1. Occupational Therapy 1940 - 1969

2. The 1940s World War II- increased demand for OTs
Changes in Occupational Therapy Education
The Structure and Focus of Occupational Therapy
Medical Advancements
Important Individuals: Clare Spackman, Helen Willard, Wilma West

3. World War II Large numbers of injured soldiers Women working/

4. Growth in OT schools Accreditation
Expansion- 1947: USC introduces first Master’s Degree program
Revision of Essentials for accreditation
More flexibility in specialties

5. Occupational Therapy Move away from Arts & Crafts Movement
Positive attitude towards work
Patients are motivated through personal interests & material goods
Goals:
1. Meet person’s interests and abilities
2. Use activity with physical/mental objective

6. Medical Model Disability is deficiency or abnormality
Disability is negative
Disability is in the individual body
Remedy for disability-related problems: cure or normalization
Change strategy: surgery, medication, medical technology and intervention
Agent of remedy: the professional
Independence seen as individual physical, cognitive, and mental ability to perform and capacity to make decisions
(Willard & Spackman, p. 871)

7. OT Practical Design
By 1940, the medical model’s influence on the practical outlook of healthcare had begun to exert pressure on occupational therapy.
Self-repair through activity was discounted in favor of applications that had more of a base in psychology, physiology and anatomy.
Over the next decade, occupational therapy redefined its mission, integrating practice with a new paradigm and professional culture built upon a scientific approach and fact.

8. 1940s Advances in Medicine Antibiotics- penicillin and streptomyocin
Vaccinations- eradication of many childhood diseases
Improvement in quality of healthcare
Federal government funds research and passes laws regarding delivery of healthcare
Life expectancy increases

9. Wilma West
Head of orthopedics occupational therapy at the Walter Reed General Hospital

10. Helen Willard & Clare Spackman

11. Publication of the first OT textbook in 1947

12. IT’S QUIZ TIME!

13. The 1950s
Post-war Effects
Social Context: Women’s Roles, Civil Rights Movement
Polio Epidemic
The Structure and Focus of Occupational Therapy
Treatment of Mental Health
WFOT
Important Individuals: Sister Elizabeth Kenny

14. Post-war Effects
Baby boom
Economic prosperity

15. Women’s Roles Housewife- ideal of femininity Discouraged from working
Continued to work, mostly in low paying jobs (“pink-collared work”)

16. Civil Rights Movement early 1950s
Korean War- desegregation of armed forces
1954: Brown v. Board of Education- Supreme Court rules segregation unconstitutional, desegregation of schools
Non-violent protests
Civil disobedience
: Rosa Parks and Montgomery Bus boycotts

17. Poliomyelitis Known as Infantile Paralysis
Most cases of polio are symptom-free
When the virus enters the blood stream, it attacks the CNS
causes muscle weakness & paralysis of the legs
Bulbar polio affects nerves responsible for breathing, swallowing and speech

18. Polio in the Media

19. “Plague Season” In 1952, there were 57,000 cases of polio in the US
Targeted children from 5-9 years old
21,000 permanent paralysis
3,000 deaths
1955: the Salk Vaccine is distributed in mass quantities
Children of the 1950’s are today’s baby boomers

20. OT Practical Design The Mechanistic Paradigm emerges
Confidence was instilled in the profession as treatment objectives encompassed more Freudian-based psychological conceptualization informing treatment of patients.
The occupational therapist became a vehicle for resolution, a mechanism for the patient to utilize.
Disability was seen as the abnormal expression of repression within
Incorporation of neurological knowledge into practice

21. OT Methodology Change
Over the course of this decade, the practice of splinting and prescribing adaptive devices flourished.
Discrete analysis of requirements needed for activity became more integral to practice
Medical model adherence promoted the emphasis on the patient returning to healthy functioning
Respect for objective measurement and scientific precision was gained
Knowledge of how internal processes and body structure informed function expanded

22. Working with Mental Patients
Do not work on causative factors of behaviors—correct symptoms
Do not stress activity over relationship with patient
Use graduation & persuasion to overcome distasteful habits
Select tasks within ability level to assure success
Give patient choice of activity
Develop patient’s sense of responsibility
Hold “community sing”

23. Video
Mental Health Rehabilitation in 1950s

24. World Federation of Occupational Therapists
Founded in 1952
1959: WFOT entered into relations with WHO
Mission:
To promote occupational therapy as an art and science
To develop and use occupational therapy worldwide
International cooperation

25. WFOT Focus Program Areas: Education & research Standards & quality
International Cooperation
Executive programs
Promotion & development

26. WFOT 1952
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark

27. WFOT 1969
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark •
Belgium • France • Germany • Netherlands • Norway • Philippines • Portugal • Switzerland • Venezuela

28. 1950s OT changes
1956: Certified Occupational Therapy Assistant (COTA) position created
1958: Pi Epsilon Theta founded at UNH

29. IT’S QUIZ TIME!

30. The 1960s
Social Context: Civil Rights Movement Continues, Women’s Empowerment
The Structure and Focus of Occupational Therapy
Medicare/Medicaid
Important Individuals: Gail Fidler, Mary Reilly, Wilma West, Elizabeth Yerxa, A. Jean Ayres

31. Civil Rights Movement
Presidents Kennedy and Johnson set tone by making civil rights a priority of their administration
Nonviolent protests continue
1960: sit-in protests
1964: Civil Rights Act passed- outlaws discrimination based on race

32. Women’s Liberation Movement
1964: Civil Rights Act- outlaws sex discrimination
Empowerment of women
More educated
More economically secure
More willing speak up about their ideas

33. OT Practical Design
By the end of the 1960s, occupational therapy’s role in mediating client illness and disability was clarified in accordance with the medical model. The psychology of the effect of pathological conditions on patients was better understood by the profession and the use of technology to intercede with dysfunction increased.

34. OT Practical Conflict
This embrace of practical shift in the profession enhanced practice but also threw the field into conflict
As therapeutic interventions focused less on confidence building activity through participation in occupational interests, the field turned from its holistic foundation to therapy based in concrete scientific rationale
The interventions previously focused on balanced living became mechanized and lost meaning in favor of achieving purpose

35. Call for a new Paradigm?
Therapists used to practicing under the original, moral paradigm of practice had difficulty adjusting to the more concrete scientific approach of the medical model
A realization by practitioners that the profession needed to ameliorate its differences was recognized
By the end of this era, occupational therapy was valued with respect to conformity with the medical model but practitioners were not united
As the times dictated, social upheaval, redefining roles and the importance placed on science informed occupational therapy practice

36. Wilma West President of AOTA from 1961 to 1964
Wanted to address changing needs of society and adapt OT accordingly
Wanted OT to have a new role of “health agent” in order to focus on prevention in the health care system

37. Mary Reilly Active in the 1960s Re-evaluation of mechanistic model
Advocated a more interdisciplinary approach

38. 1960s Changes More work with pediatrics and developmental delays
Beginning of de-institutionalization
Working to integrate formerly institutionalized clients into society as independent and productive members

39. Medicare/Medicaid
Established in Inpatient occupational therapy services covered

40. Elizabeth Yerxa
“the scientific attitude is not incompatible with concern for the client as a human being but may be one of the best foundations for acting upon that concern”
Advocate of client choices

41. Gail Fidler
Wanted to recognize the professional commitment to learning, critical thinking, and creativity
Advocated teaching more than just technical skills

42. A. Jean Ayres Developed sensory integration approach
Influenced by Piaget

43. Influences from the 40s-60s that we see today
Occupation-based therapy
Client has choices
De-institutionalization

44. IT’S QUIZ TIME!

45. Questions?