There is a common saying, “the niches are in the riches”. And this is no exception in the occupational therapy profession. You as an OT, COTA, or OTA have a lot of knowledge, which can translate into so many different niches, or categories of expertise. In this article, we’ll highlight some of the most lucrative niches that you could be adding to your occupational therapy business!

Home Modifications:
Have you ever wanted to help seniors live safer and longer within their home? By offering home modifications, you can help make recommendations on how a home could be safer – recommending such things as a chair glide, 2nd stair rail, tub bench, raised toilet seat, ramps to name just a few commonly recommended items.

This is a very easy niche to add to any practice. How could this be offered? For example, let’s say you are performing an evaluation and the patient reports to you that they have a very hard time going up their stairs and that they only have one rail and that they also have fallen several times in the bathroom during transferring into the shower. In addition to completing your evaluation and giving them help with their physical needs, you could also mention to them that you perform home safety evaluations and feel that it could really benefit them to have their home accessed as well. From there, you could provide your rates and complete the assessment with recommendations provided. While you can do this service without additional certifications, many therapists and assistants have taken the CAPS, the Certified Aging in Place Specialist Certification ( This is a great certification to learn the skills needed to confidently offer this service but it also is a great way to gain new clients as they do have a provider directory for those who have completed the CAPS program.

Have you ever seen a patient who has chronic neck, shoulder, elbow, wrist, or carpal tunnel symptoms? Are these symptoms often reported for those who sit for long periods of time at a computer? Ergonomics is a very easy niche to add to your therapy clinic as well. Similar to Home Modifications, there is not a certification required to perform this service although the Back School( does have several great programs to help you learn how to better access posture and recommend the right resources to prevent the symptoms mentioned above.

How could you offer this service? Ergonomics can be offered to enterprise or corporate clients as well as individuals. Just as in the Home Modifications example, during the evaluation, if you are hearing symptoms that highlight the fact that this patient likely has a bad work station or home station set up – they mention to them that you perform ergonomic assessments that could significantly help reduce or prevent their symptoms and then provide your rates and process.

Low Vision:
Many individuals suffer from reduced or poor vision, which can put their safety at great risk. In addition to being seen by a low vision specialist, you as an occupational therapist or assistant could also see this patient and provide occupational therapy in the form of balance, strength, daily planning, caregiver training, and home modifications.

If you really enjoy working with this population, then you can also become a Low Vision Specialist to be able to better serve these patients. You can go here to learn more about this specialist certification (

Drivers Rehabilitation:
Helping patients ensure they can safely drive after a stroke, major surgery, or other events is another amazing niche that you as an OT/OTA/COTA could provide.  There is a certification,, called the Certified Driver Rehabilitation Specialist, that you can take to help you further provide this service. This niche is very underserved and very few therapists or assistants have this certification, so it is definitely one that could help your therapy practice stand out.

Lymphedema and/or Cancer Recovery:
Did you know that in 2010, there were over 2.5 million breast cancer survivors in the United States (American Cancer Society, 2009).  The rates of cancer are increasing within the United States, and as a result, more therapists and assistants are needed to address the rehabilitation and cover of these patients. Occupational therapy can offer strengthening, flexibility, home modification adjustments, assistive device recommendations, caregiver training, proper clothes and compression garments, emotional training, and lifestyle training to name just a few approaches.  The AOTA published a very detailed article on how OTs, OTAs and COTAs could help treat breast cancer survivors here

Lymphedema and cancer are often related as according to Washington University in St. Louis, about 20% of breast cancer survivors will develop lymphedema in their upper extremities following surgery and radiation (  Although Occupational Therapists and assistants can treat cancer patients and those with lymphedema without additional education required, one can go on to be a CLT, to better serve these patients and further add quality care of people who suffer from lymphedema or are recovering from cancer to their repertoire.  There are many different programs that offer lymphedema training and the Complete Lymphedema Certification Course by the Academy of Lymphatic Studies ( is just one example.

“There is no cure for lymphedema, and sometimes it’s hard for patients to hear they will never be back to 100 percent. However, we can significantly improve their prognosis by teaching them how to manage the condition, improve their quality of life and help them to have a more positive attitude about themselves” reported the article from Washington University in St. Louis.

We’ve used breast cancer in this article to help highlight how you could even niche so far as to specifically serve not just cancer patients, but specifically breast cancer survivors for example. There are a wide range strategies and services that you could provide within your Occupational Therapy Clinic to treat patients with cancer and/or Lymphedema.

Women’s Health:
Women’s health is a growing priority, not just in the private sector but also within the public sector such as the Veterans Affairs.  You can provide therapy to this niche without any further education but there are also many courses and certifications, starting with simple CEU’s on that you can take to further your knowledge and better service this population.

Memory Deficits:
Memory deficits, in particular prevention of memory deficits, is also a growing trend. Many more people are becoming aware of Dementia and Alzheimer’s and are trying to find ways to prevent early onset or maintain the memory they currently have. This is a great additional service you can provide within your therapy clinic, and offer this training both to your patient but also to caregivers.

Similar to the above niches, you can provide this service without any additional education. However, if you want to further your knowledge and treatment skill, there are many great certifications out there. One in particular, the Certified Dementia Specialist by Dr. Mike Chua (, is a great way to start as it is very reasonably price and is an 100% online class that upon completion allows you to apply for the Certified Dementia Specialist designation.

Adding one niche can not only lead to direct patients within that niche, but as you’ve read within this article, many times your patients can benefit from several of these services. These are some of the most common niches that we’ve seen amazing occupational therapy clinics use to grow their clinic and we hope it can help you either start, or further grow your practice as well!

Request a Demo