I wanted to provide my insight regarding mental health and well-being during the process of studying for and preparing for the NBCOT exam. This is mostly directed to those who have not passed or have had some unsuccessful attempts. I’m not sure if my rambling will help anyone, but I wanted to post this here, just in case. I have been following this forum for a while now and some of the posts I’ve read have really helped me, so I wanted to give my opinion to potentially help someone who is in the same boat as me. OT Miri has been a wonderful resource for me during this process, so I definitely want to thank her and encourage others to watch all of her videos, read her encouraging articles, and in general, attempt to stay confident throughout this process.

Exam Timeline and Study Process

I took the test the first time at the end of January, the second time the beginning of March, and the third time at the beginning of May. I passed the exam on my third attempt. I literally cried with joy. Waiting for that email to come in after refreshing my email every 2 seconds made me feel like I had aged 68 years. My heart was beating so fast I felt like it was going to explode. I logged into the NBCOT website and saw I had passed!!!!! I kept rereading “congratulations on passing your exam!” over and over again in case I was accidentally reading it wrong. I immediately thought about how EXCELLENT it will feel to close out of all of my NBCOT related tabs on my computer and put away all of my study material!

First Attempt:

I read through the TherapyEd book once, took notes, watched all the OT Miri Videos, used the AOTA exam prep questions and pdfs. I studied for a little over a month. I felt pretty prepared. I got a 445.

Second Attempt:

I used Johnson’s “purple book” and I answered all of the questions within that book. I continued to refresh my memory with OT Miri and other related Youtube videos. I bought the NBCOT study guide and answered the questions that were provided. I focused this time on just answering questions, rather than reviewing the material. I got a 443. I was devastated because I didn’t understand how I managed to do WORSE my second time.

Third Attempt:

I signed up for Pass the OT. I purchased the silver plan and got 4 tutoring sessions. I studied for a little over a month using solely this program. I did some practice questions from the online program associated with the purple book as well as AOTAs. Obviously I rewatched all of OT Miri’s videos again as well. ☺ I looked over some information in textbooks I had from school if I needed more detailed information on a topic. I cried leaving the testing center. This test felt harder than the first two.

I passed with a 495.

Sources I Recommend for Studying

Because I used almost every resource, I’m sure that I learned a little bit from each one I used. I know a lot of people feel overwhelmed by the TherapyEd book, and I did too, but I do think it helped to read the entire book through once, or at least just skim through it. Additionally, I think it helped to buy a resource from NBCOT because you see directly how NBCOT might write them. I bought the study guide because the answers and rationales were provided, whereas the practice exam from NBCOT didn’t have rationales or answers provided.

**I bought the NBCOT exam but just looked though the questions and didn’t submit the exam, because I didn’t want a bad score on that to affect me negatively, since I was already super low on confidence.

I watched ALL of the OT Miri videos multiple times. The way she simplified things was easy to understand and her personality is encouraging and wonderful. I also recommend Pass the OT. The information provided on their program was very easy to understand and not too overwhelming. I believe the tutoring sessions from Pass the OT helped me build my confidence as well, as well as their structured and formatted online program.

I think the Purple Book is a helpful item to purchase for extra practice questions. There is an online portion to this book with around 500 questions to answer that match the questions in the physical book. The rationales are provided for the correct and incorrect answers here so I highly suggest utilizing this book for an additional study resource.

This was my process, but everyone’s process will be different. Everyone learns differently. You just have to find what works best for you. Below, I have listed a few things I have learned about myself throughout the process of studying for this exam.

“Comparison is the thief of joy” – Teddy Roosevelt

Get Off Social Media

If you have trouble comparing yourself to other people (I know I do) then being on Facebook and Instagram and seeing all of your friends post their success stories is hurtful and frankly, an unnecessary blow to your ego. Of course you’re happy for everyone, but I kind of adopted that “why me” mentality and began to think that something was wrong with me. You don’t need that! You’re going to make up weird reasons to justify why those students passed and you didn’t. Just because someone passes the exam on their first try does not mean that they will be a better practitioner than you. Let me say that again.

