The COTA Name Debate, Part 2

Eric, your comment about "we are all just therapists" is wrong. I am being specific here,  COTAs are not therapists...we are therapy assistants.  This is why are title COTA needs changed to reflect us as we truly are and get our just upgrade with initials...but we are "technically" not therapists.  This is another ongoing debate to rage further.  

I never really had a problem with the word assistant in my title, however, when an OTR that I worked with referred to me as her "assistant" THEN I had a problem!

I personally have never had a problem with the assistant thing.  I think some of you are being a little sensitive.  I worked as a nurse before becoming an OTA and I saw how LPN's were looked down upon and treated like second class nurses by RN's who just went sometimes 6 months longer to school.   The OT's i work with never make an issue of the COTA title.  We're all just therapists.

I agree that the assistant name should be changed.  I strongly disagree that we as COTA's know the same or as much as OTR's.  I am or was an RN who chose to be a COTA for financial reasons.   I looked into OTR schools and realized that they take lot more theory and are much more quailified on assessing patients.  I work with an OTD who is the most intelligent therapist in our faciiltiy.   I would never try to compare my OTA degree with his degree.  I noticed some of you on here think PT and PTA's make a lot more money than we do.  You must be working in the wrong place, because in Chicago that's not the case.  I am sure the OTD makes a little more than the PT here.  I never feel as though I am looked down on because I am a COTA.  The PTA's I work with do not get the respect from PT's.   I think most OTR's respect us.

Getting back to Lisa's comment, I completely agree with you.  COTAs do NOT receive their just due, and I mostly blame OTRs and NBCOT/AOTA  for this name disrecognition.  Yet go about continuing education nonsense that no 40 hour a week person has time for and NBCOT has not proven that we are any smarter now than we were back when recert started.  

Getting back to Lisa's comment, I completely agree with you.  COTAs do NOT receive their just due, and I mostly blame OTRs and NBCOT/AOTA  for this name disrecognition.  Yet go about continuing education nonsense that no 40 hour a week person has time for and NBCOT has not proven that we are any smarter now than we were back when recert started.  

I have been severance from my job of 13+ years and have always been interested in OT.  I have a BS but would need 5 classes for pre-requisites.  To work, volunteer and take courses I think it would take me until next summer to complete my pre-req’s...  I do not think I will be able to get in to the local OTR School and am considering the cost and stress of relocating to attend OTR School or to begin COTA training here locally.   Considering taking the time and money to get my pre-requisites for the OT Masters program, relocating and cost of living and school I am wondering if being an OTR is worth the extra effort.  Also how much more difficult is the training – will I make it or is it better to get my COTA and then latter go for OTR?  Will anyone that has been a cota and is now an OTR, can you tell me how the two programs difficulty compare and the exams?  What do you recommend – direct into OTR or COTA?

I have been severance from my job of 13+ years and have always been interested in OT.  I have a BS but would need 5 classes for pre-requisites.  To work, volunteer and take courses I think it would take me until next summer to complete my pre-req’s...  I do not think I will be able to get in to the local OTR School and am considering the cost and stress of relocating to attend OTR School or to begin COTA training here locally.   Considering taking the time and money to get my pre-requisites for the OT Masters program, relocating and cost of living and school I am wondering if being an OTR is worth the extra effort.  Also how much more difficult is the training – will I make it or is it better to get my COTA and then latter go for OTR?  Will anyone that has been a cota and is now an OTR, can you tell me how the two programs difficulty compare and the exams?  What do you recommend – direct into OTR or COTA?

    I feel that the name change would not cause more confusion

in the public,  but would  clear up any question  regarding the fact that "COTA/Ls" do have a degree in occupational therapy.  I can not tell you how many times in my 19 years as a COTA/L I have had a parent or a teacher assume that I have little or no education because they relate "assistant" to teacher assistant and nursing assistant etc.  The OTR/L also has had to reassure parents or teachers in meetings that we are licensend and certified as well as have a degree in Occupational Therapy.  

    I am glad this topic is finally being considered and I feel the name change will only improve the overall perception of OT as trained practioners.  

Hey Tanya, some of the OTRs you mention do not even know what Total Hip Precautions are, but can tell you everything you need to know about every Performance Component and every Practice theory.  Regarding the OTR test however,  I think COTAs are never smarter than they are right out of OTA school, and many of the concepts learned in OTA school are forgotten years later.  That would be my only doubt about many COTAs success with the OTR test.

