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COTA Thoughts

What is a COTA?

Published December 17, 2007 1:03 PM by Tim Banish
While doing a few internet searches, I have found that there are some misconceptions out there about what a COTA is. And most importantly, what it is that we do. I'm not sure if this is due to the fact that people are not educated with OT, or because of the way some COTAs attend to their daily treatments. 

Unfortunately, it seems like many people view COTAs as a glorified nursing assistant (CNA/STNA). That means a person who completes tasks like taking people to the bathroom, assisting in dressing, getting them out of bed, helping them eat, and other daily living skills. Yes, we do these things don't we?

The big difference is that as a COTA, we can also identify and address a multitude of other concerns in our effort to increase the independence of this person. We can encourage and show them ways to accomplish as much of the task as possible. We can educate them with adaptive equipment use if appropriate. We can also show them energy conservation methods to make the task less strenuous. I could continue on here but I'm not seeking to list the entire host of skills needed to be a COTA, just the basics.

Yes, a good CNA/STNA may be able to do these things too. I have worked with some great CNAs in my career that I would trust to complete these kinds of tasks, including the encouragement, equipment use and conserving energy. These were nursing assistants that had been in the field for many years, trained by therapists, and attentive to how some of these tasks should be completed. Many CNAs I've met however have showed very little therapeutic connection with these tasks. Most just want to get the job done.

Anyway, through our schooling we received education on human anatomy, diseases, medical conditions, adaptive equipment, psychology, and interpersonal communication. This education is our groundwork to build upon. However, just like any newly presented knowledge, some people will be able to comprehend and utilize it in a more productive manner. Some will only remember pieces of their training, and carry out tasks in a less efficient manner.

I think one thing to remember here is that everyone learns at a different speed, and everyone applies this learning in different manners. For the ones who stop learning after they graduate, they may find that each day becomes more of a challenge. Being open minded enough to learn alternate techniques incorporated by other therapists is a great way to gain new skills. Attending continuing education classes relevant to your area of practice is another way to continue to grow your skills.

I've always said that I learned more in the first six months of practice than I learned in school. I attribute this fact to the first OTR I worked with. Not only was this person very knowledgeable in many aspects of Occupational Therapy, but they were also able to present the facts in a manner that made a connection to the problem. But, without an open mind and the desire to learn more, any of this continued learning I was offered would have gone to waste.

So, what is a COTA? A Certified Occupational Therapy Assistant is a person who can look at their patient and see a person they can help become more independent. Someone who can identify deficits and the methods needed to overcome them. Someone who knows proper communication techniques in order to present information in a manner that the patient can understand. Someone who is open-minded enough to learn more in an effort to become a better therapist. Most importantly, a COTA is someone who cares enough about their patient to develop a bond of trust in the effort to promote increased independence.

Yes, there are many other aspects to being a COTA. The topics I've covered here just touch on the basics. Depending on the area a COTA works in, there can be a multitude of other skills that are required to be effective. However, being able to combine all these skills, and employ them appropriately, is what really makes the difference between a COTA and a nurse aide.

Till next time, hope all your thoughts are good,

Tim

8 comments

I would like to ask my fellow COTA's for some feedback. I would very much like to get an idea, of what the pay scale / salary range is for other COTA's, who might be working on an Inpatient Psychiatric Unit, in a Hospital settimg.

With in the past 2 years, the human resource department here has performed several market analysis for the OTR's, which resulted in pay increases (in an effort to compete with the "market"). They did not however, perform a market analysis for the COTA positions, stating they were not in demand at our facility.

I would like to advocate for a market adjustment, as I have learned COTA's in rehab / nursing home facilities make significantly more than I do. In fact, while inquiring recently at a facility close by, I was offered a position in which I could make $22,000. 00 more per year, than my current position.

Most people would probably say the choice was a no brainer, however I really like working with my patients, and find it really rewarding.  I am also concerned about the physical requirements and demands of working in a rehab facility, as I grow older.

I would really appreciate any information anyone might have regarding general salary ranges within hospital settings and / or Psychiatric setting for COTA's.

