Notes on Competencies for Occupational Therapists in Canada
Competencies for Occupational Therapists in Canada — Study Notes
Note: These notes follow the content and structure of the provided transcript from the Canadian competencies document. They summarize major and minor points, concepts, development process, usage, and the detailed domain competencies, along with glossary, acknowledgements, and references.
Introduction
Document title in transcript: Competencies for Occupational Therapists in Canada / Référentiel de compétences pour les ergothérapeutes au Canada.
Funded, in part, by: Government of Canada’s Foreign Credential Recognition Program.
Purpose: Present the first unified set of competencies for occupational therapists in Canada from entry level to experienced practitioner.
Collaborating national organizations:
Association of Canadian Occupational Therapy Regulatory Organizations (ACOTRO)
Association of Canadian Occupational Therapy University Programs (ACOTUP)
Canadian Association of Occupational Therapists (CAOT)
Goals of collaboration: Facilitate use of these competencies to benefit practice, regulation, and education; provide context for practice, background, development process, usage, and the competencies themselves.
Context and licensing: Occupational therapists are regulated health professionals in all provinces (not in the territories). Before registration to practise, graduates from accredited Canadian programs (or assessed equivalents) and, in most provinces, the National Occupational Therapy Certification Exam are required.
The Practice of Occupational Therapy
Core focus: Promoting occupational participation, defined as access to, initiation, and sustaining valued occupations within meaningful relationships and contexts.
Approach: Collaborative, relationship-focused to explore meaning and purpose of occupations.
Lifespan involvement: Address occupational needs across life, including prevention when health is at risk.
Contexts: Barriers can arise from culture, education, environment, society, health, disability, or spirituality; systemic barriers may affect participation.
Settings in Canada: Hospitals, mental health, rehabilitation, home and community, child development centers, long-term care facilities, workplaces, schools, primary care offices, etc.
Roles: Work within inter-professional teams; may lead in systems; involvement in education, research, policy.
Regulation and accountability: Practitioners accountable for quality of care; adhere to ethics and standards set by professional colleges.
What are competencies?
Definition: Competencies are the dynamic combination of knowledge, interpersonal and practical skills, ethical values, and occupational therapy responsibilities and attitudes.
Distinction: Competencies are different from competence; competence describes the level of demonstration (e.g., novice to expert).
Perspective: Competencies are applied and adjusted across contexts, guided by context, client situation, and professional judgment.
Cited framework references: World Federation of Occupational Therapists; European Tuning Occupational Therapy Project; Rodger et al. (2009).
Why was this document developed?
Trigger: 2016 Forum on Examinations and Accreditation for Occupational Therapy in Canada (ACOTRO).
Prior documents with varying emphases/models that prompted harmonization:
Essential Competencies of Practice for Occupational Therapists in Canada (ACOTRO, 2011)
Profile of Practice of Occupational Therapists in Canada (CAOT, 2012)
Référentiel de compétences lié à l’exercice de la profession d’ergothérapeute au Québec (OEQ, 2010, revised 2013)
Rationale: Clarify the profession in Canada, reduce confusion, ensure consistency, and avoid duplication.
How the competencies were developed
Development timeline and governance:
Start: 2019, funded in part by the Government of Canada's Foreign Credential Recognition Program.
Steering Committee with representatives from ACOTRO, ACOTUP, CAOT.
National Work Group: Occupational therapists from across Canada with consultant support.
Regulatory bodies and councils reviewed the draft; consultants revised it under Steering Committee guidance.
Consultations: Focus groups, webinars, and Indigenous-therapist and ally input to reflect Canada’s colonial history and oppression effects.
Validation: Online survey to every occupational therapist in Canada; over 2,200 responses.
Timeline milestones (summary from transcript): 2016 Forum → 2017–2019 planning → 2019 funding → 2020–2021 development → 2021 finalization → 2024 minor terminology edits (no competency changes).
Focus on inclusivity: Special attention to Indigenous voices and colonial history to deepen understanding of social structures on health and occupation.
Doing better: foregrounding anti-racism and anti-oppression
Core premise: Competencies recognize systemic racism in Canada and its impact on occupational therapy practice.
Definition used: Systemic racism involves white supremacy reflected in large social systems (education, health care, policing, justice) and colonial structures that disadvantage Indigenous peoples; historical and ongoing power imbalances shape access and opportunities.
Practical aim: Support therapists to understand how colonialism and oppression affect people’s participation in occupations; address both provider and client experiences of oppression.
Challenges: Balancing multiple perspectives on anti-racist, anti-ableist, and anti-oppressive practices; acknowledge that some individuals experience multiple forms of oppression.
