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Putting it into Practice: OT Student Blog

Defending COTAs

Published March 12, 2013 8:39 PM by Jennifer Preston
     My job hunt has been very enlightening thus far.  I feel I have spent more time defending COTAs than actually interviewing.  I have done this on three separate occasions now.  In the first instance, I was called regarding my resume, but was informed that the facility does not utilize COTAs and that COTAs only work in hospitals and nursing facilities.  That was news to me, and I politely explained that COTAs can work in any setting as long as they have the needed experience and have OTs to provide supervision.  The second instance was basically a re-hash of the first only via email.  The third instance occurred during an interview.  I interviewed for a COTA position, however, when the job description was explained to me I discovered it had nothing to do with treating patients and everything to do with assisting the OTs in making schedules, maintaining equipment, creating projects, etc.  When I questioned the interviewer about this, I was told that COTAs cannot treat patients on their own under Medicaid guidelines.  I guess I must have had a very surprised look on face because I was asked if I knew differently.  At this point, I explained what I had observed and done during my fieldwork that would directly relate to this situation, including treating Medicaid patients on my own as a student.  The interviewer seemed genuinely shocked and planned to research this more thoroughly.  I, myself, am shocked about how little is understood about the COTAs role in the work place.  I am curious, have I just had a run of bad luck or is this common?  When you come across this misconception of the COTAs role, how do you handle it?   


I have been lucky here in CT to not have run into that.  I have worked as a cota for about 10 years now - all in the pediatric field.  I was told when I was in school that I should not get my hopes up about working in Peds as a COTA but that was where my heart was and that was what I wanted to do - so I pursued it and have not had any trouble working in pediatrics as a COTA.  Don't give up - keep educating others. :)   and good luck!

Wendy Spoor-Hof August 22, 2013 3:57 PM

Thank you everyone for your comments.  I apologize for the delayed response.  This will be my 3rd attempt to post one.  

I am glad to hear that my experience seems to be the exception to the rule.  2 of the indicences where indeed with facility managers who were not OTs, however the third was an OT.  

I may have to consider moving to California after all. :)

Jennifer Preston, COTA March 21, 2013 3:32 PM
Livonia MI

Dear Jennifer,

Please do not get discouraged. I have been a COTA for approximately 14 years. As an assistant, you will learn each environment you work in will present itself with its own challenges. As you acquire more tenure in the profession, you will begin to require less supervision. Continue to add to your skill set and educate your co-workers on what you can bring to that particular environment. Also, ask your OT supervisor to deem you competent to carryout certain aspects of an eval or an assessment. All these things will help you progress in this field and secure your worth. I find that is the best way to educate OTs in what COTAs can bring to the table. Hang in there.

Patricia , COTA March 20, 2013 9:05 PM
Philadelphia PA

I just graduated in October of 2012 and I have not come across anyone saying these things. However, I feel that the supervision log should not have to be utilized. PTA's are not required to keep a supervision log, and we hold the exact same degree. I can understand the neccesity of supervision, but I feel like in the state's eyes, we are juveniles and need to have a keen eye kept on us. Believe me, any good OT will always be aware of the treatments that a COTA is providing. I think this is an outdated practice and it's not fair to those of us who are COTAs. That's why it must be hard for companies to want to utilize us because they must feel like it is their responsibility to make sure we have that supervision when in fact it is our own responsibility. Educating the public and private businesses should be every licensed COTA's personal mission.

Lana, SNF - COTA March 19, 2013 7:58 PM
Lufkin TX

I just graduated this past May and I'm working as a COTA. I have noticed that in some facilities, there are many COTAs and in others there is 1 COTA for an entire hospital. It's interesting the reasons they give for not having more than 1 COTA but they have 4 or 5 PTAs!

Michele, SNF - COTA March 19, 2013 6:32 PM
Racine WI

I have worked at both a COTA and OTR for almost 15 years and whenever I have encountered this situation which is frequently I just provide that person with education just as I do on daily basis of OT in general.  Best luck and continued success.

Tammie, COTA/OTR March 19, 2013 10:38 AM

I have worked as a COTA for 28 years in Texas, Maryland and Washington DC and have worked in all settings and all age groups. I have also worked as a Rehab Director in SNF setting. I have been blessed and have never had to explain what we do. In fact, I've found that company's in these states tend to want to hire more COTA's over OTR's due to the pay difference of usually about 3-5$ an hour. They tend to need fewer OTRs since they utilize them for evals and other paperwork. I guessing you have been interviewing with strictly HR personnel and should try to reach the Rehab director or go to work for a rehab co. , where HR knows our role and value! Good luck! .. Texas COTA

Sarah, SNF - Cota, Rehabcare March 19, 2013 9:54 AM
Ftworth TX

I have been a COTA for 10 years.  I've worked in a variety of settings, including: SNF, private school, outpatient peds clinic, acute care, and inpatient rehab.  I've never come across an employer with that misconception.  I've encountered coworkers with no clue about COTA vs OTR, though.  One actually asked me if I will ever go to school to be "a real OT".  When I explained that I did go to school, sat for the national boards, licensed by the state, etc, she then proceded to ask if I will ever "sign up" to be a registered OT.  So she still didn't get it.

I have also had various companies tell me that they don't hire COTAs because they don't want to deal with the supervision piece, or they have such packed schedules that they can't free up the OTRs to provide supervision, or to complete reevals as needed (some do reevals every three months)

Jennifer, COTA March 19, 2013 9:53 AM
Bolingbrook IL

I'm curious to know who was doing the interviewing? Was it a PT or Rehab Director? I think that would explain the lack of knowledge about the role of COTA's.

Karen Y., Home Health - OTR/L March 19, 2013 9:32 AM

I think it relates to the fact that there are two to three times as many OTs as COTAs, so employers feel no need to hire them, and prefer OTs.

Linda March 19, 2013 9:06 AM

Wow ... I am shocked!  I have been a COTA for about 15 years and I have never experienced what you have been through.  Over the years I have worked in many fields and find it shocking that you have been unable to find a job !   Come to California ... We are hiring in the schools for COTAS .  Those employers need to do more research before they put out job offers. COTAS can and do work in all fields.  Good luck with your search

Terry, Schools - COTA , San Bernardino March 19, 2013 9:02 AM
Oak Hills CA

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