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  • Integrative Therapy

Benefits of an Integrated Occupational Therapy Team in School-Based Services

Integrative Therapy is a Twin Cities based company comprised of a dynamic team of therapists who provide contracted occupational therapy services in school-based settings with a primary focus on charter schools. In our work in these spaces over a decade, we have created environments and experienced the benefits of providing an integrated team of

registered occupational therapists (OTRs) and certified occupational therapy assistants (COTAs).

To understand the benefits more specifically, it’s important to discern the education, training, and purpose of each professional. Occupational therapy practitioners (OTP) support participation in a person’s daily life activities or “occupations” by improving the person’s skills, modifying the task, or changing the environment to increase function. Within the OTP field, designations further breakdown to occupational therapists with the credentials of OTR and occupational therapy assistants with the credentials of COTA.

Individuals with OTR or COTA credentials are similar in that they are OTPs who have completed an accredited occupational therapy education program and passed a national certification exam. Some states require a license to practice occupational therapy, which is the case in Minnesota. In this scenario, credentials are listed as OTR/L or COTA/L, with the “/L” added to indicate the OTP is a licensed therapist. Occupational therapists in a current program graduate with either a master’s or doctorate level degree while occupational therapy assistants have graduated with an associate's level degree.

The OTR and COTA therapists work collaboratively across settings, and in the school setting partner together to support students’ functioning in the classroom. OT school-based services are individualized and based on the student’s individualized education plan (IEP) and often focus on academics, play and leisure, social participation, self-care skills, and transition/work skills.

In the state of Minnesota, there are specific requirements that need to be met when a COTA is providing occupational therapy (OT) services. One requirement is that a COTA is required to work under the supervision of an OTR. In the school setting, the OTR plans and documents the individualized treatment plan based on the evaluation, makes decisions about changes in services, and directs IEP based goals and interventions through regular meetings with the COTA. The COTA implements and documents the therapeutic interventions and provides feedback to the OTR on the student’s progress during treatment. Under the direction of the OTR, the COTA can also attend IEP, evaluation or parent meetings to represent OT.

Seems like a highly beneficial model, right? We’ve found that to be true, but it does take intentional planning and experience to implement the approach. Perhaps that lack of experience is why the interprofessional OTR/COTA team approach is underutilized in the school setting. In 2022, only 5% of COTAs are being employed in school-based roles according to the U.S. Bureau of Labor Statistics.

As one of the few or possibly the only local contract-based company in the Twin Cities area that offers this collaborative and cost-savings approach for occupational therapy services, Integrative Therapy is growing. Schools with large caseloads can especially appreciate the benefits of using a COTA for the majority of student services.

At Integrative Therapy, we have found it helpful and effective to have two professionals working on treatment planning and goal achievement with the same caseload of students. A team approach can foster growth and development for both members, encourages creativity and innovation, and promotes effective utilization of school resources and budget.

Interested in learning more about how an OTR/COTA partnership could benefit your school? Reach out to Integrative Therapy at to connect.

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