I love a good procedural cop show. There’s a whole lot to glean from a Law & Order marathon—including valuable lessons like, “Don’t let your emotions overrule critical thinking,” and “Most New York district attorneys are former super models.” (I’m not sure I can confirm the latter.) But the advice that’s perhaps most relevant to my life is, “Recognize when you’re in over your head, and don’t be afraid to call in backup.” It’s something that many of us learn the hard way, but having a reliable ally to back you up can be invaluable when you feel snowed under. And if you’re a rehab therapist, you should look no further than your therapist assistant.

Whether they’re lending a hand during therapy interventions or helping you tackle mountains of paperwork, therapist assistants can seriously boost your practice’s productivity. But, if you’re not allowing your assistant to apply his or her skill set to the fullest potential, then you’re not doing yourself—or your assistant—any favors. To help you avoid this blunder, I’ve compiled these guidelines for getting the most out of your therapist assistant:

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Pick an all-star lineup.

Before we dive in, I want to make sure the distinctions between therapist assistants and therapy aides are clear, as I have heard these terms used interchangeably. When I refer to therapist assistants, I’m talking about PTAs, COTAs, and SLPAs. And while both the assistant and aide roles play an important part in any therapy practice, the two are vastly different with respect to educational requirements and responsibilities. The main difference, however, is that therapist assistants are the only individuals—aside from therapists, of course—who can administer treatment to patients. Furthermore, in most states, assistants must have at least an associate degree. Therapy aides/techs, on the other hand, are largely responsible for setting up treatment areas, cleaning equipment, and transferring patients—in addition to many front office-related duties. Therapy aides typically need only a high school diploma or GED.

Because therapist assistants are able to provide treatment, they represent a huge asset to a busy therapy practice. But, it’s absolutely crucial that you hire the right assistants. Sure, assistants can lift a tremendous weight off your and your staff therapists’ shoulders, but if you’re not hiring quality people, it won’t matter how many hands you have on deck. After all, any employee in a patient-facing role should embody your organization’s culture to a T. So, avoid bringing on new assistants for skills alone. Seek out the right cultural fit. Employees who mesh with your practice’s existing culture can be your biggest cheerleaders and strongest allies.

This all starts with having a strong interview process. As this WebPT Blog article explains, WebPT Co-Founder and President Heidi Jannenga “recommends asking ‘direct, relevant, and experiential questions’ that address both competency and cultural fit.” Remember, the interview is a chance to not only determine a candidate’s skillset, but also showcase your practice’s unique culture—and the right candidate will want to be a part of that.

Also, be sure to seek out new hires who are eager to learn and have a passion for trying new things. Look for a candidates who are ready to step outside of their comfort zone. A therapist assistant who is adaptable and possesses a hunger for knowledge will be ready to tackle  whatever challenge you throw at him or her.

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For some practices, having therapist assistants available to jump in with patients as needed seems to work well enough. Other practices prefer to schedule assistants with particular patients in advance. While there are benefits to both methods, putting therapist assistants on their own schedule whenever possible can free up time for the supervising therapist to evaluate new patients and complete documentation. And as any busy practice knows, extra time is a hot commodity. This approach also allows assistants to build rapport with their patients. And the patients, in turn, feel like they are a priority to their providers—not a baton being passed from one provider to the next. 

Although assistants cannot evaluate patients, they can administer therapy and complete documentation. Depending on the needs of any particular patient, assistants can provide therapeutic exercise, functional training, and other treatments under the therapist’s plan of care. However, most state regulations forbid assistants from administering treatment without the supervision of a therapist. So before you start scheduling your patients for regular therapy sessions with a therapist assistant, make sure you know your state’s legal definition of “supervision”—as that definition can vary from state to state. Some states require the supervising therapist to be onsite—which is considered “direct supervision.” Other states simply require that the assistant be under a therapist’s “general supervision,” which, according to the APTA, means the “therapist is not required to be on-site for direction supervision, but must be available at least by telecommunications.”

Be resource efficient.

When outlining the core values of your practice—and its employees—consider the value of “doing more with less.” If your assistant is willing to learn new skills, it can be mutually beneficial: the assistant cements his or her position as an invaluable asset to your practice, and your practice gains a rockstar employee who can jump in wherever an extra hand is needed. And those skills aren’t limited to therapy treatment, either. You can help your therapist assistant learn the basics of billing, coding, scheduling, and even leadership and people management. Assistants can also attend webinars and roundtable discussions that you may not have the ability to attend yourself, particularly if you’re the only therapist on staff.

Communicate effectively.

Open communication between therapists and assistants is essential to keeping workflows streamlined. On the flip-side, lack of communication can cause major roadblocks. And in a medical setting, roadblocks can prevent patients from receiving the care they need, which can have serious consequences. 

Whether you’re in a large, multi-practice setting or a small clinic with two or three providers, communicating openly and effectively with your therapist assistant is a must. However, depending on the size of your practice, one form of communication may be more effective than others. For instance, in smaller practices, therapists and assistants often work closely with one another, so expectations and questions can be communicated as they come up. In larger facilities, recurring weekly meetings and daily rounds can help keep everyone on the same page. But regardless of staff size, you should always set aside dedicated time to ensure every staff member—assistants included—understand expectations and have the opportunity to ask questions and express concerns.


While you’re probably not moonlighting as an inner-city detective, calling for back-up—and knowing it’ll be there when you need it—can help keep you from getting ambushed by an unexpected hurdle. When a therapist and therapist assistant work together effectively, they can be an unstoppable force, and that doesn’t just benefit their practice—it benefits their patients, too.

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