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OTD 8102: Week 10 Introduction to Historical Underpinnings

OTD 8102: Introducing the historical underpinnings of occupational therapy

Rick Davenport

on 21 July 2015

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Transcript of OTD 8102: Week 10 Introduction to Historical Underpinnings

OTD 8102 Course: Foundations of Occupational Therapy
Summer Semester 2015
Week 10

Introduction to Historical Underpinnings of OT
The first references to the use of occupation in healing goes back to the Egyptians
The Prehistory of Occupational Therapy
Minchew, G. (2007, March 8). Egyptiantexture, Louvre [Photograph]. Retrieved from http://www.flickr.com/photos/moonsong/5234128364/
The oldest use of occupation as part of a therapeutic program for "madness" or "insanity" [what is today known as mental illness] dates back to the 1600's
Tall, T. (2011, July 5). First Folio 3, Utah Shakespeare Festival [Photograph]. Retrieved from http://www.flickr.com/photos/tinytall/5919974601/in/photostream/
However, many of the predominant treatments at that time were inhumane
including: bloodlettings, "nausea treatment," the use of purgatives and emetics (to weaken + help control patients), daily whippings or beatings (physical abuse was the most expedient means of controlling behavior (Kraepelin, 1917).
2630 BCE
The Birth of the Asylum and Moral Treatment
early 19th century
In the early 19th century, a fundamental shift toward a more humanitarian approach for the treatment of "the insane" occurred.

Asylums were created as reformative institutions.

The birth of the asylum also brought medicine formally into the treatment of "the insane".
Psychiatry was the new discipline directed toward the cure of mental disorders
The practice was moral treatment, intended to replace brutality with kindness and idleness with occupation.
The Birth of the Asylum
early 19th century
Considered one of the three most significant advances in medicine in the nineteenth century
The other two were antisepsis and anesthesia

The history of occupational therapy has long been associated with moral treatment

Occupations were an essential element of the moral treatment of "the insane".
Included agricultural activities and activities related to the running of the asylum
Moral Treatment
Some example occupations of the time were:
manual labor
including agriculture
working in the shoe shop
maintenance of the institution
contracted labor in the community
end of 19th century
Moral Treatment was truly a remarkable advance in the treatment of "the insane",
it had faded from the limelight by the end of the 19th century.
Reasons for disuse of term moral treatment:
term was not specifically a medical treatment
was not scientifically based
Moral treatment was replaced by the term psychotherapy
Moral Treatment
Phill, D. (2007, November 24). The lunatics have taken over the Asylum, High Royds [Photograph]. Retrieved from http://www.flickr.com/photos/phill_dvsn/2060158497/
Phill, D. (2007, November 24). I can see for miles, High Royds [Photograph]. Retrieved from http://www.flickr.com/photos/phill_dvsn/2060896434/in/photostream/
Phill, D. (2007, November 24). Don't Look Down, High Royds [Photograph]. Retrieved from http://www.flickr.com/photos/phill_dvsn/2060877408/in/photostream/
Bonus BBC Video on Asylums
The Birth/Early Years of Occupational Therapy
Individuals from diverse professions formed the National Society for the Promotion of Occupational Therapy (NSPOT) in 1917
United by the idea that occupation plays an important role in healing and health
The "official" beginning of occupational therapy as a profession
NSPOT later became the American Occupational Therapy Association (AOTA).
The founders of occupational The founders of occupational therapy at Consolation House, Clifton Springs, New York, March1917. Front row (left to right): Susan Cox Johnson, George Edward Barton, and Eleanor Clarke Slagle. Back row (left to right): William Rush Dunton, Isabelle Newton,and Thomas Bessell Kidner. (Photo Lippincott Williams & Wilkins)
Which founder played a pivotal role in naming our profession?
other titles that were discussed later: "work-cure," ergotherapy (ergo being the Greek root for "work"), and "creative occupation"
March, 1917
The Birth of Occupational Therapy

Until the latter part of the 19th century, consideration of the psyche or mental processes in the role of health had essentially been ignored by medicine.

