start applying for jobs, you’ll want to make sure you’re well-versed on the anatomy and conditions of the hand.

OT school gives you a brief overview of working with hands but does not prepare you enough to go straight to a hand clinic without any relevant fieldwork experience.

Because of this, it will help immensely to have several Continuing Ed hands courses under your belt before getting your first hand clinic job.

4. Get a job in an outpatient clinic.

According to the Hand Therapy Certification Commission, the certification requires a minimum of three years of clinical experience, including 4,000 hours or more in direct practice working with the upper extremity.

The 4,000 hours of direct practice experience must all be related to the upper extremity. Because of this, it is important to find a job setting that provides at least some hand therapy services to build up those hours of experience. Outpatient therapy settings are your best bets for this.

Many clinics will hire and train you before you have your CHT certification. Just be sure you have taken continuing ed courses related to the hand therapy before moving down this path.

5. Take the Hand Therapy Certification Examination

Once you meet the above requirements, you’ll then be eligible to sit for the Hand Therapy Certification Exam.

The exam is an intense four-hour computer-based test consisting of 200 multiple-choice items. At the time of writing this post, the exam cost is $500.

The exam covers quite a bit from anatomy and physiology of the hand and upper limb, treatment techniques and tools, to evaluation and therapeutic interventions, among other components.

For a complete list of what the exam covers, check out the comprehensive exam blueprint from the Hand Therapy Certification Commission for U.S. exam takers.

And now you’re certified!

Once you pass the exam, you’re an official Certified Hand Therapist.

As you can see, becoming a CHT is not easy.

But if you’re passionate about hand therapy as your career choice, the certification is worth pursuing to learn as much as you can to differentiate yourself.

In addition, you will open yourself up to more Hand Therapy positions that may only hire CHT’s.


Do you have any other tips for occupational therapists interested in becoming a CHT? Please feel free to share in the comments below!

If this post was helpful for you, please share on social media with anyone else interested in this topic.


“What is Hand Therapy?” (American Society for Surgery of the Hand)

American Society of Hand Therapists

Hand Therapy Certification Commission

Hand Therapy Resource Center

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  • Galit Maresky July 29, 2019   Reply →

    Hi. Good morning.
    I was wondering if you could answer this question for me.
    I am an OT and have been practicing for 24 years now.
    I don’t have a masters degree only a BOT.
    will I need to obtain a masters degree before I can go ahead and work towards the other steps in becoming a CHT?
    Thank you.

    • Sarah Stromsdorfer, OTR/L July 31, 2019   Reply →

      Hi Galit, I looked through the requirements here and it looks like you should be fine with your Bachelor’s in OT as long as you’ve gotten the relevant requirements listed on this page: Hand Therapy Certification Eligibility Requirements If you’re still unsure, I would also reach out to them via their website I linked to just to be sure.

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