GHD Blog: The International Role of a Therapist Assistant

April 2021
by: Hannah Koch

As I am sure many of us have experienced this year, disappointment was around every corner. After completing my first year in the Therapist Assistant Program at Okanagan College, I was anticipating the first round of practicums. Finally, I would be putting my knowledge into practice and working with clients! As you may have guessed, the two expected practicums were cancelled. Although I was very disappointed, I jumped on the opportunity to learn more about the CPA and use my creativity to make up for the missed practicum hours. As a seasoned traveller and enthusiastic embracer of new cultures, I have become particularly interested in the Global Health Division. They advocate for the need and necessity for physiotherapy in locations that do not have the resources that big cities have. As I read more and my interest grew, I, unfortunately, could not find much information about the role that therapist assistants (TAs) have in different countries. I believe numerous therapist assistants are curious in this regard, especially as graduation approaches. Therefore, I am taking it upon myself to answer a few questions for all those inquisitive PTAs out there. What is our role, as TAs, in developing countries? How are TAs regulated internationally? And what are some opportunities now? Let’s begin!

What Is the Role Therapist Assistants Have in Developing Countries?

The first step I took into answering this question was to talk to some therapists that work, or volunteer, outside of Canada. I interviewed Kathy Bowler, who is a physiotherapist and occupational therapist living in Malawi. She is the director of the Children of Blessing Trust, which is a rehabilitation centre that provides physiotherapy, occupational therapy, nutrition, adapted equipment, and many other services to the people of Malawi. She has decades of experience working alongside rehabilitation technicians (RTs), which is the title that is used for therapist assistants in her context. In Malawi, rehabilitation technicians are trained and certified after completing a three-year program. According to Kathy Bowler, the scope of practice in Malawi is fairly similar to Canada. The physiotherapist will do the initial assessments and the rehab technicians are called upon for follow-up. The RT’s job is to implement rehab programs, educate the client and family, and also screen the clients before they begin rehab to determine what level of rehabilitation they will be requiring. When it comes to ordering assistive equipment, the assistants will ask for a consultation to be completed with their client. All in all, the rehab system in Malawi seems quite comparable to here in Canada, however, this is not the case with Belize.

In order to learn about the rehab system in Belize, I got in contact with Nadine Intering, a physiotherapist and the rehabilitation director for Hillside Health Care International in Punta Gorda, Belize. They run a rehab program within their centre, as well as conduct home visits within the community. ‘Rehabilitation Technician’ is also the formal title used in Belize for therapist assistants; however, in Belize, RTs are trained informally, on the job. Some undergo training in other countries and then return to Belize to work. Administrative tasks are a big portion of their duties. These administrative duties include scheduling appointments, maintaining inventory, and engaging in language translation. Since there is no regulation in Belize, some RTs have the authority to complete the full rehabilitation process with their clients. 

Another country that uses therapist assistants is Peru, except there they are called ‘technicas’, which is a general term for ‘assistants’ in Spanish. Susie Paul, a therapist assistant from Canada, had the chance to experience this role in Peru during her practicum as a volunteer from 2010-2011. Although the rehabilitation practice she experienced shared many similarities with Canada, there were key differences as well. When it came to her responsibilities, which she found similar to working in BC, she was involved in the rehab sessions by providing an extra pair of hands, teaching clients exercises, gait retraining, neurodevelopment sequence training, and other physiotherapy related treatments. Key differences, however, were that she had no administrative responsibilities or equipment repairs to do and that she was always working under a physiotherapist. Although the scope of practice was not defined, she did notice that working solo as an assistant was not done within Peru. Conclusively, our role internationally may vary slightly between each country, as we can see. Nonetheless, the need and necessity for therapist assistants is very evident. 

What Are the Professional Regulations in Different Countries?

Regulation for therapist assistants varies, depending on the country they completed their training in and where they are practicing. In Belize, there is no formal body that regulates rehabilitation technicians; however, Nadine Intering mentioned there is an Allied Health Professional Council that does provide some licensing to the RTs and physiotherapists in Belize. There is no required exam, although there are still many forms and documents to be signed in order to work as a RT. In Malawi, rehabilitation technicians are regulated under the Medical Council of Malawi, which regulates many disciplines, such as physiotherapists and medical doctors. This council states that rehabilitation technicians need to work under a physiotherapist. By comparison, in Peru, there is no regulation for assistants. Although there is a lack of regulation in some countries, professional therapist assistants still have a valuable role to play. Unfortunately, little to no regulation in other countries seems to hinder the growth of this profession. It makes me wonder how international regulation for therapist assistants could not only advance the profession, but also create an abundance of jobs overseas for those wishing to work internationally. By having internationally recognized standards, the scope of practice would be consistent, therefore making our job transferable globally.

What Are Some Opportunities Now?

Although I did not find many specific job postings for therapist assistants in other countries, I am excited about the potential to pave the way. No matter what the opportunities look like, whether volunteer or paid, there is value in innovation and forging trails for future PTA students. In this context, lack of regulation and lack of resources pose some challenges that require problem solving and creativity. Therapist assistants have a role globally and that alone is exciting! Through websites such as ABIDE, Go Abroad, church sending agencies, and many others, therapist assistants are given the opportunities to obtain these highly valuable cross-cultural experiences. I encourage students to look for international practicum locations, learn another language, live and work in other cultures, and look beyond a career in Canada. By moving outside our comfort zones, we will be challenged as individuals, can learn about different cultures, and, of course, understand the greater need for access to rehabilitation worldwide. 

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Bibliography

Belize Ministry of Health. Retrieved from https://health.gov.bz/www/targets

Canadian Physiotherapy Association. (2020). Global Health. Retrieved from https://physiotherapy.ca/divisions/global-health-division

Go abroad. Project Abroad Programs. Retrieved from https://www.goabroad.com/providers/projects-abroad/programs?country_id=0&directory_id=4

Medical Council of Malawi. Retrieved from https://medicalcouncilmw.org/faq.php

Pentecostal Assemblies of Canada. Kathy & Steve Bowler. Retrieved from https://paoc.org/donate/kathybowler

Rehabilitation in Lima, Peru. (2011, March). New Centre. Retrieved from http://rehabilitationinperu.blogspot.com/2011/03/

World Physio. (2019). Physcia Therapist Support Personnel: Policy Statement. Retrieved from https://world.physio/sites/default/files/2020-07/PS-2019-Support-personnel.pdf

Verge Magazine. AIDE Abroad: International Internships. Retrieved from https://www.vergemagazine.com/program-search/work-abroad/aide-abroad-international-internships.html