Supervision Involves Sharing Knowledge

Q: I am a per-diem OTR in a nursing home. I work for an agency that also staffs OTAs. I don't see them because they come on different days. I do all the evaluations and co-sign their notes. I think the agency is being greedy by not having me treat some of the more complex cases. What are your thoughts?

A: OTAs are supposed to be supervised by OTs. Supervision means contact, to share information about patients and their treatment, to teach, to instruct, to oversee.

As the OT, you are responsible for what OTAs working under you do. If an accident happens, you would be named in subsequent legal action whether or not you were there. The OT/OTA relationship cannot be taken lightly.

In my opinion, you need to check your state laws regarding supervision of OTAs. What you are being asked to do may not be legal under your practice act. Don't risk jeopardizing your professional status or license.

AOTA offers a state-by-state listing of OTA supervision requirements on its Web site:

I have supervised many OTAs over the years. I would ask each one to tell me what he or she considered strong and weak suits, so that I was able to focus on professional wants and needs. What was the clinical reasoning of the treatment plans I wrote and developed? How could they administer treatment more effectively or more easily? How was each patient they were treating doing?

We would discuss our approaches together and talk about ways to deal with difficult patients and ways to record notes better. Sometimes I had to overcome initial resistance on their parts, but each came to anticipate and enjoy our meetings, and so did I. I wanted them to perform at their best and so did they.

Q: I read with interest your column about supervision and mentors. I work in an acute-care and outpatient setting, primarily with individuals with neurological impairments, and with some orthopedic patients. I've been an OT for 10 years and have never had supervision. I want to be a better therapist, particularly in the neuro practice area. How do I go about getting supervision and with whom? There's not a culture of education and learning at the facility where I work.

A: I suggest contacting your state association. Depending on how the organization is set up, you can try contacting the district moderators or the practice chairperson. Tell them you are looking for advanced-practice supervision; you have 10 years of experience under your belt and don't need a basic level.

You could contact AOTA in the same manner. You could also call authors of books or articles you find interesting. Consider supervision by phone or Internet, too. When you do find someone, you should expect that person to spend half an hour or so with you to see if there is a fit.

Findng the right person may take time, but it will be worth it.

Jane Sorensen, PhD, OTR, ND, practiced in all traditional OT areas over 32 years and wellness for 25 years in private practice. She currently has a supervisory and consulting practice. She has written A Therapist's Tales ( and was ADVANCE editor E.J. Brown's co-author for A Guide to Early Intervention ( You can reach her at 212-744-5836, or

Supervision For Skill-Building Archives

Hi. I would like to know if New York State law allows a newly grad OTR who has less than 3 months working experience in an SNF, can co-sign and supervised a senior and intermediate COTAs/OTAs? Thanks.

Clarissa   June 05, 2012

What is the New York State law for a newly grad OT who recently passed the board can supervise and co-sign progress notes of a senior or intermediate COTA/OTA? Thanks.

Clarissa June 05, 2012
Brooklyn, NY


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