I have a suggestion.  An RN is an RN whether they have a 2 year associate's degree or a 4 year's bachelors degree.  Correct?  I'm assuming they take a standard RN test to pass.  Has anyone ever considered taking the OTR test as a COTA to see if you could pass it?  Why not sit for the OTR test and see?  (Cause they won't let you and why you might ask? ) I have a sneaking suspicion that there's very little difference.  So, an OTR has 2 more years of theory????? It would be very interesting to see how a COTA would do on the test.  Don't ya'll think so?  It's my personal opinion but I don't think 2 more years of theory makes a "therapist" better qualified.  This is probably the best guarded secret.  COTAs are very qualified and able but OTRs have 2 more years of theory.  I bet the test is the same!!!!!!  Oh well, food for thought.  This will probably get some blood pumping............

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Paula, Paula...aren't you being a bit redundant here?

I love this debate and blog. Hey does anyone have any ideas or suggestions on how to advance from a cota ot an otr on line? Doesnt it piss you all off to know that pt and pta make more money then we do. Even new grads. After all they do is kick, marches, butt squeeze and walks. Specifically on acute in LTC. I also get anoid when they use our equipment like cones and peg boards to bill for time and call it neuro or standing balance. Lets stick to gether .... paula a, cota/l

I love this debate and blog. Hey does anyone have any ideas or suggestions on how to advance from a cota ot an otr on line? Doesnt it piss you all off to know that pt and pta make more money then we do. Even new grads. After all they do is kick, marches, butt squeeze and walks. Specifically on acute in LTC. I also get anoid when they use our equipment like cones and peg boards to bill for time and call it neuro or standing balance. Lets stick to gether .... paula a, cota/l

Ditto Nicole's comments to John ... with an addendum.  Many of the COTAs in this field cannot afford to get an OTR bachelors or masters degree, so we decide to be COTAs with Associate in Science/Art degree.  What is wrong with us being recognized as equal to an RN who has the SAME LEVEL DEGREE?  All I am saying is, the degree earned should equal the title...the title assistant simply is not equal to an Associate degree accomplished.  Also, how could this possibly be offensive to John or other OTRs who want to advance the field??  Moreover, if COTAs like Jordan have the time and money to advance their career...great for you.  But, many COTAs have full time positions and cannot advance...just want to be "justified with better earned title name and credentials that we already have earned."

As a practicing COTA for 9 years I have always had a problem with the word   "assistant".  So I did something about it, I am currently finishing my master's degree in occupational therapy.  I feel if you do not like the word "assistant" you should go back to school and get the education that is required in order to change your title.   COTAs are very valuable to the OT profession, but lets not forget COTAs are assisting the OTR in providing OT treatments.  

Well said Nicole!!

Such a shame that this has been spoken about and unfortunatley "argued" for such a long time on this blog and forum and throughout, yet not only is nothing be done about it but OTRs and OTAs are being split on it rather then coming together as a whole.  As most of the OTRs say, "its just a title" so whats the big deal?  The big deal is, we dont have the trust and respect from our patients as we should... apparantley we seem to not have it from some of our OTRs as well.

John, you missed Bobby's point completely.  As, it is the job of all OT practitioners to advance the field, I ask you what is the COTA/OTR ratio in all of the organizations responsible for advancing OT?  A very large majority of them are OTRs, and these organizations have done little to promote the profession.  Nursing and therapy are different entities, but you show little reason to support the claim their education levels can't be compared.  Why?  They still have legislation and ethics to clarify the separate professions, but those people who went to school and have proven their competence are permitted to a title reflecting that.  You suggest looking to the PT field, but guess what, they are having the same debate for the same reasons.  Like you, I went to school caring nothing of the letters I would have at the end of my name, but the stigma of "assistant" has become very apparent with both med professionals as well as patients/families.  I guess I wouldn't expect you to understand, and you have never had to give the "Yes, I'm an assistant, but I can still competently treat you, and I'm sorry you can't see the real therapist everyday." speech, have you?  The majority of OTRs haven’t given the slightest thought to the basis COTA’s provide in support of a name change.  You are automatically opposed to it, like it takes something away from you.  I’m sorry you feel so threatened by it, but your inherent interest to protect yourself isn’t justification enough not to consider something that many feel would give all OT practitioners respect  from the general population, which would promote the entire profession in the public’s view.

