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

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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.”
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3. 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).
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4. 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
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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.
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The Early 20th Century
Innovations in:
Science
Technology
Medicine
Impact of mechanization and industrialization on everyday life
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7. Forces that Shaped Occupational Therapy
Industrialization
Arts and Crafts movement
Progressive Era
Work cure over rest cure
Moral treatment of mentally ill people
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8. 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
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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
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10. Impact of Federal Legislation
Soldier’s Rehabilitation Act of 1918
Civilian Vocational Rehabilitation Act of 1920
Moved occupational therapy more into world of rehabilitation
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11. The Organization of the Profession (cont.)
Made up of:
Medical professionals
Social workers
Teachers
Craftspeople
Volunteers
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12. The Organization of the Profession (cont.)
Therapeutic to engage in meaningful activity
Vision of the founders:
Meaningful engagement leads to good health
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13. 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).
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14. Knowledge Bases of the Profession (cont.)
Psychiatry
Anatomy
Physiology
Medicine
Psychology
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15. Knowledge Bases of the Profession (cont.)
Crafts
Architecture
Design
Education
Psychology
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16. 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).
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17. 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).
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18. 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
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19. Occupational Therapy at a Crossroad
Occupations as curative and valuable in own right
Versus
Occupations looked at through scientific lens
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World War II (1939 to 1945)
Urgent need for OTs to treat the wounded:
Fast track training established
Functional skills training focus
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21. 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
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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
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23. Need to Create a Formalized Occupational Science: Training
Change focus of training from:
What to do to
Understanding why it’s done
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24. Need to Create a Formalized Occupational Science: Practice
Shift practice from:
Crafts, activities, and holism to
A scientific biomedical practice
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25. Need to Create a Formalized Occupational Science: Both
Yerxa and Reilly :
Include origins of profession while expanding scientific biomedical focus
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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
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Balanced Budget Act 1997
Result of rising health care costs
Diminished amount of treatment OTs provide
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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
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29. Occupational Therapy Proves Its Worth
Growth in where it is used
Original occupational theory needed:
Kielhofner and Burke (1980) Model of Human Occupation
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30. 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
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31. 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).
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