Chapter 1 Historical Perspectives of Occupational Therapy by Amy Wagenfeld, PhD, OTR/L SCEM, CAPs

Copyright © 2016 Wolters Kluwer • All Rights Reserved Learning Objectives After studying this chapter, readers should be able to: Summarize the role that history plays in the current status of the profession of occupational therapy. Identify the roots of occupational therapy originating from multiple disciplines and state the impact on the current profession as we know it. Discuss the connections between the Founding Vision and the Centennial Vision of occupational therapy. Describe what the profession of occupational therapy “is.” Copyright © 2016 Wolters Kluwer • All Rights Reserved

Introduction: AOTA Definition of Occupational Therapy “helping people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations)” (AOTA, n.d.c). Copyright © 2016 Wolters Kluwer • All Rights Reserved

The Moral Treatment and Reform Movement Treat mentally ill people Balance of work and leisure Learn ways to cope with stresses Live life with dignity Environment is part of treatment Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Settlement Houses Part of the Reform Movement Central to the evolution of occupational therapy Provided social services to influx of immigrants in the late 19th and early 20th centuries Eleanor Clarke Slagle: Learning to take care of self is meaningful and purposeful. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved The Early 20th Century Innovations in: Science Technology Medicine Impact of mechanization and industrialization on everyday life Copyright © 2016 Wolters Kluwer • All Rights Reserved

Forces that Shaped Occupational Therapy Industrialization Arts and Crafts movement Progressive Era Work cure over rest cure Moral treatment of mentally ill people Copyright © 2016 Wolters Kluwer • All Rights Reserved

Influence of World War I (1914 to 1918) Need to rehabilitate wounded soldiers Idea of optimal care and rehabilitation changed Meaningful activities rebuild the body and mind: Example: Thomas Kidner’s manual training programs Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Change in Role of OTs Duty of the soldiers to engage in rehabilitation Duty of the soldier to become productive member of society Duty of the country to provide aide to the soldiers Duty of the OTs to provide physical rehabilitation to soldiers: Change from prior exclusive work with those with mental illness Copyright © 2016 Wolters Kluwer • All Rights Reserved

Impact of Federal Legislation Soldier’s Rehabilitation Act of 1918 Civilian Vocational Rehabilitation Act of 1920 Moved occupational therapy more into world of rehabilitation Copyright © 2016 Wolters Kluwer • All Rights Reserved

The Organization of the Profession (cont.) Made up of: Medical professionals Social workers Teachers Craftspeople Volunteers Copyright © 2016 Wolters Kluwer • All Rights Reserved

The Organization of the Profession (cont.) Therapeutic to engage in meaningful activity Vision of the founders: Meaningful engagement leads to good health Copyright © 2016 Wolters Kluwer • All Rights Reserved

Establishment of a Professional Organization Primary objective of the National Society for the Promotion of Occupational Therapy: “study and advance curative occupations for invalids and convalescence; to gather news of progress and occupational therapy and to use such knowledge to the common good; to encourage original research, to promote cooperation among occupational therapy societies, and with other agencies of rehabilitation” (1917). Copyright © 2016 Wolters Kluwer • All Rights Reserved

Knowledge Bases of the Profession (cont.) Psychiatry Anatomy Physiology Medicine Psychology Copyright © 2016 Wolters Kluwer • All Rights Reserved

Knowledge Bases of the Profession (cont.) Crafts Architecture Design Education Psychology Copyright © 2016 Wolters Kluwer • All Rights Reserved

Founding Vision: Melding Occupation with Science “the particular objects for which the corporation is formed are as follows: The advancement of occupation as a therapeutic measure; for the study of the effect of occupation upon the human being; for the scientific dispensation of this knowledge” (National Society for the Promotion of Occupational Therapy, 1917). Copyright © 2016 Wolters Kluwer • All Rights Reserved

The Progression of the Profession Name changed to the American Occupational Therapy Association in 1921 Mission defined as: “advancing the quality, availability, use, and support of occupational therapy through standard setting, advocacy, education, and research on behalf of its members and the public” (AOTA, n.d.c). Copyright © 2016 Wolters Kluwer • All Rights Reserved

Growth of the Profession Standardization of Programs in 1923 National Registry Established in 1931 Accreditation of programs: American Medical Association AOTA took over in 1994 Copyright © 2016 Wolters Kluwer • All Rights Reserved

Occupational Therapy at a Crossroad Occupations as curative and valuable in own right Versus Occupations looked at through scientific lens Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved World War II (1939 to 1945) Urgent need for OTs to treat the wounded: Fast track training established Functional skills training focus Copyright © 2016 Wolters Kluwer • All Rights Reserved

Rehabilitation Movement (1942 to 1960) Rapid changes in profession OTs sought after 1945 first registration examination Specialty areas of practice developed Occupational therapist assistance role developed Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Medicare 1965 Greater role for OTs to work with older adults in inpatient settings Beginning opportunity to work in outpatient settings Direct reimbursement for services legislated in 1988 Copyright © 2016 Wolters Kluwer • All Rights Reserved

Need to Create a Formalized Occupational Science: Training Change focus of training from: What to do to Understanding why it’s done Copyright © 2016 Wolters Kluwer • All Rights Reserved

Need to Create a Formalized Occupational Science: Practice Shift practice from: Crafts, activities, and holism to A scientific biomedical practice Copyright © 2016 Wolters Kluwer • All Rights Reserved

Need to Create a Formalized Occupational Science: Both Yerxa and Reilly : Include origins of profession while expanding scientific biomedical focus Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Late 20th Century Federal laws increased demand for services and specialties: Rehabilitation Act of 1973 Education for all Handicapped Children Act (EHA) of 1975 Handicapped Infants and Toddlers Act Technology-Related Assistance for Individuals with Disabilities Act of 1988 Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Balanced Budget Act 1997 Result of rising health care costs Diminished amount of treatment OTs provide Copyright © 2016 Wolters Kluwer • All Rights Reserved

Copyright © 2016 Wolters Kluwer • All Rights Reserved Professional Issues Licensure granted at the state level Graduate programs offered in the 1980s Americans with Disabilities Act: Expanded the scope of practice specialties Individuals with Disabilities Education Act: Required the need for OTs in public schools Copyright © 2016 Wolters Kluwer • All Rights Reserved

Occupational Therapy Proves Its Worth Growth in where it is used Original occupational theory needed: Kielhofner and Burke (1980) Model of Human Occupation Copyright © 2016 Wolters Kluwer • All Rights Reserved

Twenty-First Century: Looking Forward Explosive growth in membership in the American Occupational Therapy Association and World Federation of Occupational Therapists Increase in number of accredited occupational therapy programs Copyright © 2016 Wolters Kluwer • All Rights Reserved

Founding Vision and Centennial Vision Central to both is healing nature of occupation. Differ in expanded definition of occupational therapy to include “preventing and overcoming obstacles to participation” (AOTA, 2007, p. 613). Copyright © 2016 Wolters Kluwer • All Rights Reserved