Outcome goal: An early but critical step toward dismantling structures that privilege some people over others in occupational therapy.
Who will use this document?
Occupational therapists: Self-reflection, continuing competence, professional development.
Educational programs (OTs and OT assistants): Curriculum guidance, learning outcomes, assessment.
Regulators: Governance guidance for the profession.
Professional associations: Support for excellence in practice.
Students, internationally educated OTs, and re-entering practitioners: Descriptions of requirements for practice in Canada.
Occupational therapy assistants: Clarify roles and responsibilities relative to OTs.
Clients: Inform expectations for safe and effective practice.
Employers: Recruitment, orientation, training, performance management, organizational development.
Researchers: Facilitate collaborative research and questions related to practice.
General public: Learn about the profession.
Other professional groups and interprofessional teams: Understand OT roles.
International agencies: Information about credentialing of OTs.
Navigating the competencies
Scope: Six domains (A–F) reflect the broad range of skills and abilities across a career in Canada.
Practical application: It may not be necessary or possible to apply all competencies in every context; apply them considering the practice context and client situation.
If a competency/indicator is not applicable, provide a reasonable explanation.
Structure: Domains, competencies, and indicators are organized to guide practice and assessment.
Domain overview and glossary linkage: A plain-language domain description is provided; link to glossary for term clarification.
Flow of competencies: How competencies map to practice and decision-making.
The competencies (by domain)
A. Occupational Therapy Expertise
Core purpose: We facilitate occupations; therapists analyze what people do and what they want or need to do, and help them do it.
Practice ethos: Co-create approaches with clients; mindful of rights, needs, preferences, values, abilities, and environments; promote health and well-being.
A1 Establish trusted professional relationships with clients
A1.1 Co-create with clients a shared understanding of scope of services, expectations, and priorities.
A1.2 Use a mutually respectful approach to determine the nature of services.
A1.3 Respond to service requests promptly and clearly.
A1.4 Support clients to make informed decisions, discussing risks, benefits, and consequences.
A2 Use occupational analysis throughout practice
A2.1 Keep clients’ occupations at the centre of practice.
A2.2 Facilitate clients’ use of strengths and resources to sustain participation.
A2.3 Address strengths and barriers in systems (e.g., health care) affecting participation.
A2.4 Apply knowledge, evidence, and critical thinking from social, behavioural, biological, and occupational sciences to analyze participation.
A2.5 Share rationale for decisions.
A3 Determine clients’ needs and goals for OT services
A3.1 Respond to context influencing the client’s request.
A3.2 Develop a shared understanding of occupational challenges and goals.
A3.3 Decide whether OT services are appropriate at this time.
A3.4 Evaluate risks with the client and others.
A3.5 Periodically review client expectations.
A4 Assess occupational participation
A4.1 Agree on assessment approach.
A4.2 Select appropriate tools/methods.
A4.3 Consider client context in assessment process and outcome.
A4.4 Incorporate client perspectives throughout assessment.
A4.5 Analyze results in context.
A4.6 Communicate assessment findings clearly.
A5 Develop plans with clients to facilitate occupational participation
A5.1 Agree on service delivery approach.
A5.2 Determine intervention, timelines, outcomes, resources, contingency plans, responsibilities.
A5.3 Anticipate and address implementation difficulties.
A6 Implement the OT plan
A6.1 Support client access to resources to implement plans.
A6.2 Confirm shared understanding and progress.
A6.3 Evaluate results with client and others.
A6.4 Adjust services based on evaluation.
A6.5 Plan for concluding or transitioning services.
A7 Manage assignment of services to assistants and others
A7.1 Identify situations where assistants/others may deliver services.
A7.2 Assign only to competent individuals.
A7.3 Monitor safety/effectiveness through supervision, mentoring, teaching, coaching.
A7.4 Follow regulatory guidance for assignment/supervision.
B. Communication and Collaboration
Core emphasis: Listen, share, and work with others; build respectful relationships with clients, teams, and systems.
B1 Implement respectful and effective communication
B1.1 Organize thoughts and present views clearly.
B1.2 Facilitate information exchange to develop mutual understanding.
B1.3 Use communication approaches and technologies suited to context/user needs.
B1.4 Adjust to power imbalances affecting relationships/communication.
B2 Maintain professional documentation
B2.1 Maintain clear, accurate, timely records.
B2.2 Protect confidentiality and data integrity in sharing, transmission, storage, management.
B2.3 Use electronic/digital technologies responsibly.
B3 Collaborate with clients, professionals, and others
B3.1 Partner with clients in decision-making; advocate when appropriate.
B3.2 Share OT role and knowledge.
B3.3 Identify situations benefiting from collaborative care.