Don't Compare Yourself to Others


These are thoughts that are going to go through your mind. I know you’ve thought that at least one time, but please stop! It’s not true, and you know it. You are going to be great. Everyone tests differently. Everyone studies differently! Looking at all of the Facebook pages online with everyone’s opinions, to me, was not the most helpful thing. However, some people like support from others and hearing tips of how other people conquered the test. It just depends on what is helpful to you personally. I feel like I could have followed an exact study plan of someone who passed with flying colors the first time and I still might’ve not passed. Just take your time and don’t compare yourself to anyone else. Learn about yourself and how you study best. If you start reading the TherapyEd book and find it’s too overwhelming for you, then switch the study material you use. You don’t have to follow the exact same plan as anyone else. You know what is best for you personally and it is okay if you go about the study process in a different way than how your friends and classmates are studying.

“Failure is only the opportunity to begin again, only this time more wisely” – Henry Ford

You might fail. But THAT IS OKAY.

If you fail once, twice, 8,000 times (ok maybe not THAT many times), it’s not the end of the world. It might seem like it, but your life is not over. Take a week or 2 off to relax, regroup, and reassess. Figure out how you’re going to tackle it the next time. Don’t let this exam defeat you. I mean, you came this far. Think about it. You went through K-12, then college, and then you decided what you were going to do with your life. You kept a high enough GPA and got into a grad school, only after observing OT at different places, taking that awful GRE test, and stressing every step of the way!!!! Whether you went to grad school right out of college or waited a few years and had another job, we all got to this same position one way or another and we all have to conquer the NBCOT beast in the end. This is only one more obstacle in life. Plus imagine all of the other personal obstacles that each and every one of us face throughout our lives. You’ve come this far in this battle, why stop at the last quest? You keep going and going until you WIN. Keep doing this journey until you WIN.

“If there is no struggle, there is no progress.” –Frederick Douglass

Allow yourself to have fun.

There is no way you are going to study 24 hours a day every day of your life for however many weeks. You will lose your mind, guaranteed. Take weekend breaks. Spend time with friends and family. Do whatever occupations you are interested in! Try to stay confident. Also, keep laughing. Keep laughing at yourself. “Well maybe I can start practicing OT when I finally pass at the age of 75” is something I have said to my mom multiple times. You gotta laugh at yourself sometimes, it’s the only way you will stay sane.

Studying gets tiresome. You’re going to get burnt out. Honestly, just keep on trekking even when you absolutely could think of 10 other things you’d rather be doing. One day I washed my car, watered the grass, washed the deck, and cleaned out my closet just to avoid studying. (Talk about productive!) But all jokes aside, just do a little bit every day. Positivity really is key. I do this boot camp class with my dad and our coach always says “Push through the burn” and my dad had been saying that to me throughout my study process. Push through that mental burn.

Final Note

You're going to pass the test

Whether it be today or in a few months or in a year, you’re going to pass the test. I mean, if you take the test every 30 days, you’re bound to pass it eventually, let’s be honest. You might be $50,000,000,000 dollars in debt, but I mean, what’s a little more money on top of those loans you have to pay back anyway, right?

Honestly, failure builds character. Failing at something makes you even more determined to succeed at it, and makes it even more rewarding to pass in the end. Once you do pass, it will be even more exciting than if you had passed the first time.

I got tired of people saying to me “you can do it” and “you got this next time!!!!” I get the sentiment, and I appreciated everyone support, but to me, that got tiresome. I needed some cold, hard, truth. It’s okay to feel rough and to feel down on yourself. You failed and that sucks. It’s okay to feel hopeless at times and to wonder if you even have what it takes to conquer this test after all. But instead of saying failed, say you didn’t make it, you didn’t pass, or you’re going to have to try again another time. I feel like once we hear the word FAIL or FAILURE we start to believe that we have failed at every aspect of our lives. But you just didn’t pass a test. A super important test, of course, but it’s just a test. 

Throughout this process, one thing I have learned is that it is honestly okay to doubt yourself and to feel lost in the world. It is okay. As long as you realize that at the end of the day, you WILL get through this obstacle eventually. In a few years, this will just be a tiny moment to reflect back to in your life. Throughout this time, learn to discover who you truly are and never lose faith in yourself. Don’t compare yourself to other people. Be strong, but also know it is okay to be worried, upset, and frightened. You are going to make an incredible occupational therapy practitioner. I mean, you’ve chosen a career that is based solely in helping the lives of others, which is incredible in and of itself. Don’t let one test get in your way of that dream. Keep pushing through the burn. You’ve come this far, why give up now?