Why Occupational Therapists Are at High Risk for Burnout

Healthcare professionals broadly are vulnerable to burnout. But occupational therapy professionals face an additional layer of risk factors specific to the nature of the work itself. Understanding what those factors are , and what actually helps, is where this post begins.

A 2025 study published in the American Journal of Occupational Therapy examined burnout among OT professionals in depth, identifying the strongest predictors and the most effective interventions. What it found is worth understanding, whether you're currently experiencing burnout, beginning to recognize its early signs, or trying to understand what made this particular school year feel as heavy as it did.

The Risk Factors That Are Specific to OT

Healthcare professionals as a whole face unique stressors — exposure to human suffering, pressure from patients and families, and demanding working conditions. Occupational therapy professionals carry those same stressors, plus a set that the research identifies as specific to the profession. These include:

• Unmanageable workloads

• Lack of autonomy and respect in the workplace

• Lack of professional identity recognition

• Managers' unrealistic demands

• Managing unique cases

  
  

For school-based OTs, many of these factors are amplified by the structure of school practice. You carry caseloads that include students with widely varying needs, often across multiple buildings or grade levels. You navigate the documentation demands of the IEP process on top of intervention responsibilities. And you frequently do it as the only OT in your building, without the peer consultation and clinical support that practitioners in other settings may take for granted.

Research also shows that occupational therapists with ten or fewer years of experience are at higher risk for burnout. If you're earlier in your career and you're already feeling the weight of it, that's not a sign that you aren't cut out for this work. It's a documented pattern — and it matters that you know it.

From the research: "Workload was the single strongest predictor of burnout among OT professionals, accounting for a significant portion of both personal and work-related burnout." (Lynner et al., 2025)

The Workload Problem — What It Actually Includes

Workload in school-based OT includes the visible work: intervention sessions, evaluations, progress monitoring, IEP meetings. It also includes the invisible work: writing legally defensible evaluation reports, translating clinical findings into educationally relevant goal language, preparing for meetings, following up on documentation after meetings, and carrying the cognitive weight of a diverse caseload home at the end of the school day.

It includes spending your own time and often your own money building the materials and resources your students need — because the infrastructure that should already exist often doesn't. It includes the Sunday afternoon prep time that was never part of anyone's official calculation of your workload, but has become a quiet constant of school-based practice.

When you look at workload that way — all of it, named honestly — the research finding isn't surprising. It's clarifying.

When Your Professional Identity Goes Unrecognized

One of the most painful dimensions of burnout in occupational therapy isn't physical exhaustion. It's the erosion of professional identity, the slow accumulation of experiences in which the depth, complexity, and value of what you do goes unseen or misunderstood.

School-based OTs make nuanced clinical judgments every day — about sensory processing, motor development, neurodevelopmental differences, handwriting, fine motor skills, and how all of those areas intersect with a child's ability to participate and learn. The training that prepares you for that work is rigorous and specific.

When that work is routinely described as "the fine motor person" or treated as a supplementary service rather than a clinical one, it produces a kind of professional dissonance that research links directly to burnout. It's not just frustrating. Over time, it chips away at the sense of meaning and professional efficacy that sustains good practice.

The research identifies professional identity strain as one of the significant predictors of personal burnout in OT professionals (Lynner et al., 2025). This isn't incidental. Occupational therapy's scope of practice is broad and often poorly understood outside the profession. In school settings particularly, where OT sits alongside other related services and is frequently explained in terms of what it is not, rather than what it is, that misidentification accumulates into a real and measurable cost.

"You weren't trained to be a fine motor technician. You were trained to understand the whole child — development, participation, meaning, context. When the work doesn't reflect that, the gap has a name. The research calls it professional identity strain."

Autonomy and Respect in the Workplace

Closely related to professional identity is the question of autonomy — the degree to which you have real control over how you do your work. For occupational therapy professionals, lack of autonomy in the workplace is a documented burnout risk factor, and it shows up in recognizable ways in school-based practice.

