is occupational therapy stressful

Is Occupational Therapy Stressful? 6 Things Pre-OTs Must Know

If you’ve landed on this article, you more than likely have done a quick Google search wondering if occupational therapy is stressful. If you’re a prospective occupational therapist, I’m sure you’ve heard many different things or have read articles that occupational therapy is on the top-ten list of “Least Stressful Jobs” or that it is a “Top job of [insert a current year].”

After reading those articles myself, I’m fairly convinced that whoever wrote those articles probably isn’t an OT…but I digress.

So if you are not yet an OT and you’re wondering “Is it really low stress?”

The short answer is no, for a variety of reasons that I’ll get into.

However, I also don’t think that OT is special because of the sometimes high stress levels. If you’ve never had an “adult” job before, it’s important to know that most jobs, as well as going to school and parenting are all stressful in their own ways.

Life is stressful! (Yes, this might be an understatement!)

That being said, even though I feel the stress on a regular basis, I still love being an occupational therapist, and would not do anything over if I had the chance. Although, like any normal person I sometimes briefly imagine changing up my job or setting. But I think everyone has this happen at some point or another. 

Why is occupational therapy stressful, when reports say it’s not? 

These are the key factors:

1. Productivity Targets

The first and sometimes most stressful aspect of being an OT of which I can attribute to is productivity.

Almost every OT job in the adult setting – whether it’s acute care, inpatient rehab, outpatient therapy, home health, or skilled nursing – will have some sort of productivity requirement.

This still can stress me out at least a few times a week if I get caught up in something that is “unbillable time.”

My current PRN jobs in two acute care settings each have their own percentages, and my target can be hard to make in the unpredictable world of hospitals.

Whether I get bogged down with multiple patient refusals or an excess amount of paperwork from many evaluations, it’s easy to feel behind. 

No matter the setting, it can feel like you’re a factory worker running from patient to patient with no time to breathe at times. 

The best way to avoid unrealistic productivity demands is to be sure you find out the requirements before you accept a job, and ask multiple therapists at your prospective job how they feel about this.

2. High Amounts of Paperwork

Speaking of paperwork, if you are an OTR you will sometimes have seemingly never-ending piles of paperwork from evaluations, contact notes, weekly/progress notes, to discharges.

The more our healthcare system changes, the more nitty-gritty things get added to the paperwork.

As an example, at my inpatient rehab fieldwork the hospital changed their daily notes to include 13 pages on the computer system, each with different boxes to check for a session. So if you saw your patient twice for 30 minutes, that’s 26 pages of clicks for just that one patient.

Evaluations for Medicare and other insurances are asking for more and more assessments to justify treatment, and with each daily note you will have to explain in detail every aspect of the session and why you chose a particular intervention and how it ties to improved function.

Every note you write can have an impact on insurance payout and whether the patient can continue therapy service.

This does seem to be the way every health profession is going these days, though, so I feel there’s no getting around this aspect. 

3. Challenging Patients

My pediatric OT friends can attest to this, and can add in stories of challenging parents as well.

While I can’t relate to pediatrics, I can say that working in the adult population, there will be patients that test your patience, to say the least.

It’s an unfortunate reality that some people are just not very nice to begin with. So when they’re in a vulnerable and challenging situation of their lives, this often just exacerbates their negativity. While they are less common to work with, you will still encounter difficult patients on a sometimes regular basis.

occupational therapy stressful patient

While all clinicians know and understand this, it can still be pretty draining to work with this type of person every day while they are rehabbing. 

If you happen to have two to three of these types of people on your caseload at once, this can lead to some major feelings of stress and anxiety and a rough week.

4. Heartbreaking Situations

As a therapist, I want to help each and every one of my patients achieve all of their goals and go home living the most fulfilling life they can.

Unfortunately, the world sometimes has other plans for people and no matter how much we try in the medical field, people sometimes get sicker and may not make it home.

This can be especially devastating when you’ve gotten close to a patient over a period of time (young or old), and they suddenly take a turn for the worse and end up passing.