B3.4 Negotiate shared/overlapping roles.
B3.5 Maintain mutually supportive working relationships.
B3.6 Actively and respectfully participate in collaborative decision-making.
B3.7 Participate in team evaluation/improvement initiatives.
B3.8 Support evidence-informed team decision making.
B3.9 Recognize/address conflict fairly, respectfully, and promptly.
C. Culture, Equity, and Justice
Core focus: Respect and learn from traditions; address inequities in society and OT; recognize determinants of health and occupation; reflect on personal identity/privilege.
C1 Promote equity in practice
C1.1 Identify ongoing effects of colonization on Indigenous occupational opportunities/services.
C1.2 Analyze effects of systemic/historical factors on people/groups’ opportunities.
C1.3 Challenge biases and structures that privilege or marginalize.
C1.4 Respond to social, structural, political, ecological determinants of health and occupation.
C1.5 Work to reduce unequal distribution of power/resources in OT service delivery.
C1.6 Support factors that promote health/well-being/occupations.
C2 Promote anti-oppressive behaviour and culturally safer relationships
C2.1 Create culturally safer, anti-racist, anti-ableist, and inclusive practice environments.
C2.2 Practice self-awareness to minimize personal bias and inequitable behavior.
C2.3 Demonstrate respect and humility when engaging with clients; integrate client health/well-being/occupation perspectives.
C2.4 Seek resources to develop culturally safer/inclusive approaches.
C2.5 Collaborate with local partners (e.g., interpreters, community leaders).
C3 Contribute to equitable access to participation and OT
C3.1 Raise awareness of the role/right to occupation.
C3.2 Facilitate participation in occupations that support health and well-being.
C3.3 Assist with access to support networks/resources.
C3.4 Navigate systemic barriers to support clients and self.
C3.5 Engage in critical dialogue on social injustices and inequitable opportunities.
C3.6 Advocate for environments/policies supporting sustainable participation.
C3.7 Raise awareness of limitations/bias in data, information, and systems.
D. Excellence in Practice
Vision: Strive for ongoing excellence; take responsibility for continuing competence; reflect and learn; manage influences on practice.
D1 Engage in ongoing learning and professional development
D1.1 Develop professional development plans.
D1.2 Engage in development activities to improve practice and continuing competence.
D1.3 Enhance knowledge, skills, behaviours, and attitudes.
D1.4 Ensure skills meet practice needs.
D2 Improve practice through self-assessment and reflection
D2.1 Self-evaluate using performance/quality indicators.
D2.2 Learn from varied information/feedback.
D2.3 Provide useful feedback to others.
D2.4 Manage work resources and demands effectively.
D2.5 Be mindful of occupational balance and well-being.
D3 Monitor developments in practice
D3.1 Stay aware of how political, social, economic, environmental, and technological factors affect OT.
D3.2 Stay updated with research, guidelines, protocols, practices.
D3.3 Appraise evidence related to knowledge/skills.
D3.4 Integrate relevant evidence into practice.
D3.5 Consider social/economic/ecological costs of care.
E. Professional Responsibility
Focus: Safe, ethical, and effective practice; high professional standards; serve clients and society.
E1 Meet legislative and regulatory requirements
E1.1 Respect laws, codes of ethics, rules/regulations governing OT.
E1.2 Work within personal scope and area of expertise.
E1.3 Obtain/maintain informed consent appropriate to practice context.
E1.4 Protect client privacy/confidentiality.
E1.5 Respond to ethical dilemmas using ethical frameworks and client values.
E1.6 Address real/potential conflicts of interest.
E1.7 Be accountable for decisions/actions in practice.
E1.8 When observed, respond to/unreport unprofessional, unethical, or oppressive behaviour as required.
E1.9 Respect professional boundaries.
E2 Demonstrate a commitment to minimizing risk
E2.1 Follow organizational policies; address conflicts with professional standards/client values/evidence.
E2.2 Respect clients’ occupational rights and choices while minimizing risks.
E2.3 Take preventive measures to reduce risks to self, clients, and the public.
F. Engagement with the Profession
Purpose: Help the profession grow and contribute to society; stay current, respond to change, and lead across contexts.
F1 Contribute to the learning of OTs and others
F1.1 Contribute to entry-to-practice education (e.g., fieldwork).
F1.2 Facilitate continuing professional development activities.
F1.3 Act as a mentor or coach.
F2 Show leadership in the workplace
F2.1 Support assistants, students, support staff, volunteers, and team members.
F2.2 Influence colleagues toward workplace values/goals.
F2.3 Support workplace improvement initiatives.
F2.4 Serve as a role model.
