If you are living with a hand, wrist, elbow or shoulder condition and are looking for the right specialist to help you, you may have come across the letters CHT after a therapist’s name. This guide explains what that qualification means, why it is significant and what it means for the quality of care you receive.
What does CHT stand for?
CHT stands for Certified Hand Therapist. It is the highest internationally recognised accreditation in hand and upper limb rehabilitation, awarded to Occupational Therapists and Physiotherapists who have demonstrated an advanced level of clinical knowledge and experience in treating conditions of the hand, wrist, elbow and shoulder.
The certification, administration and recertification process is overseen by the Hand Therapy Certification Commission (HTCC) in the United States. The CHT is recognised across the world as a benchmark credential in this specialist field.
How do you become a Certified Hand Therapist?
Becoming a CHT has a clear pathway but it cannot be fast tracked. To be eligible to sit the demanding examination, a therapist must meet three strict criteria.
First, they must hold a current licence as an Occupational Therapist or Physiotherapist. In the UK this means being registered with the Health and Care Professions Council (HCPC).
Second, the therapist must have a minimum of five years of clinical experience. Finally, the most significant of the criteria is that the candidate must have completed at least 4,000 hours of direct Hand Therapy practice. That is the equivalent of working full-time in Hand Therapy for two years on top of an existing clinical career. Though this is the minimum requirement, the rigorous nature of the examination will often mean therapists have considerably more experience before sitting it.
Once the criteria have been met, the therapist must pass a rigorous written examination testing advanced knowledge across the full spectrum of hand and upper limb conditions, anatomy, assessment, splinting, rehabilitation and clinical reasoning. Even for experienced Hand Therapists, it requires a significant commitment to preparation and study.
The result is an accreditation that is genuinely difficult to achieve, held in very high regard within the Hand Therapy community and among hand, wrist, elbow and shoulder surgeons.
How is a CHT different from an Occupational Therapist or Physiotherapist?
Both Occupational Therapists and Physiotherapists are highly trained healthcare professionals who play an important role in rehabilitation. However, hand, wrist and upper limb conditions are a specialist area that requires considerable depth of knowledge.
A general Physiotherapist or Occupational Therapist will have broad clinical knowledge across many areas of the body. A Certified Hand Therapist has spent thousands of hours focused specifically on the hand, wrist, elbow and shoulder.
This distinction matters most in complex or difficult-to-treat cases. If your condition has not resolved or you are not progressing as expected, the specialist knowledge of a CHT can make a significant difference to your outcome.
Why does it matter for your care?
When you choose to see a Certified Hand Therapist you are choosing a clinician whose expertise has been independently verified to the highest international standard. In practice, that means several things.
A CHT is trained to identify subtle presentations and complex conditions that can be missed in a more general clinical setting. Conditions such as TFCC injuries, scapholunate ligament damage and nerve entrapments are frequently misdiagnosed or overlooked. A CHT will know what to look for.
Your treatment will be more targeted. Rather than a standard protocol applied broadly, a CHT will tailor your treatment to the specific structures involved, your individual presentation and your personal goals for recovery.
Rehabilitation will be guided by extensive experience of the hand, wrist, elbow and shoulder. With thousands of hours of direct Hand Therapy practice, a CHT has encountered a wide range of presentations and outcomes. That breadth of experience informs every clinical decision made on your behalf.
What questions should you ask when choosing a Hand Therapist?
When researching Hand Therapy specialists, it is worth considering their experience across the disciplines within the specialty, including Plastic Surgery, Orthopaedic Surgery, Rheumatology, Neurology and Paediatrics. Depending on your location it can be difficult to find a practitioner with dedicated experience in all of these areas.
Here are the questions worth asking:
Do you hold the CHT qualification? This is the most direct way to establish specialist credibility in this field.
Are you currently certified and up to date with recertification? The CHT requires ongoing recertification to remain valid. A practising CHT will be able to confirm their current status.
Which hospitals have you trained and worked at? Working in specialist trauma or teaching hospitals may mean experience with a different range of conditions from outpatient-only practice.
Have you treated this condition before? For complex or less common conditions, this is a reasonable question that a confident specialist will be happy to answer.
Do you have experience with post-surgical rehabilitation for this procedure? If you have had or are planning surgery, specialist post-operative rehabilitation is critical to a good outcome.
Ms Razo is Belfast’s only Certified Hand Therapist and has extensive clinical experience across Plastic Surgery, Orthopaedic Surgery, Rheumatology, Neurology and Paediatrics. She is also an active international educator and conference presenter, and a qualified Expert Witness providing medico-legal services. If you have been living with a hand, wrist, elbow or shoulder condition and have not found answers elsewhere, specialist assessment with Ms Razo is the next step.