10 tips for navigating a non-traditional OT fieldwork

Lauren Jones 02/01/2025

The vast majority of occupational therapy (OT) and occupational therapy assistant (OTA) students complete their Level II fieldwork placements in traditional settings such as schools, hospitals, outpatient clinics, and home-health programs. Fewer will complete fieldworks in mental health facilities, community-based settings, or even more non-traditional practice areas such as vocational rehabilitation or criminal justice systems. With a quick Google search, you can read about students’ fieldwork experiences in hospitals, schools, and mental health institutions across the country and around the world.

But what about the few, proud, and mighty OT and OTA students who are not completing fieldwork in these places? For the most part, there are very few resources available for students in non-traditional fieldwork settings. And while there are multiple studies touting the benefits and possibilities for students who complete non traditional or “innovative” fieldworks, there is virtually no research examining the student experiences, challenges, and learning outcomes in these settings.

I have no regrets about my Level II fieldwork in a state office of vocational rehabilitation, and I’ve enjoyed learning about the clients, common health conditions, and ins and outs of this setting. However, it has often been a challenge to find my place in a site where most people are unfamiliar with OT. Fortunately, my experience in this non-traditional setting has given me a great perspective to share with other students who may be in or entering a similar situation!

10 Tips for OT Students in Nontraditional Fieldwork Settings

Develop your knowledge. Although I have not yet provided classic occupational therapy services in this setting, I am learning a great deal about working with clients with mental illness, low literacy levels, and problems such as substance abuse and homelessness—all things I had not been familiar with before. As a result, I’ve spent a lot of time researching best practices in these areas and collaborating with my supervisor about how I can best serve these clients. Even if you are uncomfortable in your setting at first, taking time to learn about what to expect can help you settle in.
Communicate early and often. If you feel that your experience is not encouraging the growth of the skills you need to be a successful clinician, speak up! Your supervisor will not always know if you think you’re missing something as it’s likely they’re not an occupational therapist themselves, so find a time to meet and voice your concerns, passions, and vision for your experience. You should also keep your Academic Fieldwork Coordinator apprised of your situation; it’s likely that they will have had students in similar situations and can offer you helpful advice.
Accept what you cannot change. One of the frustrations I have in my setting is the length of time between when clients are referred and when I get to work with them. However, being annoyed won’t change it—I’ll see clients when I see them, and this is just something I’ve had to learn to live with. By letting go of unproductive thoughts, you’ll free up mental space for more useful work.
Make your own way. Work with your supervisor(s) to identify specific clients, cases, or programs that you feel will further your learning, and focus on these. For example, although I spend much of my time completing lengthy intake paperwork, I am also actively seeking opportunities to do things like shadowing job coaches in client workplaces and visiting the state assistive technology center to support my learning and interests.
Own your OT identity! Being the only OT or OTA in a setting can be nerve-racking at first, but you can use your fieldwork as an opportunity to advocate for why an OT practitioner (OTP) is necessary where you are by providing a different set of skills and perspectives to your clients and coworkers. Use evidence-based practice and resources to structure your thinking and interventions, and you can’t go wrong! I also make it a point to educate others about what occupational therapy is and the skilled, client-centered, and effective services OTPs are able to provide (our distinct value!) whenever I can.
Reflect on your learning. It may be difficult to parse out the things you are actually learning during your fieldwork as you see clients throughout the day. However, by taking time every week to reflect on the different skills you are developing, you may find that you are learning more than you think!. As a budding practitioner, your experience as a fieldwork student is similar to what many of your occupational therapy clients will be doing—learning skills without even realizing it!
Keep things in perspective. Even if you feel like you’re floundering or have negative feelings about your placement, do the best you can every day and realize that it’s only 12 (or so) weeks of your life! A month after your fieldwork, you’ll be back in classes, looking for a job, or doing a million other things—keep in mind that your fieldwork situation may not be where you’re going to be for the rest of your life, so take advantage of the experience and be present in the moment!
Sharpen whatever skills you can. In my setting, I do not have the opportunity to provide “hands-on” interventions with many clients. However, I am responsible for interviewing clients and writing accurate, detailed notes for every encounter I do have. As a result, I have significantly improved my interviewing, therapeutic use of self, documentation, and active listening skills.
Focus on the positive. Even if you are uncomfortable or have mixed emotions regarding your nontraditional fieldwork setting, you can make a choice to focus on the ways in which your experience is benefiting you and your clients. For example, consider how your presence as a student is allowing clinicians in your setting to work with more clients than they would typically be able to. Or, think about how hard you’ve worked for the past few years to get where you are! By keeping a positive mindset, you can help keep negative thoughts at bay and get the most out of your experience.
Comparison is the thief of happiness. If you spend all your time talking to classmates about their fieldwork experiences, reading about settings you wish you were in, or comparing your experience at a site to students who came before you, you’re never going to be able to be truly successful.

Know that you can learn something wherever you are, and even if you aren’t necessarily developing a “standard” skill set, think broadly about the skills you have gained. Have you become a champion organizer? Have you gotten over your fear of cold-calling clients? Have you learned how to interact with people of diverse skills sets and backgrounds? Then you’re on your way to being a great OT or OTA, whether in a non-traditional setting or not!

This article is adapted from a post on the blog Gotta Be OT.