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Healthcare · Occupational therapy practices
HR for Occupational Therapy Practices: Therapists, Assistants and Session Schedules
An occupational therapy practice runs on long, one-to-one sessions with children, adults and older patients. Here is how to run the people side so each therapist's day holds together.
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Share your requirementsAn occupational therapy practice helps people regain or build the skills for daily life: children with developmental needs, adults after a stroke or injury, and older patients adjusting to changed abilities. Work happens in sessions of thirty to sixty minutes, mostly one to one, in therapy rooms with sensory and exercise equipment, and sometimes at homes or schools. A small team of therapists, therapy assistants and a front desk carries a long list of regular patients, many of whom attend several times a week for months. Parents and caregivers often sit in or ask for updates, so how a therapist communicates matters as much as technique. Records of goals, progress and consent must be kept session by session. See also HR for healthcare. What makes HR different here is that the therapist is the service: when one leaves, a block of families waits on a replacement, and the relationship built over many sessions does not transfer easily.
- Plan
- Hire
- Onboard
- Manage
- Develop
- Perform
- Engage
- Retain
- Exit
- Improve
When HR is weak in occupational therapy practices, you may see
- Families follow the therapist, not the centre
- The schedule is back to back
- Pay mixes fixed salary and per-session work
- Assistants learn on the job with little structure
- Home and school visits stretch the day
- Caseload is uneven between therapists
These are the places the people side of this kind of business tends to give way. The rest of this page works through them.
Who does the work in occupational therapy practices
HR here has to work for each of these groups, not only the office. The set-up below is written with all of them in mind.
- Occupational therapists
- Paediatric and sensory integration therapists
- Therapy assistants and aides
- Special educators working alongside therapy
- Front desk and appointment coordinators
- Centre manager or clinical lead
- Visiting and part-time therapists
Where HR strains in occupational therapy practices
Families follow the therapist, not the centre
When a therapist resigns, parents ask to move with them or stop coming, and the practice loses sessions it had booked for months.
The schedule is back to back
Long sessions leave little time for notes, parent updates or a break, so records slip to the evening and tired therapists leave.
Pay mixes fixed salary and per-session work
Part-time therapists paid per session and salaried ones sit side by side, and cancellations by families leave the per-session people unsure what they will earn.
Assistants learn on the job with little structure
Aides handle children with complex needs after a short watch-and-learn start, and the line between assisting and treating is not written down.
Home and school visits stretch the day
Travel time between visits is rarely counted in the schedule, and safety and reporting for a therapist working alone in a family's home are left to the individual.
Caseload is uneven between therapists
Popular therapists run full while newer ones wait for patients, which breeds resentment and uneven incentives.
HR topics for occupational therapy practices
Start with the topics that matter most here: Retention and Attrition Management; Compensation, Payroll and Benefits; Organisation Design. Then work through the rest. Each topic is written for healthcare, not in general.
Retention and Attrition Management
Who leaves, when, why — and which of them mattered.
Compensation, Payroll and Benefits
Salary structure, payroll inputs and a month that closes on time.
Organisation Design
Structure, reporting lines and who is allowed to decide what.
HR Strategy and Workforce Planning
How many people, in which roles, by when — and what they will cost.
Recruitment and Talent Acquisition
Requisition to joining, the same way every time.
Onboarding and Probation
A first day that is the same for the fifth joiner as the first.
Employee Administration
Records, attendance, leave and the day-to-day HR that must simply work.
Performance Management
Goals, reviews and ratings that hold up in a conversation.
Learning and Development
Training planned from need rather than from the calendar.
Career and Succession Management
Named backups for the roles that cannot be vacant.
Employee Engagement and Experience
Communication, recognition and the conditions people actually work in.
Employee Relations
Two routes — one for complaints, one for conduct — kept separate.
Policies, Compliance and Governance
Policies a manager can apply, and obligations with owners and dates.
Health, Safety and Wellbeing
Induction, records, incident reporting and follow-through.
Exit and Alumni Management
Resignation to relieving letter, in a defined order.
HR Technology and Automation
Records that survive people, and approvals that do not queue.
HR Analytics and Management Reporting
A short monthly pack management actually reads.
HR Operations and Governance
An HR function that runs the same way every month.
What a working HR set-up looks like
The pieces a occupational therapy practices business puts in place, in an order that makes each easier. Open any card for the detail.
Define roles for therapists and assistants
A written description of what a therapist, a senior therapist and an assistant each do, including what an assistant may carry out under supervision.
What this coversHide
Define roles for therapists and assistants
A written description of what a therapist, a senior therapist and an assistant each do, including what an assistant may carry out under supervision.
What this coversHideA written description of what a therapist, a senior therapist and an assistant each do, including what an assistant may carry out under supervision. The role design and job descriptions work sets this out.
Plan caseload and session load
A fair maximum of sessions per therapist per day, with time for notes and parent updates built in, and a simple way to move new patients to those with room.