Sincerely

Carolyn

Carolyn, Psych - COTA, University of VA March 7, 2008 3:09 PM
Charlottesville VA

Sarah,

I feel where you're coming from, but again, I believe that more schooling still does not make for a better therapist. Ten years after you graduate, how much of your book learning will you remember? I'm guessing probably not much. Yes, we need school for the basic groundwork, but the ability to treat people is something you'll never learn from a book. And, if they increase the school requirements for a COTA, I see the profession dying. At the salary range currently offered, schooling cost would outweigh the return of a full time job. Since many COTA's are currently employed part time (due to PPS) I don't see many wanting to deal with these financial aspects, then get into a field that offers little chance for promotion. Since COTA's are not allowed to become a CHT, MOT, etc., we are limited in many types of promotions. I've known several COTA's who held a B.S. degree, but they were still a COTA, and paid as such. If there were a test to upgrade your degree by knowledge only, many COTA's could probably be an OTR now.

I see you're from the north country. I actually graduated from Lake Superior College when it was still called Duluth Technical College. St. Catherine's did not yet offer the OT program, or I might have attended there!

Stay Warm, I know the winter has been cold and snowy there. I follow the weather through a family member still living there.

Tim Banish, COTA/L February 12, 2008 4:29 PM
Cincinnati OH

Hey there, I think if the OT is now required to be a masters, and soon the possibilities of Docterate, then yes, why should you still be with an AA?  I understand your concerns, and I know it is hard to go back to school, there should be exams out there or something to give the COTA's a break, the OT's with the bachelors got grandfathered in....just a student's opinion.  And I know that when I am done with school I will be looking up to the older COTA's in the profession for guidance.  I wish I could give you  the paycheck as well.

Sarah Croft OTS, Occupational Therapy - Student, College of St.Catherine February 5, 2008 12:14 PM
MN

Thanks for all the comments here. I agree that a name change would be nice, but doubt it will happen anytime soon. As far as requiring further education, I hope it never gets to that but only AOTA and NBCOT can make that call. I think of myself as a Therapist too, not an assistant. I can't tell you how many OTR's I've trained in my years!

Tim Banish, COTA/L January 3, 2008 5:18 PM
Cincinnati OH

Name change yes.

Further schooling no. I couldn't afford it at this stage in my life. Why not keep COTA an associates program so that people could actually "afford" to start a profession.

If you want to go back to school why not go all the way to become an OTR?

I have no problem with being a COTA . Been one for 20 years and never had a problem with it. I found that if I listened to others comments about....Why are you still an assistant? and "But you're only an Assistant, right?" affect me I would not be the COTA that I am today. I consider myself a therapist no matter what anyone else thinks. As a result I do a great job and have great results with my patients.

Pam, hand therapy - outpatient January 3, 2008 11:02 AM
Ft. Myers FL

YES!!  I totally agree and am very glad that I stumbled across this blog.  I have actually started this topic called "whats in a title, OTA/OTR on the forum and it has had 29 comments this far, both negative and positve.  We need to come together and stand up for ourselves, what we do and what we are trained for.  We are good therapists that have earned the right to be called as that, we are NOT assistants.  Thank you Tim for starting this blog, it is very important and I only hope that the AOTA takes a look at this and finally listens to what needs to be heard.

R, COTA/L January 1, 2008 6:32 PM
MA

I agree that we need a name change to drop assistant.  This site has had 84 hits and only me and 1 other person took the time to write a commet.  We need to take more PRIDE in our profession and start the process for a name change so we do not become a step up from an aide who can write a note and charge the Insurance Company and/or Medicare.  We all are Ot's in our Patient's  eyes when we help them accomplish their goals and they are able to return their prior level or function.

Marianne, Geriatric - COTA, contract January 1, 2008 10:06 AM
Houston TX

I strongly support a title change for COTA's because of all the confusion in the word ASSISTANT, I also believe that OTA education should be step up to the BS level, we hear all the talk about the OT education raised to a Masters and now DR, so where do the OTA education fit?  Are we still going to remain at AS/AAs isn't time for a change for OTA's?  A nurse regardless of LPN or RN is still called a nurse, an RN with a AS,BS,MS,DR addeded to their title is still called a nurse, what is wrong in a title change and raising the education level of the OTAs?  I am tired of reading  fellow OTA'S and OTs comments on how costly it would be to upgrade the edu/title change for OTA's, what is the big fear?  I hear all the talk of promoting OT and making our profession known to the public etc... , don;t you think is about time to address the real feature of OTA?  I believe the time for a change is right now, and if there is ever a vote to make the changes I will be the first to vote.

nadia , COTA December 28, 2007 8:45 PM
Ny

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