Support Workers, Therapy Assistants and Your Therapy Plan

Since the introduction of NDIS, utilising support workers and therapy/allied health assistants has been a great opportunity in supplementing clients’ therapy. This blog post will outline some information to help clients and their families decide why and how to engage a support worker or therapy assistant in order to optimise their outcomes. 

What is an Allied Health Professional? 

Allied health professionals (AHPs) are occupational therapists, physiotherapists, speech pathologists, dieticians, psychologists and social workers. They are educated at university-level and possess advanced expertise in their respective fields. People with health conditions, developmental disorders and disabilities are assessed, identified, diagnosed, treated and supported by AHPs. In order to practice, AHPs need to be registered with the Australian Health Practitioners Regulation Agency (AHPRA), or another professional regulatory agency (e.g. Speech Pathology Australia, Occupational Therapy Australia). AHPs must only practice what they are qualified to perform (work within their scope of practice) in order to remain registered. They are also required to spend a specific amount of hours annually to keep up to date with research and expanding their clinical knowledge and skills, and must maintain professional indemnity and public liability insurance while practicing. 

Support Workers vs. Therapy Assistants

Support workers (SW) cover a broad spectrum of individuals with varying roles and responsibilities, all of which involve assisting a person with their daily routine and/or activity programs. There is currently no national consensus on the specific duties or titles of SWs, and these may differ depending on the workplace, however they usually include caring for and supporting individuals with disabilities. Some support workers may have TAFE Cert III or IV qualifications, whereas some may have no qualifications. SWs have no requirement for professional registration or ongoing professional development. They have no mandatory requirement to have public liability or indemnity insurance (although many will).  

According to the national register for training in Australia, allied health (AHA) or therapy assistants (TA) are defined as:  

“...workers who provide therapeutic and program related support to allied health professionals. The worker is required to conduct therapeutic and program related activities under the guidance of an allied health professional. Supervision may be direct, indirect or remote and must occur within organisation requirements. The worker is required to identify client circumstances that need additional input from the allied health professional.” 

– HLT42512: Certificate IV in Allied Health Assistance 

Allied health or therapy assistants are recognised as support workers who: 

• Hold a Cert IV in Allied Health Assistance, and/or 

• Are currently studying a bachelors/masters degree in one of the allied health fields 

• Are directly employed and supervised by a registered allied health professional 

It would be expected that TAs would receive ongoing training, supervision and assistance from an allied health professional as part of their employment arrangement in order to ensure that the work they accomplish meets a specific standard. This also implies that a therapy assistant may be able to perform various duties that require a higher degree of expertise and proficiency than that of another support worker. TAs are typically protected by public liability and indemnity insurance through affiliated health businesses or professionals. 

Why might it be useful to have a support worker and/or therapy assistant? 

Some of the advantages of having a SW/TA to assist with therapy programs: 

• It is cheaper to engage a support worker/therapy assistant, as a result the client may be able to participate in more therapeutic activities with their funding. 

• SW/TA can take the load off parents/families and reduce carer burnout – so they can free up some of their time for work, household tasks, etc. 

• Some or most children may respond better with a SW/TA than a parent when engaging in therapeutic exercises to achieve their goals. 

When to use an allied health professional vs. support worker or therapy assistant 

Only a qualified allied health professional can conduct an assessment of a client’s development and needs, identify difficulties, possibly diagnose, provide specific education of the conditions, treatment recommendations, develop a program and deliver therapeutic interventions.  

However, Occupational Therapy Australia (OTA), Speech Pathology Australia (SPA), and the Australian Physiotherapy Association (APA) all encourage the use of support workers and/or therapy assistants to supplement the roles and services provided by allied health professionals. 

Some clients, settings, and/or therapeutic activities are better carried out by an allied health professional rather than a therapy assistant due to the difference in knowledge and skills. These include: 

Clients who: 

• Have medically unstable conditions and require close monitoring 

• Have complex movement difficulties or complex disabilities 

• Have significant behavioural difficulties 

• Have significant deformities that require careful handling and facilitation  

Situations such as: 

• When a client needs to trial a specialised equipment 

• Early in a client’s rehabilitation when they are improving or changing rapidly 

Therapy activities that: 

• Are new to the client 

• Require constant or frequent modification/adaptation in response to client’s efforts and abilities 

• Are physical or mentally challenging or demanding, and the therapist wants to push the client’s abilities 

• Involve the use of a specialised equipment that is not yet part of the client’s home therapy routine 

• Require on the spot clinical reasoning and problem solving 

• Require specialised handling and facilitation of movement 

While this list is not exhaustive, this may help parents and/or families determine whether or not the client will benefit from the assistance of a therapy assistant or support worker at a particular point in time. 

How can we ensure the support worker or therapy assistant is performing the activity to an appropriate standard? 

Prior to commencing therapy with the client, support workers or therapy assistants must have received adequate training and supervision regarding the client’s needs as well as the appropriate activities for them to perform. 

To ensure that the therapy program is implemented safely and effectively (and that any issues are addressed appropriately and within a reasonable timeframe), there must be a clear and open channel of communication between the allied health professional(s), the support worker/therapy assistant, and the family. This also helps the allied health professionals to monitor and adjust the program as needed, and ensure that the funding is being used efficiently and effectively.