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History of OT

My timeline of important landmarks in history

Lauren Musick

on 6 September 2012

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Transcript of History of OT

from moral treatment to the americans with disabilities act A history of occupational therapy Phillippe Pinel Moral Treatment and Occupation William Tuke Moral treatment means treating one's emotions Occupation is directed use of time, energy, interest and attention Treatment in mental institutions began to include music, exercise and other leisure activities Arts and crafts provide patients with a sense of relaxation and productiveness Leisure activities are best adapted to the patient's level of functioning and interests George Barton National Society for Promotion of Occupational Therapy (SPOT) Eleanor Clarke Slagle Susan Tracy Adolf Meyer Thomas Kidner 1917 AOTA 1923 1958 COTA the mentally ill A profession very much a product of the social environment veterans from WWI the survivors and miracles made possible through modern medicine deinstitutionalization of mental institutions in 1963 followed by homelessness Treating veterans with mental illness and physical disability Occupational Therapy and the US Military Reimbursement for services Support for occupational therapy education and leadership training Specialized medicine, and specialization in occupational therapy 1960s and 1970s demand for more scientific evidence and research disability rights and civil rights laws governing rehabilitation and special education, meant more access to ot more personal responsibility in health 1959 university of florida occupational therapy degree 1954 colorado state university offers a bachelor of science in occupational therapy 1969 colorado state university offers a master of science in occupational therapy greater attention to quality of life, prevention, and maintaining health 1980s and 1990 patient self-determination act of 1990 americans with disabilities act of 1990 prohibited discrimination patient autonomy from NSPOT to AOTA ties to the military, society of friends, medicine, social work, arts and crafts holistic

occupation satisfies needs, responsibilities, and roles

activity is purposeful and matches needs

person is actively involved and interactive with environment
ot enables and facilitates

human potential and self-worth from small successes and competency

therapeutic relationship and therapeutic use of self

there is no set methods or tools

occupation changes throughout the lifespan

inherent cultural bias

philosophy and theory are still being defined occupational therapy today 1700s 1800s Benjamin Rush use of moral treatment in the u.s. William Hall adapted arts and crafts for medical rehabilitation in the u.s. Ruskin, Morris, and Barton enthusiasm about arts and crafts and occupation as a treatment model growing concern over the health effects of the industrial revolution and about the segregation of people with disabilities William Rush Dunton psychiatrist
father of occupational therapy social worker
first school for ot practitioners nursing teacher
arts and crafts disabled architect
consolation house became a workshop for founding leaders and occupation became a treatment method Susan Johnston arts and crafts teacher
standards of ot education architect
vocational rehab with WWI and tb patients psychiatrist
philosophy of ot medical model is a reductionist model, threatening occupational therapy's roots working more with physical disabilities,
polio, tuberculosis treating the effects of disability

focusing on function rather than dysfunction

the consumer has control and makes decisions

unbiased beliefs about disability

considers how a person can affect or be affected by the environment MOHO model of human occupation Dr. Gary Kielhofner 1980 models of human behavior, theories and tools applied in occupational therapy practice, and the research that can support or improve these models habituation performance capacity volition physical and mental abilities underlying skilled performance process by which occupation is organized into patterns and routines motivation for occupation physical
environment social environment 20 different assessments, othere resources for applying to patients across the lifespan the context of movement activity Kinesiology Biomechanics (cc) photo by medhead on Flickr study of internal and external forces 5th c BC 1950 16th century Aristotle described the human musculoskeletal system as a mechanism with concepts such as levers, forces, and center of gravity Galileo and mathematics

Isaac Newton founded classical physics Descartes separated mind and body a mechanistic philosophy that we are made up of separate parts 20th century Einstein studied the mathematics of chaos, such as weather patterns and heart rhythms a transformative philosophy characterized by
dynamic interactions between players, and their environment creative adaptation change emerging over time, transforming the past and future 1918 Bird T. Baldwin, a psychologist voluntary activities that are graded and adapted to specific muscles pr joints lead to a return to function a reconstruction model Marjorie Taylor an orthopedic model activities that are specific to the muscle or joint problem William R Dunton and Sidney Licht a kinetic model promoted more scientific activity analysis promoted ideas for adaptive equipment a rehabilitation model adaptations toward function in meaningful activity,

