In large rehabilitation centers, therapists may work in spacious rooms equipped with machines, tools, and other devices generating noise. The work can be tiring, because therapists are on their feet much of the time. Those providing home healthcare services may spend time driving from appointment to appointment. Therapists also face hazards such as back strain from lifting and moving clients and equipment.

Therapists increasingly are taking on supervisory roles. Due to rising healthcare costs, third-party payers are beginning to encourage occupational therapist assistants and aides to take more hands-on responsibility. By having assistants and aides work more closely with clients under the guidance of a therapist, the cost of therapy should decline.