Occupational therapy began during a time of cultural change in American history and the history of medicine
A confluence of events occurred that propelled the psyche into the forefront of medical practice:
The success of the rest-cure (rest & milk diet)(demonstrated the psychological element of healing, helping to stimulate the recognition of the role of the mind in healing and the mind-body connection)
The successes of the Christian Science movement
(a significant mind-cure that sought to scientifically master the teachings of Christ in order to reestablish his mission to heal the sick)
The successes of faith healers were viewed not as displacing medicine but as highlighting the medical community's disregard concerning the role of the mind in healing, with medicine emphasizing drug therapies up until this time.
The psychodynamic revolution and birth of psychotherapy
With the birth of psychotherapy, the stage was set for the introduction of a new profession: occupational therapy (Gordon, 2002).
The word psychotherapy was coined in 1891 (to describe a new and groundbreaking form of medical treatment (Ellenberger, 1970).
The new profession of occupational therapy, which was initially considered by some as a form of psychotherapy (Barker, 1908; Carroll, 1910; Schwab, 1907), emerged from the world of dynamic psychiatry.
Ornellas, J. (2009, March 27). Sunrise over Haleakala, Hawaii [Photograph]. Retrieved from http://www.flickr.com/photos/ornellas/3405093001/
The early founders of occupational therapy endeavored to create a new role for occupation in the process of healing both the mind and the body. Although early writers certainly acknowledged the age-old tradition of the use of occupation as a curative measure, including moral treatment, the systematic use of occupation was seen not as a continuation of past practices but as a truly new endeavor in therapeutics (Dunton, 1919b; Hall, 1910a).
OT a New Treatment Approach
The Formation of Occupational Therapy's Professional Organization and Birth of the Profession
Adolph Meyer most clearly articulated the philosophy of occupational therapy as the profession began.
He espoused the need to utilize scientific thought and progress
He proposed the need for understanding the temporal aspects of life, which center on fundamental activities of:
Work and Play
Rest and Sleep
Meyer's ideas remain touchstones of current occupational therapy practice today.
Adolf Meyer, renowned psychobiologist and author of The Philosophy of Occupation Therapy (1922). (Photo from Lippincott Williams & Wilkins)
The philosophy of Occupational Therapy
Early 20th century:
Psychotherapy emerged to address mind & body ailments of the mentally ill and general population
Focus of OT broadened to include people with
physical disabilities
due to:
Industrial age
Treatment of tuberculosis
World War I
Efficiency experts sought to streamline activity; the beginning of energy conservation practices.
early 20th century
Key Events in the history of the Profession (Early 20th century)
In the early years of occupational therapy, the predominant therapeutic activities that were used comprised a great variety of handcrafted goods and activities.
At times, the marketability of these goods was critical to the economic viability of the institution.
However, this was a point of contention even among early leaders, who were fearful that this would diminish the therapeutic mission of the new profession.
Other forms of therapeutic interventions were encouraged from the beginning of the profession, including the use of recreation, music, and art.
Crafts were commonly used as a form of therapy in the early years of the profession. (Photo Lippincott Williams & Wilkins)
Early Years
World War I - Reconstruction Aides
Up until WWI, occupational therapy had been concerned primarily with the treatment of people with
mental illness
. However, U.S. involvement in the Great war (WWI) and the escalating numbers of
injured and disabled soldiers
presented a daunting challenge to those in command. The military enlisted the assistance of NSPOT to recruit and train over 1,200 "reconstruction aides" to help with the rehabilitation of those wounded in the war. Given that "
shell shock
" was a common cause of disability during the First World War, these forerunners of occupational therapy provided treatment that was significant for its holistic approach. This provided
the boost in attention and interest that would help to eventually propel occupational therapy into the status of a profession.
Occupational Therapy. Toy making in psychiatric hospital. World War I era.
Otis Historical Archives National Museum of Health and Medicine, (2008, June 4),Reeve41455, [Photograph]. Retrieved from http://www.flickr.com/photos/27337026@N03/2550390351/
Reconstruction aides in official uniform capes of grey with maroon lining. (Photo Lippincott Williams & Wilkins)
Occupational therapy. Patients in vulcanizing school. World War I.
Otis Historical Archives National Museum of Health and Medicine, (2007, September 27), Reeve41512, [Photograph]. Retrieved from http://www.flickr.com/photos/7438870@N04/1446744711/in/photostream/
Occupational Therapy. Patients in automobile repair shop. World War I.
Otis Historical Archives National Museum of Health and Medicine, (2008, June 4), Reeve41503, [Photograph]. Retrieved from http://www.flickr.com/photos/7438870@N04/1446756751/
Selkovjr, G., (2007, June 23), The engine of the industrial Revolution, [Photograph]. Retrieved from http://www.flickr.com/photos/selkovjr/2173614324/
The 1920s - 1980s
1900s continued
The 1920's and 1930s:
Standards of education were established for OT, laying the foundation & organization of the profession.
Mental health theories continued to evolve (psychodynamic theories, behaviorism)
The Great Depression of the 1930s presented a challenging time for the new profession, OT remained viable, continuing to raise educational standards.
1920s & 1930s
Advertisement for the 1st edition of Willard & Spackman's Occupational Therapy.
Willard & Spackman 1st Edition
1960 - 1980s
Changes in the 1960s through the 1980s
The 1960s and 1970s were a time of rapid change and growth for the profession
OT assistant programs had developed.
New scientific knowledge, e.g., the neurosciences, led occupational therapists to develop new approaches.
Rapid growth of the profession also presented challenges.
Some believed that the profession had lost its focus on occupation.
Leaders in occupational therapy challenged current practices.
Buckle (2006, January 28), Great Depression, [Photograph]. Retrieved from http://www.flickr.com/photos/44901254@N00/1410021213/
World War II
World War II and the Growth of Rehabilitation:
World War II created a skyrocketing demand for therapists to treat the injured (Membership in the field expanded from 1,144 registered therapists in 1941 to 2,265 in 1946)
Occupational therapy underwent dramatic growth and change.
Occupational therapists continued to use constructive activities such as crafts
Activities of daily living were introduced.
Educational requirements continued to expand.
Wilma L. West, head of orthopedics occupational therapy, Walter Reed General Hospital, Washington, DC, 1943-1944. West was a founder of the American Occupational Therapy Foundation and its president from 1972 to 1982. She was also president of AOTA from 1961 to 1964 and Eleanor Clarke Slagle lecturer in 1967. (Photo Lippincott Williams & Wilkins)
Reilly challenged the profession to better understand “occupation” from an interdisciplinary view
Yerxa stressed the importance of allowing the client to exercise choice in the occupational therapy process
Dr. Mary Reilly created a frame of reference known as occupational behavior. She was the Eleanor Clarke Slagle Lecturer in 1961 and a charter member of the Academy of Research of the American Occupational Therapy Foundation. (Photo Lippincott Williams & Wilkins)
Dr. Elizabeth J. Yerxa led the initial development of the academic discipline of occupational science. Dr. Yerxa received many awards for her work, including the AOTA Award of Merit for her leadership of the profession. (Photo Lippincott Williams & Wilkins)
World War II
For a great overview of the OT profession check this video out
that was produced by OT students from the 2012 class from San Jose State University
The End
Unless otherwise stated all material utilized for this Prezi is based on 2 sources:
Cole & Tufano, 2008 textbook, chp 1;
Willard & Spackman, 2009 texbook, chps 21-23
This semester you have been reviewing various theories, models, and FORs now it is time to go back in time to study the historical underpinnings of our profession.
*Be sure to read the definition of OT in the textbook from 1947
Full transcript