1. Chapter 2 A Contextual History of Occupational Therapy
Charles H. Christiansen and Kristine Haertl

2. Learning Objectives After reading this chapter, you will be able to:
Appreciate that historical accounts are retrospective attempts to reconstruct and understand the events of the past with the purpose of gaining improved insight into the present.
Identify key personalities and events that influenced the founding and development of occupational therapy.
Recognize that wars, social movements, and legislation were associated with significant developments in occupational therapy.

3. Learning Objectives (Continued)
Discern how mind/body dualism and the competition between social and biomedical approaches to health care have been persistent points of tension since occupational therapy’s founding.

4. Historical Periods 1700-1899 - Pre-history
Era of the Founders
Growth and Stabilization
WW II and Medicalization
OT Theory Evolves
Era of Competing models
2000- Pres- Era of evidence

5. Pre-History ( )
The Age of enlightenment (reason) questioned old ways of viewing the world and provided new ways of knowing.
Technological advancements, human migration and industrialization created social challenges and social developments.

6. Pre-History: Key Figures
John Locke
Rene Descartes
Philippe Pinel
William Tuke
Adolf Meyer
John Dewey

7. John Locke 17th Century Philosopher and Physician
Locke’s ideas had a significant impact on modern thought. Many fundamental ideas in occupational therapy can be traced back to his influence

8. Adolf Meyer, MD and Colleagues at Kankakee Asylum in Illinois

9. Era of the Founders ( )
Modernization, immigration and industrialization created mental health problems that existing treatments were unable to address
The “work cure” replaced the “rest cure” and led to a belief that active engagement could be an effective remedy for nervous disorder-this became known as occupation therapy

10. Era of the Founders: Key Figures
Susan Tracy*
Herbert J. Hall, M.D.
Eleanor Clarke Slagle*
William Rush Dunton, Jr., M.D.*
George Barton*
General John J. Pershing
Thomas J. Kidner*
Clifford Wittingham Beers

11. (L-R) Susan Cox Johnson, William Rush Dunton, Jr. , M. D
(L-R) Susan Cox Johnson, William Rush Dunton, Jr., M.D., Isabelle Newton, George Barton, Thomas Kidner and Eleanor Clarke Slagle at Clifton Springs, N.Y. in March, 1917

12. Surgeon General Gorgas pictured with Reconstruction Aides, 1918

13. Postwar Growth ( )
After WWI, a period of standardization and stabilization ensued, where the new profession worked to gain recognition and sought to standardize practice and education to the extent possible
It’s alliance with the AMA helped it gain legitimacy, but at a cost of autonomy
From its deep roots in mental health, the profession branched out into physical rehabilitation and tuberculosis care

14. Postwar Growth: Key Figures
Franklin Delano Roosevelt
Eleanor Clarke Slagle
William Rush Dunton, Jr., M.D.
Thomas B. Kidner
Col. Frank Billings, M.C., N. A.
Douglas McMurtrie

15. Eleanor Clarke Slagle, Founder
Early President and Secretary of the American Occupational Therapy Association

16. Franklin Delano Roosevelt
Disabled by a neurological illness, Roosevelt was elected to four terms. He was influential in the creation of social security and other key recovery programs during the depression of the 1930’s

17. WW II & Continued Development (1940-59)
Large numbers of soldiers were deployed to European, African and Pacific Theatres to fight Germany and the Axis powers
Occupational therapy, strongly influenced by medicine, plays a key role in rehabilitation of soldiers
Developments in prosthetics, assistive technology and neurodevelopmental care were accelerated during this period

18. WW II & Continued Development (1940-59)
Colonel Ruth Robinson
Jonas Salk
Margaret Rood
Karl & Berta Bobath
Wilma West
Paul Elwood, M.D.

19. Colonel Ruth Robinson
Ruth A. Robinson served in World War II and helped establish training programs for therapy personnel. She later served as AOTA President, and influenced the creation of Certified Occupational Therapy Assistant programs.

20. Medicare, Vietnam and the further Evolution of OT: (1960-1979)
Civil rights, Medicare, and the Vietnam War provided important context on society as it addressed social justice
School based services for disabled children is mandated by law
AOTF is created

21. Key Figures: (1960-1979) Lyndon B. Johnson Mary Reilly, Ed.D.*
A. Jean Ayres, Ph.D.
Gail Fidler
Wilma L. West

22. President Lyndon B. Johnson
Lyndon Johnson, the 36th president, succeeded John F. Kennedy, and presided over the Viet Nam war. He signed the Medicare/Medicaid Legislation of 1965, an historic turning point in U.S. health care.

23. Mary Reilly, Ed.D.
Dr. Mary Reilly, at the University of Southern California, strongly influenced conceptual thinking about the importance of occupational therapy to human productivity.

24. New Theories, ADA, and Occupational Science: (1980-1999)
Occupational therapy experiences dramatic growth
Graduate education evolves, and along with it, new theories and models of practice
New theorists urge a return to occupation-based practice, which gains momentum
Occupational science is born

25. Key Figures: (1980-1999) George H. W. Bush Paul Elwood, M.D.
Elizabeth Yerxa, Ed.D.
Gary Kielhofner, Dr.P.H.
Florence Clark, Ph.D.
Gail Fidler
Wilma L. West

26. President George H. W. Bush
George H. W. Bush, 41st president, signed the Americans with Disabilities Act in This legislation increased fairness, accessibility and participation for persons with disability in the United States.

27. Elizabeth Yerxa, Ed.D. & Florence Clark, Ph.D.
Dr. Elizabeth Yerxa (top) and Dr. Florence Clark, leaders at the University of Southern California, developed the first Ph.D. in occupational science and advocated strongly for research.

28. New Millennium: (2000-Present)
Digital technology and the Internet have a profound effect on lifestyles
9/11 leads to wars in the Middle East, which again challenge rehabilitation and O.T. with polytrauma cases
Occupational science matures
Cost containment comes to the forefront as health care costs rise

29. New Millennium: (2000-Present) (Continued)
Federal health care policies emphasize the importance of evidence to guide practice
Occupational therapy researchers gain new heights
Occupational therapy expands globally

30. Key Figures: (2000-present)
Barack Obama
Ann Wilcock, Ph.D.
Carolyn Baum, Ph.D.
Elizabeth Townsend

31. President Barack H. Obama
Barack Obama, the 44th president, became the first president of color. He signed the Affordable Care Act into law in 2010, increasing access to health care for millions of Americans without insurance.

32. Elizabeth Townsend, Ph.D. & Ann Wilcock, Ph.D.
Dr. Elizabeth Townsend (top) of Canada and Dr. Ann Wilcock, of Australia advanced the idea of occupational justice as an important social aim with health implications.

33. Tax deductible contributions to the AOTF can be made at www.aotf.org
Acknowledgment
Many of the photographs and materials used to formulate this chapter were from the Archives of the American Occupational Therapy Association, which are maintained by the American Occupational Therapy Foundation (AOTF), Inc.
Tax deductible contributions to the AOTF can be made at