Increasing Diversity in Occupational Therapy: The Coalition of Occupational Therapy Advocates for Diversity (COTAD)


In case you weren’t aware, the profession of occupational therapy is many things – rewarding, exciting, and fast-growing, for example. However, diverse is generally something this profession is not – although efforts are being made to change this. According to AOTA, the profession looked like this in 2013-141:

Race and Ethnicity Percentage of Workforce
White, Hispanic & non-Hispanic 82%
Black, Hispanic & non-Hispanic 4%
Asian, Hispanic & non-Hispanic 6%
Native & Pacific Islanders, Hispanic & non-Hispanic <1%
Other- Hispanic & non-Hispanic 7%

The makeup of OT/A academic programs was similarly lacking in diversity2:

  • Programs offering doctoral degree level programs—88.6% Caucasian
  • Programs offering master’s degree level programs—72.8% Caucasian
  • Programs for OT assistants—74.6% Caucasian

In the AOTA’s Advisory Opinion on Cultural Competency and Ethical Practice, they state that “cultural competence is key to effective therapeutic interactions and outcomes,” and I vehemently agree. However, as of 2006, over 72% of students in OT and OTA programs and nearly 90% of students in OTD programs in the United States were Caucasian. These disappointing data (although they are outdated) indicate that students and professionals in our field may not represent a sufficiently broad range of experiences, perspectives and backgrounds that are vital for successful therapist-client relationships and meaningful professional development. Increased diversity within the profession means that occupational therapy will be improved for both clients and practitioners, and the addition of more socioculturally diverse professionals to the workforce will result in more effective and culturally appropriate client care as well as enriched professional exchanges.

So why does diversity matter? Continue reading

Brown Like Me? Pretty Rare in OT.

Silent Diversity
Image: Silent Diversity by DryHundredFear

Many people have asked this question: How diverse is occupational therapy as a profession?

In my own experience, I had to look no further than the slideshow for the Eleanor Clarke Slagle Lectureship at the 2015 AOTA Conference to find an answer.

After spending several minutes watching the slides tick by, I began to notice a trend.


I kept waiting for the photos on the slides to change as I watched and the year 2015 approached, but from 1955 onward I saw only 4 or 5 people who didn’t fit the White woman mold. In the SIXTY YEARS that the Slagle lectureship has existed, there have been a handful of men and only one African American woman who have spoken. Since 1969, when Dr. Lela Llorens, PhD, OTR, FAOTA, delivered her speech, there has not been a single Slagle lecturer who looks like me.

I know, I know. There are the very obvious “You can’t judge a book by its cover!” and “There’s more to diversity than skin color!” arguments to be made here, and they are certainly valid! I’m sure that each of these lecturers had merits and achievements that warranted their selection, and I won’t pretend to know each one’s ethnicity or cultural background. However, while those faces in the slideshow certainly seemed to be an accurate reflection of the profession’s demographics (86.2% AOTA Members are Caucasian according to a 2006 Workforce study), I don’t believe they are an accurate reflection of the wonderful diversity of the profession’s many innovators and influencers.

I find it extremely hard to believe that in the nearly 100 years since OT was officially established as a profession only White women have “creatively contributed to the development of the body of knowledge of the profession through research, education, and/or clinical practice,” which are the requirements to become a Slagle Lecturer. Honestly, I can’t pretend that watching a 10-minute slide show celebrating the biggest thinkers, visionaries, and leaders in my profession and seeing only one person of color didn’t hurt – for me, it was really very discouraging.

I’m sure this lack of diversity wasn’t intentional, and many AOTA leaders have been instrumental in developing or supporting initiatives to promote increased professional diversity. However, it may be time to take a closer look at the unspoken message about the value of diversity the profession is sending to students and members with its speaker selections and the makeup of its leadership committees.

For example, another place in which a similar lack of diversity a problem is in the AOTA Special Interest Section leadership. As I perused this page to learn more about the SIS internship program leaders, I found myself viewing another set of photos of primarily White women. Again, let me be clear in saying that this is not a comment on the qualifications of any of these leaders or a “call to arms” to start filling every open position at AOTA with the person who looks least likely to get a sunburn. But it is just another very visible indication that within the profession there is a longtime trend that continues to be a very real problem.

This isn’t the first time the lack of diversity in the profession has been acknowledged as an issue, and I’m sure it won’t be the last. In fact, concerns about decreasing professional diversity was one of the main issues raised at the dialogue about the potential transition to the OTD as the profession’s single point of entry with the AOTA Board of Directors. In all fairness, there is really no way to tell what the impact of such a decision would be, but I think it says a lot that many practitioners of varied backgrounds raised this question, and I hope that our leadership (and members!) will take steps to continue pushing for a more diverse profession today and in the future, whatever the outcome of that particular discussion. (For more information on diversity and the OTD, check out the table in the middle of the page HERE).

And though professional diversity is clearly an issue, it is hard to know how to address it because it is nearly impossible to know where the true heart of the problem lies. Are people of color simply not electing to be in leadership positions? Do they feel alienated or unwelcome in a profession whose leadership consists primarily of people who they feel may not value their perspectives? Is it a recruitment issue? These are all questions I’ve wondered about, and I’m hopeful that there will be more research into this issue in the future to help inform the profession’s next moves in this area.

So how am I dealing with all of the frustration that I feel in regard to this issue? Because I tend to be a very proactive person, I have actively sought out role models of color who can help me navigate these and other professional issues as well as serving as examples of how I can achieve my goals and do great things even if I don’t look like the “average” OT (i.e. a youthful White woman). I’ve also participated in several events to support my school’s efforts to promote the profession to a more diverse audience.

At this point, you might be saying “Why not join a group like the National Black Occupational Therapy Caucus?” Believe me, I considered it! But I don’t see the point in joining a group that doesn’t offer me opportunities for growth and doesn’t have an active presence that I can be a part of. It’s great that there are active NBOTC chapters in several areas, but none of them are near me, and I just can’t justify sending my hard-earned money off to an organization that seems to be a ghost of what it once was (although it may be in a building stage at the moment, I’m not really sure).

In order to have a diverse profession, you need diverse members. Again, there is clearly more encompassed by the term “diversity” than just skin color – there is diversity of socioeconomic status, sexual orientation, gender identification, language…more things than I can even begin to count. And having practitioners with more diverse ethnic, linguistic, geographic, cultural, and other backgrounds will not only enliven and enrich the professional dialogue, but improve client experiences as therapists will be better able to serve the increasingly diverse clientele who access OT services. I am hopeful that more and more people of diverse backgrounds will become OTs, and I have faith that we are on the way to fulfilling the 2017 Centennial Vision of OT as a “…diverse workforce meeting society’s occupational needs,” although we are not there yet.

I have high hopes for my career in OT – I want to make a difference in the lives of my clients as well as the profession as a whole, and I’m not going to let some unintentionally offensive slide show tell me I can’t. But if I’m being honest, there are some days when I still have to stop and wonder whether or not my big hair and brown skin will make the ladder to the top just a little bit harder to climb.

I'm hopeful that our profession will continue working to make the celebration of diversity more than just a slogan on a Conference ribbon.
I’m hopeful that our profession will continue working to make the celebration of diversity more than just a slogan on a Conference ribbon.

Additional Information

Transcripts of all Eleanor Clark Slagle Lectures since 1955.

Articles about professional diversity:

Other opinions on diversity in the profession:

Initiatives and Organizations Supporting Diversity in Occupational Therapy