This has happened more than a few times in my career, but it still hits me like a ton of bricks when it happens.

Other tragic situations are patients with little to no financial and/or family support that must be discharged from therapy to a home or facility lacking resources they need to succeed, even causing regression or poor outcomes.

The best thing we can do as clinicians in these situations is give these patients our all while we have them and provide as many resources for them to utilize post-discharge.

5. OT is Physically Demanding

This aspect is up there with productivity requirements as one of the hardest things for me as an occupational therapist.

I know the correct body mechanics, and try to use them as much as I can. But some days I can have some very heavy patients and even with the proper form, I go home with some major low back pain or neck pain.

This exists at almost every adult-based OT job, even outpatient/hand therapy at times. Pediatrics can also entail quite a bit heavy lifting and getting up and down from the floor frequently, which can be hard on the body.

Most OTs and PTs recommend if you’re a therapist that you try to be in decent physical shape (strength-wise especially) so your body can handle the physical demands of patient care. If you’re working as an OT or are in clinicals and notice a tweak or pain that won’t go away, be sure to see a PT ASAP to fix it before it gets worse (trust me from personal experience).

6. Workplace Drama

Thankfully this doesn’t exist at every OT position you’ll ever work at. But it does exist, especially if you’re in a higher-stress work culture.

This is also something that can be at any type job, but I had to add it in here as workplace politics and drama can occur at times.

It’s always best to remember that you’re there to do your job, and try your hardest not to sucked into it. Even though it can be tempting to gossip, it’s more important to take yourself seriously as a professional and never talk badly about other co-workers. 


And there you have it, the truth about the most stressful aspects of OT, and why it isn’t as stress-free as some of these surveys may lead you to believe.

However, I also want to quickly discuss the reasons why being an OT is an amazing career even though it does sometimes come with added stress.

The number one reason why it’s a terrific career is my patients. Hands-down.

Yes, even each and every difficult patient I’ve had. I’ve given my all to give them to best treatment because I care about all of them, even when they’re having a bad day (or month, or year).

I love that I am able to work directly with each person to help them overcome some of their hardest life challenges and obstacles.

I love seeing each and every small and large milestone that I help them to accomplish, even if it’s as small as finally being able to put on shoes independently.

It really touches me to see patients and their family members moved to tears for how grateful they are that I was able to help them get their basic function back.

At the end of the day, I’m so grateful to be a part of this profession and wouldn’t have it any other way.

Do you have any thoughts on this for people that are looking into becoming an OT? Please share in the comments below!

This post was originally published on September 29, 2016 and updated on May 18, 2021.

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  • Laura Hely May 14, 2016   Reply →

    Well written, really takes me into the OT world. Any healthcare position is fraught with paperwork and physical demands, not to mention heart-wrenching deaths. But in OT you get to spend a lot of 1:1 time with your patients s, a “luxury” many other healthcare workers don’t have. That may be one of the reasons it gets such high marks as a career. With more experience, you may find ways to shorten how much writing you have to do by a fraction. Paperwork is the most unrewarding aspects of any healthcare job, there’s no getting around that. How big an issue is liability in OT? Do you have to carry malpractice insurance?
    Thank you for this concise but very informative piece.

    • Sarah May 16, 2016   Reply →

      Hi Laura, thanks for your comment! It definitely is a luxury being able to actually have time to talk with my patients (as I did not have a lot of time for as a CNA). As any healthcare provider, we do have liability for each patient we care for, so thorough and proper documentation (as well as following precautions!) is crucial. I currently do not carry my own liability insurance but after you mentioned it, I do remember a professor back in grad school saying it was only something like $15 a month, so it is definitely something I and other OT’s should consider, especially if you are an independent contractor.

  • Zequek Estrada September 29, 2016   Reply →

    I love the point of view that this post was written. It makes sense why it’s important for an occupational therapist to be in great physical shape. I imagine that’s something that not many people may think about when thinking about that career.

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