What this coversHide
Plan caseload and session load
A fair maximum of sessions per therapist per day, with time for notes and parent updates built in, and a simple way to move new patients to those with room.
What this coversHideA fair maximum of sessions per therapist per day, with time for notes and parent updates built in, and a simple way to move new patients to those with room.
Make part-time pay predictable
A clear rule for what a per-session therapist earns when a family cancels late, so income does not feel like a gamble.
What this coversHide
Make part-time pay predictable
A clear rule for what a per-session therapist earns when a family cancels late, so income does not feel like a gamble.
What this coversHideA clear rule for what a per-session therapist earns when a family cancels late, so income does not feel like a gamble. The compensation and rewards strategy work covers this.
Plan handover when a therapist leaves
A standard handover note per patient, a joint session with the new therapist and a message to families that explains the change before it happens.
What this coversHide
Plan handover when a therapist leaves
A standard handover note per patient, a joint session with the new therapist and a message to families that explains the change before it happens.
What this coversHideA standard handover note per patient, a joint session with the new therapist and a message to families that explains the change before it happens.
Set a routine for travel and visits
Counted travel time, a check-in when a therapist reaches and leaves a home, and a rule on who accompanies a new therapist on a first visit.
What this coversHide
Set a routine for travel and visits
Counted travel time, a check-in when a therapist reaches and leaves a home, and a rule on who accompanies a new therapist on a first visit.
What this coversHideCounted travel time, a check-in when a therapist reaches and leaves a home, and a rule on who accompanies a new therapist on a first visit.
Start by checking where you stand
Before changing anything, find out what is true today. These checks take an afternoon and tell you which of the topics above to start with.
Share your requirements- List each therapist's weekly sessions and see how many have time for notes inside the working day.
- Write down what a therapy assistant may and may not do on their own, and read it to your assistants.
- Look at the last therapist who left and count the patients who stopped coming within two months.
- Ask your part-time therapists what they earned in the last month and whether it matched what they expected.
- Confirm with a qualified professional the registration, record-keeping and employment obligations that apply to your occupational therapy practice.
Confirm with a qualified professional. What applies to you depends on your business, your state and your arrangements, and it changes. This page describes practice. It does not state a legal position.
How GullyHR helps
The services below fit this kind of business best. Each starts by recording where you stand, and every later report compares against that. We do not promise outcomes.
- Role design and job descriptions
Clear lines between therapist, senior therapist and assistant, so supervision and accountability are written down.
- Attendance, shift and leave
Session schedules, travel time and part-time hours recorded in one place, so pay and workload match.
- Retention and attrition
A look at why therapists leave, and what each exit costs in lost sessions and unsettled families.
- Learning and development
A plan for assistants and newer therapists to build skill with supervision, instead of learning by chance.
Start with a free conversation, or see the paid HR Diagnostic.
Our hospital HR transformation approach
- 1
Assess
Understand the hospital, its workforce, current processes and HR challenges.
- 2
Identify gaps
Find the missing, weak, inconsistent or person-dependent processes.
- 3
Design
Create the structure, processes, policies, SOPs, dashboards and systems needed.
- 4
Implement
Help HR and department managers actually adopt the new system.
- 5
Automate
Digitise repetitive and approval-based workflows where it is worth doing.
- 6
Measure
Track hiring, attendance, employee cost, performance, training and attrition.
- 7
Improve
Strengthen the people-management system continuously, not once.
Blogs worth reading first
From the GullyHR blog: one on HR in healthcare, and one on each of the topics this page points to.
HR Management
How to recognise and address employee workload problems
How to spot an unmanageable workload before it becomes an exit or an error, what to look at, how to talk about it and what to change, without guessing.
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HR Management
Salary bands for SMEs: building grades when you have never had any
Most salary structures grew one negotiation at a time. How to build grades and bands from what you already pay, without repricing everybody at once.
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HR Management
Everyone reports to the founder: when and how to redesign the structure
A flat structure works until the founder becomes the only route to a decision. How to tell when you have passed that point, and how to redesign without a reorganisation.
8 min readRead articleMore on the GullyHR blog.
Questions owners ask
Plan the handover before it is needed: a written summary per patient, a joint session with the incoming therapist and a clear message to families. It will not remove every loss, but it keeps most relationships.
There is no single number. It depends on session length, age group and how much writing and parent contact each session needs. Look at where your therapists finish notes and set the load from that.
Both are common. Per-session pay suits part-timers, but it needs a clear rule on cancellations. Salaried roles give stability and suit core staff. Confirm the employment treatment with a qualified professional.
How to handle and calm a child, the safety rules for equipment, what they must report to the therapist, and what they must not do alone. A short check at the end of the first week helps.
Use one simple template for goals, session notes and progress, and agree when notes are due. Consistency makes cover and handover much easier.
We would list each therapist's weekly sessions and see who has time for notes, write down what a therapy assistant may do alone, and look at what happened to patients when the last therapist left. A good first step is clear roles and a caseload plan. After the conversation, scope and fee go in writing.
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