The second sentence of my last post should have said:

First of all, it is NOT just the OTRs responsibility to “advance” the field as you mentioned.

Bobby, here is the response you requested. First of all, it is just the OTRs responsibility to “advance” the field as you mentioned. It is the responsibility of all of those involved with occupational therapy.

For you comment stating that “some OTRs have left facilities for many weeks to let the COTA manage facilities independently...who needs the OTR in these cases?” I am somewhat surprised that you ask this. Legally speaking, a COTA must have a specific amount of supervision from a OTR as listed in state practice guidelines. I’m not saying that COTA’s do not make good managers or cannot function on a daily biases without an OTR on site. I am just saying the guidelines must be followed for services provided by COTA’s to be legal and ethical.

And for your statement, “I chose the profession because I wanted to make a change, not just eval and dump patients off.” This is a generalized statement that you seem to be directing toward all OTRs. Maybe you have not worked with an OTR that does more treating than evaluations. Also, if an OTR is not needed, who will do the evaluations?

You wrote, “with an associate degree earned, the name COTA is simply not in line with the parallel RN degree. You must recognize that therapy and nursing are two different entities and can not be compared. What you can compare your title with is the physical therapist assistant. This is a similar profession with an associate degree.

You wanted to know, “how would John feel if his OTR was named something less than the title?  Well, to me a title does not matter. It is just letters that follow my name and it doesn’t define me or how I do my job. When I realized I wanted to be an occupational therapist, I didn’t do it so I could use the OTR after my name. I did it so I could do what I love by helping patients/clients improve their independence and quality of life.

I do think we should start a petition for both a name change and a greater voice in the profession in general.  Really, for every OTR that is hired by AOTA, NBCOT, and state organizations a COTA should also be hired.  We do make up half of the workforce or more depending on the area you're from.  Additionally, this quota should go for upper level positions in these organizations- I don't want some party favor. And don't tell me that one needs a masters to hold a position of this nature.  I've had 5 jobs (traveler), and by far the best 2 bosses I've had were both assisstants!  Side note, my current boss's (COTA) clinic has grown about 5 times it's size in one year so it's not just some personal bias I have.  Bobby's absolutely right, those in charge of these organizations have done very little to promote the occupation and demand the respect for all of it's practitioners- it's time for a change!

As a side note, to John's "confusion" theory, try explaining to a patient why and how they are being treated by an assistant and have seen their therapist but once.  The word assistant is actually what confuses people in the first place!  Patients feel as if they are being short changed.  Also, did it ever occur to the OTRs who seem to be so appalled by COTAs that if it weren't for us 1) this profession wouldn't be half as big as it is now(not enough therapists to go around) and 2) you sure wouldn't be making the money you do if all of your were mastered therapists?  I was just curious.  I'm not sure why it threatens you so much to consider changing the word assistant (as most assistants in the med field (aside from PAs) have no college ie CNAs).  It would do much to foster the respect and trust of a patient right off the bat to have a title which implied we do have the training we worked for.

This is response to John's (OTRs) comment about COTAs...I don't know if it is a lack of true understanding or what, but OTRs have not advanced the OT field like it should be nor have help educate the community about OT. Furthermore, COTAs, who certainly are "therapists,"  have had little voice in the changing of any licensure rules or re-registration nonsense of the past years.  MOREOVER, some OTRs have left facilities for many weeks to let the COTA manage facilities independently...who needs the OTR in these cases???  Maybe it is because he is jealous that many OTRs are becoming completely obsolete.  Maybe OTRs feel like they are becoming too good for the field. For John to say that there is some easy way for a COTA to make a change, he must be somewhat in outer space.  I specifically hated the assistant name from 15 years ago, but I chose the profession because I wanted to make a change, not just eval and dump patients off.  The assistant name change would be simply in line with what a associate degree RN would be...not a "certified" but a "registered" practitioner.  COTAs are not registered practitioners...they are certified practitioners and definitely "therapists", but fail to get the real recognition/title.  With an associate degree earned, the name COTA is simply not in line with the parallel RN degree.  Unfortunately, the COTA name as it currently stands is equal to a LPN...but COTAs are educated equal to an RN!!!  How would John feel if his OTR was named something less than the title?   I would love to read Johns response to this....