F2.5 Act responsibly when environmental or social impacts arise from personal or team behaviour/advice.
F3 Contribute to the development of occupational therapy
F3.1 Help build the OT body of knowledge.
F3.2 Contribute to research and innovative practices/roles.
F3.3 Participate in quality improvement, data collection/analysis.
F3.4 Collaborate in research with individuals, communities, and other disciplines.
F4 Show leadership in the profession throughout career
F4.1 Promote the value of occupation/OT in the wider community.
F4.2 Advocate for alignment between OT standards/processes, organizational policies, social justice, and emerging best practices.
F4.3 Participate in professional/community activities (e.g., events, committees).
F4.4 Influence the profession and its contribution to society.
Glossary
Anti-oppressive behaviour: Action to challenge oppression and discrimination against marginalized people; may involve challenging one’s own or others’ words/actions; can address systemic oppression in organizations.
Anti-ableist behaviour: Action to challenge prejudice/discrimination based on abilities.
Anti-racist behaviour: Action to challenge racism based on race/ethnicity/skin color/symbols; racism can appear in thoughts, language, policies, and practices.
Client: OT works with people of any age, plus families, caregivers, substitute decision makers; may involve groups or the public.
Context: Three layers affecting occupational possibilities: micro (immediate environment/health status), meso (policies/processes in health/education/justice/social services), macro (larger socioeconomic/political context).
Culturally safer: Refinement of cultural safety; OT acknowledges power dynamics and aims to provide care that respects identity/culture; practice aims toward safety but recognizes not all clients may feel fully safe.
Ethical spaces: Dialogue space that is neutral and human-centered when worldviews differ.
Equity: Resource/opportunity allocation based on individual circumstances to achieve equal outcomes, not simply equal resources.
Humility: Cultural/intellectual humility; acknowledge limits of one’s own culture; listen deeply; remain open to questioning professional knowledge/beliefs.
Occupational analysis: Start with identifying goals/activities; explore context and factors enabling or hindering access, initiation, and sustaining occupations.
Occupational participation: Accessing/initiating/sustaining valued occupations within meaningful relationships and contexts.
Occupational possibilities: Opportunities to access, enter, and sustain occupations; influenced by context.
Occupational rights: WFOT definition: rights to take part in occupations that support health/well-being; freedom to choose occupations without coercion; safety, dignity, equity in engagement.
Privilege: Unearned advantages associated with dominant social groups.
Social position and power (positionality): How identity and privilege shape opportunities; therapists analyze their own positionality to act justly.
Acknowledgements
Collaborative project led by a Steering Committee with representatives from three national bodies: ACOTRO, ACOTUP, CAOT.
Groups/individuals acknowledged:
ACOTRO: Philippe Boudreau, Kathy Corbett, Elinor Larney
ACOTUP: Lori Letts, Sara Saunders
CAOT: Catherine Backman, Hélène Sabourin
Special thanks to Indigenous occupational therapists and allies for shaping thinking on colonial history and oppression.
Notable individuals mentioned: Laura Yvonne Bulk, Stephanie Desjardins, David Fry, Shannon Gouchie, Danielle Hogan, Jessica Lam, Carmen Lazorek, Alana Maertins, Amanpreet Singh Rangi, Allison Rinne, Yvonne Thompson, Heather Young, and others listed.
Acknowledgement of language/terminology guidance from Mary Egan and Gayle Restall; national survey participation (>2,200 therapists).
References
ACOTRO. (2011). Essential competencies of practice for occupational therapists in Canada (3rd ed.).
CAOT. (2012). Profile of Occupational Therapy Practice in Canada.
Egan, M., & Restall, G. (Eds). (2022). Promoting occupational participation: Collaborative, relationship-focused occupational therapy.
Ermine, Willie. (2006). The ethical space of engagement.
OEQ. (2010, revised 2013). Référentiel de compétences lié à l’exercice de la profession d’ergothérapeute au Québec.
NPAG. (2017). NPAG Competency Profile for Physiotherapists in Canada.
Rodger, S., Clark, M., Banks, R., O’Brien, M., & Martinez, K. (2009). A comparison of international occupational therapy competencies.
Southern Chiefs Organization Inc. (2021). Anti-racism resources.
WFOT. (2008). Entry-level competencies for occupational therapists.
WFOT. (2019). Position Statement: Occupational Therapy and Human Rights.
Table of contents (summary)
The purpose of this document
The practice of occupational therapy
What are competencies?
Why was this document developed?
How the competencies were developed
Doing better: foregrounding anti-racism and anti-oppression
Who will use this document?
Navigating the competencies
The competencies (A–F): detailed domains and indicators
Glossary
Acknowledgements
References