Preceden

History of Occupational Therapy

Periods of Time

Prehistory

1700 - 1899

  • People with mental illness have a negative view from society creating more humane or moral treatments. (3)
  • The Age of Reason focused on logical ways of knowledge, leading to evidence-based practice.
  • Important people during this period were John Locke, Philippe Pinel, William Tube, and Aldof Meyer to create what occupational therapy is today. (4)

Progressive Era

1900 - 1919

  • Included great social improvements with education and mental health reforms.
  • The 19th amendment, providing women's rights, improved advocacy for women's health in OT as they made up a large percentage of the workforce.
  • OTs and PTs were sent to help during “The Great War” and were called “reconstruction aides”. The “experiment” with reconstructive aides demonstrated the importance of both professions in the healthcare system, later called rehabilitation.
  • The Emmanuelism movement involved improving patient-centered, community-based, holistic, and comprehensive within the healthcare system. (Creating the stepping stone to which OT interventions are focused around currently.)
  • Herbert Hall created a work-based approach for treating a functional nervous disorder. This disorder typically leading to fatigue, lack of interest, and the absence of emotions due to increased stress from society’s push on productivity and efficiency. The work-based approach had patients engage in activities such as weaving, art, pottery, basketry to improve their mental health. (1/4)
  • During WW1, multiple programs training occupational therapists as the United States anticipated needing many rehabilitation facilities. (3/4) Reconstruction aides were split among orthopedic work, massage, corrective exercises, and military bases. (4)
  • In 1915, the first OT educational program was created by Eleanor Slagle. (3)
  • Important people during this period were Susan E. Tracy, William Rush Dunton (father of OT), Clifford Beers, Eleanor Clarke Slagle (mother of OT), George Edward Barton. (4)

Neo Professional Era

1920 - 1939

  • After WWI, the stock market crash and the Great Depression occurred.
  • Occupational therapists focused on working more closely with medicine strategies as the popular treatments of electroconvulsive therapy and lobotomies were having positive and negative outcomes. (4)
  • Medical Model was created in the early 20th century due to disease at the time, understanding the spread of disease and how to prevent it. OTs struggles to keep up with medicine advances so remediation, adaptation, and compensation were created. Remediation is the use of occupations to increase the ability to function. Adaptations are changes in tasks and environment to enable participation in occupations. Compensations include the techniques in which medication could not help such as splinting, Assistive Equipment, and technologies. (2)
  • Over 50 hospitals held occupational therapists to focus on helping soldiers wounded from WW1.
  • The AOTA continued to grow in members, meetings, and publications of multiple journals. AOTA used this time to create and advance educational programs.
  • Adapting the use of equipment to improve people's strength, endurance, and range of motion was adopted by OTs.
  • Important people from this era include Eleanor Clarke Slagle, William Rush Dunton Jr., Thomas Kidner, and Adolf Meyer. (4)

War and Development

1940 - 1959

  • Following Pearl Harbor, WWII occurred.
  • OT focuses shifted from activities of arts and crafts towards rehabilitation techniques based on scientific methods.
  • Activities of daily living (ADL), ergonomics, and vocational rehabilitation became important when reintegrating veterans into the community.
  • OTs were being trained in prosthetic training, adaptive tools, and compensatory techniques to best serve the population.
  • In 1956, the Certified Occupational Therapy Assistant (COTA) position was created to increase OT professionals. (4)
  • The client-centered model was started in the 1950s with Carl Rogers. Also named community model or social model, allows for client and therapist partnership. In this model, the client has a choice and plays an active role in the health process. (2)
  • Important people during this time were Karal and Berta Bobath, Col. Ruth A. Robinson, and Margaret Rood. (4)

Evolution of Profession

1960 - 1979

  • This time of the civil rights movement and the Great Society made influences in health care.
  • The AOTA was reorganized and the AOTF was established to continue with the advancements of science.
  • After WWII, neuromotor and musculoskeletal systems and their impact on functions became very important for OTs to serve the population.
  • Increased knowledge regarding neuroscience leads to knowledge of a sensory integration theory for children.
  • The Education for All Handicapped Children Act of 1975 created more areas for OTs to provide services.
  • ADL tools and adaptive equipment (AE) were created and being used to ease ADL difficulty. (4)
  • The Biopsychosocial (BPS) model was proposed by Engel in 1977 as an expansion of the medical model. This model focuses on condition, psychological components, and social components and all three must be handled together. Critics say “that the BPS model does not fit the definition of a scientific model, has not been adequately tested as a theory, and has not worked to inform medical practice” (Cole & Tufano, 2020). According to the International Classification of Functioning (Cole & Tufano, 2020), BPS integrates social and medical models. The medical model views a disability as a result of disease or trauma and should be attended to by healthcare professionals. The social view views a disability as a result of a social issue and requires social action in order to manage. BPS is a holistic model, meaning every part of the individual is considered.
  • The Recovery model in mental health was created in the 1970s with a focus on skills/activities that medication could not fix. This model reflects the idea the people with mental illness and/or substance disorders will reach a state of health, well-being, and recovery through the completion of everyday activities. The recovery model uses components from the medical model in addition to the use of medication. (2)
  • Influential people during this time were Mary Reilly, A. Jean Ayres, Gail Filder, Ann Mosey, Wilma L. West, Elizabeth Yerxa, Lela A. Llorens. (4)

Occupational Science

1980 - 1999

  • A spike in the growth of OT was created after Vietnam War.
  • Civil rights were granted to people with disabilities through the Americans with Disabilities Act.
  • There was an emphasis on research, efficacy, and defining OT.
  • Healthcare services continued to grow, creating a greater need for OT services.
  • The Balanced Budget Act changed regulations of OT practice through certifications and licensures.
  • Important people during this period are Florence Clark, Gary Kielhofner, and Elizabeth Yerxa. (4)

New Millennium

2000 - Present

  • In the United States, OT was influenced by federal and state legislation.
  • More therapy is offered on an outpatient basis due to the pressure of rapid discharge from inpatient settings as a result of the change in insurance.
  • Digital technologies were becoming more popular, increasing the use of different cultural perspectives and online education.
  • Revisions to the world health organization’s model began in 2001. Shifts towards more holistic interventions were made.
  • Important people during this era are Carolyn Baum, Elizabeth Townsend, and Ann Wilcock. (4)

References