School-based occupational therapy can be one of the most rewarding settings our profession offers. And I’m not alone in thinking this – it consistently tops lists as being one of the most common settings for OTs to go into. Despite this, there is a huge disconnect between how likely it is for OTs to work in this setting vs the amount of time we spend learning about it in grad school. For me, I took one pediatrics class. And while it was a good class, it also had to address all the other pediatric settings too – outpatient, early intervention, hospital, NICU, etc. We learned the broad strokes of school-based practice but not much else. I actually fared a little better than many of my classmates because I was lucky enough to have a Level 1 Fieldwork in the schools. Still, this was only 5 days of observation.
Needless to say, when I transitioned to schools 2 years into my pediatric practice, I was pretty lost. And after talking to hundreds of new school-based OTs across the country, I now know my experience wasn’t atypical. Sadly, it’s incredibly common for OTs to be thrown into this setting woefully underprepared.
Despite this, it absolutely IS possible for OTs to be successful in this setting without much prior training or experience. The key is having strong mentorship. In an ideal world, this type of relationship would be guaranteed – any OT new to the school system should be paired with an experienced therapist at their district who can show them the ropes. Unfortunately, in practice this doesn’t always happen, whether it’s due to lack of time from more experienced therapists, unrealistic expectations from administration, or the fact that many smaller districts only have one OT (that was me!)
But fear not – you can still obtain high-quality mentorship no matter what your situation – it just might take more upfront work on your part. So if you find yourself searching for a job in the schools (or are already there and are struggling) try these strategies now to ensure your success in this role.
Arrange a Mentor At Your Place of Work
If you’re lucky, your first job in the schools will already have many strong school-based OTs who have been working for the district for years. This is really the best option because you’ll not only have an experienced school OT, you’ll also have someone who knows the inner workings and quirks of your specific district. If you find yourself in the lucky position of choosing between multiple districts to work for, definitely prioritize one where you’ll be joining a team vs being the only OT.
But even if you’re joining a team, don’t assume that mentorship is a given – many administrators want new school OTs to hit the ground running. It’s important to remember that most school admins are not OTs themselves and therefore likely aren’t as familiar with the nitty-gritty details of our schooling. They may incorrectly assume that our training is more similar to teachers, where you not only learn all about the school system but also typically pick an area of special education to focus on, such as severe disabilities or autism. They may not realize that we also have to learn how to work in SNFs, hospitals, and home health. Truthfully, their assumption that OTs should come out of grad school knowing how to do this job is a reasonable one – which is why it’s so important to advocate for yourself if you don’t feel entirely prepared.
If you’re interviewing for school-based positions, prioritize asking about mentorship options. Get specifics if possible – it’s very easy for your interviewer to promise that mentorship is available, but then have it fall by the wayside once you accept the role. And if at all possible, try to find a role that will allow you to take a smaller caseload as you’re starting out. Otherwise, you could have the most wonderful mentor in the world that you never have time to meet with because you’re already so busy. Set up a specific meeting schedule with your mentor – and stick to it.
If you’re already working in schools but still struggling, this method could still be an option for you. It’s worth scheduling a meeting with your supervisor to let them know how things are going and ask for more formal mentorship. A good admin will work with you to help get the support you need.
Ask Your Contract Agency
If you’re one of the many OTs working for an agency instead of directly for the district, this is another good option to look into. While it’s not quite as beneficial as having someone who is working at your specific district, you might be able to find an OT who is working in your general geographic area or state. Like mentorship at your district, it’s important to get specifics here. Many travel therapy agencies in particular will advertise that mentorship is available, but then pair you with a therapist 3 timezones away who never answers their phone when you call. Again, set up a specific schedule for you to meet with your mentor – whether that’s in-person, by phone, or video chat.

Ask Alumni From Your School
This is the option that saved me. Because I was new to the schools, but not new to OT, I had several members from my class that had been practicing in the school system for a couple of years by the time I transitioned to the setting. I ended up leaning pretty hard on my best friend from grad school, and I’m still grateful to her for the answers she provided to all of my frantic questions those first few months. If you’re a brand new grad, this still might be an option for you, but you’ll likely need to look beyond your graduating class. If your school has an alumni network, it’s worth reaching out to see if there are any therapists who would be willing to mentor you.
The Dynamic School OT Course + Coaching
One of the nice things about being new to school-based practice is that you’re not alone. There are tons of therapists out there right now who have a nearly identical list of questions, fears, and doubts as you right now. And even though there are small differences with how each state and even each district handles special education, it is largely the same on a national level. Despite being overwhelmed by school-based practice when I first started, I also found that I was incredibly passionate about it. So I soaked up as much knowledge as I could as I traveled between multiple districts and states learning all of the intricacies of this setting.
Eventually, I realized that I needed to share this knowledge and passion with others. So I created The Dynamic School OT – a course that will turn all school OTs into effective, confident, and most importantly, HAPPY practitioners. It’s a great primer that will teach you all of the basics of this setting, but also goes beyond that to show you how to move beyond the caseload model and be a more impactful, universal support for all students. Beyond the course, I also offer coaching options for anyone who wants a more personal touch as you’re learning about this setting. If you have any questions about this program, please feel free to email me at thedynamicschoolot@gmail.com.

Call Upon Your Larger Social Circle
If you’ve exhausted your professional/educational contacts, it might be time to cast a wider net. You’d be surprised who you might be able to connect with through a few degrees of separation! Let everyone know you’re looking for a school-based OT to mentor you. Tell your friends, your family, post on social media. Don’t be shy! Networking like this can have immense benefits and taking the onus upon yourself to find someone shows immense dedication to your success.
If All Else Fails, Look Outside the Profession
The best person to mentor a new school OT is going to be just that, another school OT. However, there are many other people to learn from in the school system. School-based PTs have a lot in common with us, and SLPs are fairly similar as well. Despite being the only OT in the first district I worked for, I had several therapists, school psychs, and SPED teachers that I was able to lean on. While you’ll likely still need other resources to learn about OT treatment and intervention, these people can be a wonderful support for learning about the laws and processes within the school system.
I hope this got your gears turning with options for mentorship for school-based OTs! Though being brand new to the schools was exhausting at first, it is inarguably my favorite OT setting now. I’m crossing my fingers that you will find the same love. If you have any questions, I would love to have you join me in my Facebook Group where I share videos and resources all about school OT.