For those of you complaining about use of the word "assistant", I must ask a question. If the term assistant is such a big issue to you, why did you choose this as your profession? You knew what your title would be before you graduated. It is ones choice to get an associates degree to become a occupational therapy assistant. If you want a new job title then you need to get the degree that is necessary to do so.  

I respect the opinions of those who suggest a title change, but I disagree with it. In my opinion, changing the title will only confuse patients and the general public.

I am with you!  I would sign a petition or do what it takes to be heard and have the title changed.  This has been spoken about in great length on the forum and the blog for such a long time.  It is discussed throughout the working world as well, something needs to be done.

Thanks Nicole.  Do you have any ideas on how to get this issue addressed?  There are probably a lot of COTAs who feel like us.  Thanks for any feedback!

Kathleen, I'm with you.  We are the low men on the totum pole.  How many COTA's actually hold respectable positions within any OT organizations?  Very few... we have no voice, and until we do nothing will change.

How can we go about actually getting this issue addressed?  Can COTA professionals sign a petition for a job title change?  It does not seem fair that we are referred to as assistants.   Can we really take action for change?

This topic seems to bring out more peoples emotions and feelings than any other topic I've ever covered. Again though, can you all see how many opinions there are regarding a name change? With OT becoming more mainstream, people are beginning to become aware of what it is we do. At this time changing the titles might be more confusing to the public as we struggle to take our place in the medical professions. My opinion is that we need to look past the title, and be the best at what we do, which is helping people regain their skills.

My biggest complaint with AOTA/NBCOT is not only the COTA name but the professional Occupational Therapy discipline name in general.  COTAs have the same degree as an RN but the professional organizations fail to react to it...want to really further the profession?  Recognize the COTA as an Associate degree professional and change the name of Occupational Therapy to Practical Life Therapy or another more meaningful name, instead of just taking our fees and fighting amongst themselves.

 Moreover, COTAs with 10 years experience should be grandfathered automatically to OTRs.  Any thoughts?

I was a COTA/L for 13 years and struggled with this issue of the word "assistant" in the title. I am now an OTR for 4 years and so I now see it from both perspectives. an LPN is considered a nurse with 12-15 months training, certificate a state test. A COTA has  a two year college degree, state test for some etc... but has the word assistant tagged to their title. In Nursing, with the same amount of education as a COTA their title is RN. I believe the word assistant should be removed from their title. It creates a stigma that from experience, patients may look at them as less knowledgeable. I believe certified occupational therapy practitioner is a suitable title, and OTR can remain as is. It does not take anything away from the OTR. It simply shows respect and appreciation to all OT practitioners. The OTR does have a more extensive education then the COTA and therefore there should be a difference in the titles. Registered vs. Certified is that difference. Ultimately, the goal is for the field to remain unified while all its practioners can be proud to be a part of it and, there can be mutual respect regardless of our titles.

I am ALL for changing the name!  We earned the respect and dignity as the OTRs have earned theirs.  I do like the COTP/L sounds better and people will stop saying "COTA" as if it is a word on its own.

I work as an OTA/L.  What about the OTA/L's that are not Certified OTA?  What will our title be changed to?  Besides Certification is optional in some states.

I have worked with many great COTA's over the years & respect their role.  On the other hand-I did attend three additional years of school compared to a COTA and therefore have earned the right to write OTR/L.  I don't see Physician assistants getting upset over their title-they are not doctors but assist them.  By changing the title you will confuse the public into thinking you are an OT with 4-5 years or education.  I know many COTA's that had more knowledge & experience then some OT's but unfortunately you need to spend the time in school to receive the credentials-unfortunately on the job training doesn't count towards that.

I do feel a name change is needed.  I have worked under overbearing OTRs who have felt I am their personal assistant, and I don't know what, if anything, a name change would do to help that.  The problem is within the COTA/ OTR relationship and needs to be addressed.  I do, however, see the need to change the name when representing myself to patients, family, and other medical professionals.  I found the problem to be much more prevalent in the geriatric field, when addressing adult patients and their families.  I usually introduced my self as being from the OT dept, and I elaborated if asked.  I have had patients and family  put off from my title, especially since I look and sound much younger than I am.  I also have a serious problems trying to address issues with med professionals, as sadly, they are not familiar with OT in general, let alone the distinction between assistants and aides.  I have read comments about not changing to name secondary to the OT field finally getting respect, but I ask what respect? And secondly, I would hope you would want the whole field to have the respect they earned, not just half.

One must remember during any discussion of roles in occupational therapy that the profession in unlike other disciplines.  The COTA is not an assistant to the OTR.  The occupational therapy assistant is just that... therapy assistant.  This unusual degree allows the COTA to work in settings without OTR supervision.  The only time the COTA needs supervision is when occupational therapy services are being charged.  Without this understanding the current undertow of resentment is threatening our structure as a whole.  OTRs cannot supply the demand, alone.  COTAs practicing within occupational therapy, need the OTRs.  Please, consider the whole brain thinking approach... using the left side, and right side... and bridge the gaps to promote OT.

As an OTR/L, I have worked on a full-time basis with alot of COTAs. I respect their role and know their value as clinicians. I just want to hear from you that suggest a name change is necessary. If the word "assisstant" is changed to "practicioner", "associate", "certified OT" or "registered OT", what will the OTR be referred to as?

In my opinion, occupational therapy is finally getting its respect from the general population and a name changes will only further confuse the public of our role.

From my experience, most patients don't know or really even care about your credentials or job title as long as they are recipients of services that meet/exceed their expectations during therapy. And remember, if a therapist makes an impact on a patient, the patient will remember the clinicians name, not the letters that come after it.

Well, I figured this blog entry would get more comments. Once again though, there are several different suggestions for a title. But can anyone tell me what relation M.D. and Maryland, and P.T. and Portugal have to do with this? As Christopher Alterio states? Here is a direct quote from the NBCOT site, what does the little "R" in the circle mean to you?

NBCOT's Professional Development Provider Registry is a service specifically designed to help practitioners certified as OCCUPATIONAL THERAPIST REGISTERED OTR® and CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA® meet their certification renewal needs.

COTA is a trademark; it is not a copyright and it is not a patent.

A "trademark" is a word, name or symbol which is used to identify particular products or services offer by a particular source.

The trademark distinguishes and authenticates a product of a particular source from similar products offered by others. The owner of a Trademark has the right to prevent others from using the same or similar trademark on their products.

I don't believe that there is any confusion between a Certified Occupational Therapy Assistant and the Central Ohio Transit Authority.  Similarly, there probably is not much confusion between Medical Doctors and the State of Maryland - or Physical Therapists and the internet domain designation for the Country of Portugal.

However, at any time that an entity believes that confusion may exist, they would reserve the right to 'protect' their marks that have been registered with the United States Patent and Trademark Office.  

This is important because health professionals who earn credentials certainly would not want their credential confused with something that it did not indeed represent.

I feel that we should not be called assistants. People constantly confuse this with teacher assistants and nursing assitants who have less training and education than we do. LPNs are nurses and we are therapists. I do like either Liscensed OTs ( OTRs can be called Registered OTs) or associate or assistant therapists because we are therapists.%0d%0a

I refer to myself as an Occupational Therapy Practitioner because that's what I am.  I much prefer C.O.T.A. to being called a "COTA" which stems from something one of my instructors said in school about "COTA" being unprofessional slang.  We don't call OTRs "Otters" or PTs "Petes" or PTAs "Petas" but instead give the respect of their title.  I am proud to be a COTA and don't mind keeping that title when it is used respectfully.  

I do like that we are Therapy Assistants instead of Therapists Assistants.  I don't see myself as an assistant to a therapist, but rather an assistant in the field of Occupational Therapy.  Semantics?  Maybe, but I like the feeling of a collaborative relationship with OTRs rather than one of rank and file.

How about OTC/L for an assistant (Occupational Therapist, Certified/Licensed?

How about Certified Occupational therapist Practitioner, I mean lets be honest

How about Certified Occupational therapist Practitioner, I mean lets be honest

Why do we have to change it all? I think changing the name at this point would creat more confusion.What if you are a COTA in %0d%0aHand Therapy COTAHT?? That almost looks like a new strand of DNA.%0d%0aHow about COTAORTHO??%0d%0aJust having fun here!!