rather than remediation of specific body parts study of movement and the active and passive structures involved uses elements of musculoskeletal anatomy, neuromuscular function, and biomechanics not a comprehensive framework for OT Kinesiology and Biomechanics have a tendency to reduce and isolate problems from the context of activity cognitive, emotions, social, and environmental factors Vocational Rehab In schools Government and Reimbursement Patient Rights Milestones in the Profession National Defense Act(1914): education for soldiers to regain work skills for civilian life
Smith-Hughes Act(1917): Federal Board for Vocational Education (FBVE)
Smith-Sears Act(1918): Soldier Rehab Act: program for disabled veterans unable to work, expanded FBVE
Smith-Fess Act(1920): Civilian Rehab Act: extended services to non-military, funding voc. guidance, training, placement, prostheses
Rehabilitation Movement(1942-1960)
Vocational Rehab Act(1943): changed to include coverage for ADLs and adaptations, increased coverage for more disabilities
Vocational Rehab Act(1954): included coverage for teaching health professionals
Vocational Rehab Amendment(1965): increased services for socially handicapped and severely disabled, included fair housing, employment, rights, grant funded community services SPOT(1917) AOTA(1923) National Registry(1935) Smith-Fess Act(1920): Civilian Rehab Act: extended services to non-military, funding voc. guidance, training, placement, prostheses
Federal Industrial Rehab Act(1923):increases in industrial accidents after wwI, hospitals must provide OT
Women's Medical Specialist Corps(1947), became the Army Med Specialist Corps, Korean War(1950) called for active Army hospitals with OT depts to continue
Medicare(1965): federal and state governments responsible for fair housing, employment, rights, and grant funded community services; covers inpatient OT and limited outpatient OT services
(1988)Medicare provider numbers allowing direct reimbursement for OT services
Omnibus Budget Reconciliation Act(OBRA)(1980): nursing home reform, coverage for home health, OT qualified as a primary service for Medicare
Diagnostic Related Groups(DRG)(1983) Prospective payment system(PPS) for Medicare; resulted in shorter hospital stays in acute care and more use of long-term care facilities and home health
Balanced Budget Act (1997) reduction in Medicare spending, encouraged development of managed care plans, limitations on fee-for-service plans, $1500 cap on OT, $1500 on PT/SLP (1920s-1935) Growing number of OT education programs, AOTA set educational standards
(1958) COTA education programs Community Mental Health Act(1963): deinstitutionalization
Vocational Rehab Act(1943): changed to include coverage for ADLs and adaptations, increased coverage for more disabilities
Vocational Rehab Amendment(1965): increased services for socially handicapped and severely disabled, included fair housing, employment, rights, grant funded community services
Architectural Barriers Act(1968): federally funded buildings must be accessible
Rehabilitation Act(1973): prohibited employee discrimination by disability in federally funded programs, required accessible facilities, state agencies required to prioritize services for persons with the most severe disabilities, client participation in service-planning with Individualized Written Rehab Program(IWRP), emphasized need for rehab research and standards for outcomes assessment
Patient Self Determination Act(1990): requirement to inform patients of existing rights, increase patient decision making
Americans with Disabilities ACT(ADA)(1990): prohibits discrimination based on disabilities regardless of federal funding, accessibility in all public places Education of Handicapped Act(1970)
Education for All Handicapped Children Act(1975): free and appropriate public ed for all children, IEPs, included OT as a related service
Handicapped Infants and Toddlers Act(1986): extended services to children birth to 5, OT as a primary service
Technology Related Assistance for Individuals with Disabilities Act(1988)
Individuals with Disabilities Education Act(IDEA)(1991) schools are responsible for providing least restrictive environments and assistive technology
IDEA 97(1997) strengthened the role of parents and consideration of assistive technology needs in the IEP John Ruskin William Morris Arts and Crafts Movement William Rush Dunton "occupation therapy" Herbert Hall adapted the Arts and Crafts Movement for medical purposes (1904)

graded activity as "work cure" and an alternative to the "rest cure" SPOT President 1920-1923 George Edward Barton opened Consolation House, where occupation was used as treatment

contacted others who were working in rehab or in reforming asylums and who were influenced by the Moral Treatment Movement studied under Morris

personally experienced disability Sheppard Asylum, where patients used a craft workshop and were expected to actively participate in their treatment

influenced by Moral Treatment Movement Moral Treatment Movement Philippe Pinel and William Tuke Eleanor Clarke Slagle Treasurer and President of SPOT
Long-time Editor of its journal, "The Archives of OT," now titled "AJOT" directed occupational therapy department at Henry Phipps Psychiatric Clinic of Johns Hopkins Hospital in 1912

developed her program of "habit training" started the first OT school, the Henry B Favill School of Occupations Executive Secretary and held other positions in the association Susan Tracy nursing instructor in Arts and Crafts Movement

developed the occupations program at Adams Nervine Asylum

tried to make patient occupation a nursing specialty wrote "Studies in Invalid Occupations,"
the first book on OT Chair on SPOT Committee of Teaching Methods Susan Cox Johnson arts and crafts teacher

Director of Occupations at NY Dept of Public Charities

demonstrated that occupation could improve mental and physical states of patients and be morally uplifting, that patients can contribute to their self-support taught occupational therapy at Teachers College

advocated for high education standards for practitioners Thomas Kidner
advocated for OT to be included in Vocational Rehabilitation

responsible for OT's inclusion in tuberculosis treatment Secretary of National Tuberculosis Association architect-friend of Barton

constructed institutions and developed system of vocational rehab for patients with physical disabilities presented SPOT's principles of occupational therapy in 1918 Adolf Meyer psychiatry professor at Johns Hopkins

developed the psychobio approach to mental illness

dedicated to a holistic perspective

believed involvement in meaningful activity is a distinct human trait and promoted health 1921 Keynote address "The Philosophy of Occupational Therapy" the Founders tree Founders and friends SPOT Arts and Crafts Movement influential movements the social-cultural climate rights and responsibilities reductionism and research Mary Reilly Elizabeth Yerxa Phil Shannon Gail Fidler return to roots MOHO Kielhofner occupational science Revised OT Practice Framework (2008) ACOTE(1994), independent accrediting body (accreditation of OT curriculum and ed programs, distancing OT as a profession away from reliance on physicians and medical model)
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