It might look like scheduling that doesn't account for the clinical needs of your caseload. Or evaluation timelines that don't accommodate what a thorough OT evaluation actually requires. Or the sense that clinical decisions about students' needs are being shaped by factors that have nothing to do with the clinical picture.

Lack of respect operates alongside autonomy, and it's worth naming separately. Respect in a professional context isn't about personal relationships, it's about whether the demands and complexity of your role are genuinely understood and accounted for in how the workplace is structured around you. When they aren't, the gap between what the work actually requires and what the environment provides becomes one of the most persistent and demoralizing features of daily practice.

The Importance of Meaningful Work

The research on burnout in occupational therapy points toward something important on the protective side of the equation: meaningful work — specifically, the alignment between daily tasks and core professional values — is one of the most significant buffers against burnout taking hold.

Lynner et al. (2025) recommend that organizations actively help OTs align their daily tasks with their core professional values. When that alignment exists — when the work you're doing connects to why you chose this profession — burnout is less likely to take hold. When it doesn't — when the majority of your day is consumed by documentation, administrative demands, and tasks that feel disconnected from the clinical work you trained to do — depletion follows predictably.

This is one of the most actionable findings in the burnout research, because it points toward something you can work with even within a constrained environment. It doesn't require systemic change to begin. It requires an honest look at where your day currently goes, and a deliberate effort to identify and protect the parts of your practice that connect most directly to your professional values.

For some OTs, that might be a particular student population, a specific intervention approach, or a form of collaboration that feels genuinely like clinical practice. For others, it's the moments of real functional progress — the child who couldn't hold a pencil in October holding one correctly in March. Whatever it is for you, knowing it clearly, and protecting access to it, matters more than most burnout conversations acknowledge.

Questions worth sitting with

What parts of your practice feel most aligned with why you became an OT? Be specific. Not "working with kids" broadly, but the particular work that still feels meaningful even on hard days.

What parts of your practice feel most disconnected from your professional values? Not every task can be eliminated — but naming the disconnect honestly is the first step toward either changing it or holding it differently.

Is there one demand you could craft differently next school year? Job crafting — proactively adjusting aspects of your role to reduce demands and increase meaningful work is the most evidence-supported individual intervention for OT burnout (Lynner et al., 2025). It starts with knowing where the misalignment is.

A note on scope: The risk factors described in this post — workload, lack of autonomy, professional identity strain — are structural in origin. They require structural solutions at the organizational and systemic level, not just individual coping strategies. Individual approaches like job crafting and investing in professional community help, and they are worth pursuing. But they work best alongside an accurate understanding that these are workplace problems, not personal ones. For more on the systemic side of this conversation, see the companion post on burnout as a workplace safety issue.

What to Take From This

If any part of this post named something you've been carrying without language for it — the workload that never fully gets counted, the professional identity that goes unrecognized, the days that feel disconnected from the reason you chose this field — I hope the clarity is useful.

Understanding the specific risk factors that make OT professionals vulnerable to burnout isn't about building a case for complaint. It's about knowing what you're actually dealing with so you can respond to it more effectively than you would if you thought it was just about working harder or resting more.

The foundational post on burnout in occupational therapy, including the WHO definition, the three dimensions, and job crafting as an evidence-supported intervention, is a companion read. And if you want resources built specifically for the students you serve, my newsletter is where I share what I'm building first.

References

Lynner, B., Stoa, R., Fisher, G., del Pozo, E., & Lizerbram, R. (2025). Feel the burn, heal the burn: Job crafting and burnout among occupational therapy professionals. American Journal of Occupational Therapy, 79, 7901205080. https://doi.org/10.5014/ajot.2025.050731

Shin, J., McCarthy, M., Schmidt, C., Zellner, J., Ellerman, K., & Britton, M. (2022). Prevalence and predictors of burnout among occupational therapy practitioners in the United States. American Journal of Occupational Therapy, 76, 7604205080. https://doi.org/10.5014/ajot.2022.048108

World Health Organization. (2019). Burn-out an "occupational phenomenon": International Classification of Diseases (ICD-11). https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases