Occupational Occupational therapy then and therapy then and

nownow

Tracing the origins of occupational therapy:

Mapping the future

Developed by Anita Hamilton Developed by Anita Hamilton in conjunction with Lynne Adamsonin conjunction with Lynne AdamsonWith support from Sharon Brintnell With support from Sharon Brintnell and Genevieve Pepinand Genevieve Pepin

Aims:Aims:

►Provide information about history of Provide information about history of the professionthe profession

►Encourage thinking about your place Encourage thinking about your place in the profession’s futurein the profession’s future

►Create awareness of the development Create awareness of the development of philosophical and theoretical of philosophical and theoretical perspectivesperspectives

Why bother with history?Why bother with history?

►Occupational therapy’s place in a Occupational therapy’s place in a wider world - medical, social, historicalwider world - medical, social, historical

►Conceptual development - theories Conceptual development - theories guiding current practiceguiding current practice

►Learning from historyLearning from history►Your place in history and the futureYour place in history and the future

When did thinking about When did thinking about occupation begin?occupation begin?►2600BC

Chinese believed that “disease was caused by organic inactivity and thus used physical training for the promotion of health…”(Hopkins 1988, p 16).

►1000BCPersians used physical training to prepare young men for military duty

Philosophy and Philosophy and occupationoccupation►Greek philosophers

Socrates (400B.C) and Plato (347 B.C) - the relationship between physical status and mental health

Hippocrates (359 B.C), Galen (200 A.D) - founders of medicine,- recommended exercise as a means of recovering from illness

Play and work…Play and work…

►Play, games and recreation Part of all primitive life - toys, drawings, sculptures found in excavations - Egypt, Babylonia, China, Aztecs, Incas

►3400 BC Egyptian men of leisure still engaged in outdoor work, not idle all day

►17ADLivy - “Toil and pleasure in their nature opposites are linked together in a kind of necessary connection”

Inca leisure occupationsInca leisure occupations

Source: http://www.mexicolore.co.uk/uploadimages/133_00_2.jpg

1780s France 1780s France ►Moral treatment

Pinel introduced work in an asylum for the insane: “humane treatment”

►Injury and disease French cavalry used crafts and recreational activities for disabilities of muscles and joints following disease or injury

Source: http://www.epicidiot.com/thisday/images/pinel.jpg

Developing sciencesDeveloping sciences

►The Enlightenment: 18The Enlightenment: 18thth Century Century Moving from tradition, irrationality, Moving from tradition, irrationality,

superstition and tyrannysuperstition and tyranny emphasised reason, science and emphasised reason, science and

rationality rationality

Occupational therapy Occupational therapy beginnings beginnings

► 1880s The settlement house concept begins in England ► 1892 Dr. Adolf Meyer, a psychiatrist, reported that "the

proper use of time in some helpful and gratifying activity appeared to be a fundamental issue in the treatment of the neuropsychiatric patient”

► 1895 William Rush Dunton, Jr., "Father of Occupational Therapy," psychiatrist fitted a metalworking shop for the treatment of patients.

► 1895 Mary Potter Brooks Meyer, (Meyer's wife), a social worker, introduced a systematic type of activity into the wards of a state institution in Worcester, Massachusetts.

► 1904 Dr. Herbert J. Hall began to prescribe occupation for his patients as medicine to regulate life and direct interest. He called this the "work cure."

► 1905 Susan E. Tracy noticed in her training as a nurse the benefits of occupation in relieving nervous tension and making bedrest more tolerable for patients.

Source: http://www.recreationtherapy.com/history/rthistory2.htm ; Gordon, 2009, p.206)

The founders of occupational The founders of occupational therapytherapy

Back row (L to R): William Rush Dunton, Isabelle Newton, and Thomas Bessell Kidner. Front row (L to R): Susan Cox Johnson, George Edward Barton, and Eleanor Clarke Slagle.

(Gordon, 2009, p. 206)

Eleanor Clarke SlagleEleanor Clarke Slagle► A Social Worker who

became interested in the new field of occupational therapy

► Conducted General occupational therapy training at Hull House, Chicago

► 1922 NY state director of OT

► First large-scale OT program for a state hospital system

Adolf MeyerAdolf Meyer

Meyer (1922) noted that just as our heart beats in a rhythm, so do we respond to the greater rhythms of day and night, sleeping and waking, and hunger and satiation, all centered on the fundamental activities of human life: “work and play and rest and sleep” (p. 8).

These ideas remain as touchstones of occupational therapy thought and practice to this day.

Adolf Meyer, renowned psychobiologist and author of The Philosophy of Occupation Therapy (1922).

(Gordon, 2009, p. 207)

Thomas B. KidnerThomas B. Kidner► Architect► Immigrated to Canada from England in

1900► 1915 Vocational Secretary of Military

Canadian Military Hospitals Commission ► 1918 loaned by the Canadian

government to the US as advisor on the voc. rehab. of wounded soldiers

► Took an active interest in the organization and development of the American Occupational Therapy Association and served for six years as its president.

► From 1926 to the time of his death conducted a private consulting business in hospital architecture. (No Author, 1932/1995)

The Badge (1919)Foreshadows the 1990’s

Per Mentem Et Manus Ad Saniatem

Through Mind and Hand To Health

Triangle: Mind, Body and Spirit

1919

Goldwin HowlandGoldwin Howland

► Born in Toronto, 1875► Family in business & politics► Studied medicine► Became a neurologist► Served in WWI as a medical officer

Where he witnessed “War Aides” in action► Set up the first OT department in Canada in

1919► Became a crucial force in the advancement

of OT in Canada► Part of group to establish the OT course at

UofT in 1926► Established the CJOT in 1933

The influence of war…The influence of war…

WWI 1914 - 1918WWI 1914 - 1918►Reconstruction Aides

- “bedside occupations” for wounded soldiers- Eleanor Clarke Slagle directed the training of 4000 aides for the American Armed Services

““Reconstruction” as an Reconstruction” as an ideaidea

Reconstruction aides in official uniform capes of grey with maroon lining

(Gordon, 2009, p. 208) (Christensen, 1991, p.31)

WWII 1941 - 1944WWII 1941 - 1944► Improved medicine Improved medicine

- greater survival- greater survival

- greater disability- greater disability

►Occupational therapy focus shifted to Occupational therapy focus shifted to enable returned soldiers return to enable returned soldiers return to productivity.productivity.

The influence of war…The influence of war…

Occupational therapy in Occupational therapy in CanadaCanadafill in the gaps…fill in the gaps…Name the pivotal events in

occupational therapy in Canada for these years: 1918 1920 1922 1926 1932-34 September 1933 1939

If we were in……If we were in……19391939…………

► OT offered its services for injured OT offered its services for injured soldiers of World War II. soldiers of World War II.

““A profession established during A profession established during an earlier war was now grown, and an earlier war was now grown, and ready to contribute again.” ready to contribute again.”

► Growing interest in vocational Growing interest in vocational training and industrial therapy training and industrial therapy programsprograms

Therapeutic use of Therapeutic use of activityactivity

(Anderson & Bell, 1988, p.83)

Adapted tasks for Adapted tasks for rehabilitationrehabilitation

(Anderson & Bell, 1988, p.183)

Wilma WestWilma West

Wilma L. West, head of orthopedics occupational therapy, Walter Reed General Hospital, Washington, DC, 1943-1944, founder of the American Occupational Therapy Foundation and president from 1972 to 1982. She was also president of AOTA from 1961 to 1964 and Eleanor Clarke Slagle lecturer in 1967.

(Gordon, 2009, p. 209)

Helen WillardHelen Willard

(Christensen, 1991, p.33)

American Association pioneers Helen Willard and Sidney Bottner at the E.D. Hines, Jr. Hospital, Maywood, Illinois, 1924.

Advertisement for the first edition of Willard & Spackman's Occupational Therapy. Price: $4.50

(Gordon, 2009, p. 209)

(Cockburn, 2001)

The 1940sThe 1940s

1939: who was Mary Wilson? 1939-45: What was the CAOT stance on OT

for war rehab? 1943: Who got DVA services up and

running? 1947: how many editions of CJOT were

produced annually?

Name the pivotal events in occupational therapy in Canada for these years:

Muriel DriverMuriel Driver

► 1943 Enlisted in the RCAMP Sole therapist for Hamilton Military Hospital Overseas posting in the UK

► 1946 organized first OT dep’t at Runnymeade Hospital, Toronto

► 1948 Supervisor of OT dep’t at Hospital for sick kids Toronto

► 1959 director of the CAOT OT program at Kingston

► 1967 Senior Lecturer at Queens University OT program

► Many years of service to CAOT & WFOT

http://www.caot.ca/default.asp?pageid=1357(Cockburn, 2001)

Thelma CardwellThelma Cardwell

► Graduated from the U of T in 1942► Had a range of clinical positions before her

service as a Lieutenant (OT) in the Royal Canadian Army Corps 1944-45

► Lengthy academic career 1945-1983► President of CAOT 1966► President WFOT 1967-1972► Co-founder of the Canadian Occupational

Therapy Foundation (funding scholarship and research)

► Thelma Cardwell Lecture series named after her in 1977

Isobel RobinsonIsobel Robinson

► Graduated from the U of T in 1939

► Director of the Uof T program 1967 – 1981

► Associate editor of CJOT► CAOT board of directors ► First archivist for CAOT► Co-founder of COTF► Muriel Driver lectureship 1981► Co-authored and produced the

video “Fifty years of Occupational Therapy in Canada”

The 1950s and 1960sThe 1950s and 1960s

Name the pivotal events in occupational therapy in Canada for these years: 1952 1959 1960 1961 1966 1970 What theme emerged in

the 1960s in the OT profession?

Kitchens as a place of Kitchens as a place of interestinterest

(Anderson & Bell, 1988, p.171)

(Cockburn, 2001)

Working with childrenWorking with children

(Willard & Spackman, 1971, p.363)

Mary ReillyMary Reilly

…challenged the profession to work more diligently toward understanding occupation from an interdisciplinary perspective, including findings in oranizational theory, sociology, psychology, philosophy, economics, and biology.

(Gordon, 2009, p.211)

The 1970sThe 1970s

► 1971► 1974► 1974► 1975► 1977► Examples of being more

“business like” Changes to education of OTs Provincial Legislation Emerging talk about models of

practice

Name the pivotal events in occupational therapy in Canada for these years:

Sharon BrintnellSharon Brintnell

► Past president CAOT► Muriel Driver lectureship in 1985► Director of the OPAU at the UofA► Consultant to the National Institute

of Disability Management and Research

► Pivotal role in development of OT guidelines for client-centred practice

► Secured the grant to develop the national certification examination in OT

► Active role in developing OT in Saudi Arabia, Indonesia,

► Past honorary treasurer WFOT► Current president WFOT

The 1980sThe 1980s

► 1981 International Year of Disabled Persons► Revised standards for education of

occupational therapy students► 1983 (May 17) Canadian Occupational

Therapy Foundation (COTF) spearheaded by Karen Goldenberg

► 1983-1986 Development of the National Certification Examination

► Graduate programs Canada's first MScOT program offered at the

University of Alberta in 1986

Elizabeth YerxaElizabeth Yerxa

…warned that occupational therapy had often not met the challenge of the profession… Yerxa believed that the profession must focus on its unique assets, such as allowing the client to exercise choice in the engagement of “self-initiated, purposeful activity” (Gordon, 2009,

p.211)

The 1980s continued…The 1980s continued…► Return to historical

emphasis on holistic mind-body-spirit perspective focusing on occupation and client-centred practice

► 1987: First ever National OT week

► 1983: Development of nationally-based, generic guidelines for the practice of occupational therapy

Gary KielhofnerGary Kielhofner

► …influenced by Reilly and Yerxa…

► discussed the need for the profession to continue to develop a paradigm of occupation that takes into account the active nature of the human adaptive process with attention to ongoing research concerning developmental and social theory Picture source:

http://tinyurl.com/nxecm8

The 1980s were busy!The 1980s were busy!

►The Guidelines represented the initial stage in formulating the Canadian Model of Occupational Performance (CMOP)

►CAOT formed the Client-Centred Practice Committee in 1989

►This decade featured work in the areas of social and political activism by the profession and development of a strong professional identity

The 1990sThe 1990s

► Mary Law chaired a committee to develop an outcome measure based on the Guidelines: Their work resulted in the development of the

Canadian Occupational Performance Measure (COPM) in the 1990's.

► Sharon Brintnell chaired a committee to develop the Occupational Therapy Guidelines For Client-Centred Mental Health Practice Published in 1993.

The 1990sThe 1990s

► Health promotion on the agenda► CMOP and COPM being used widely in

Canada and Internationally► COPM translated into 20 different languages► 1997: Enabling Occupation: An

Occupational Therapy Perspective was published

► Evidence of “practice efficacy” being called for Emergence of the EBP era

Elizabeth TownsendElizabeth Townsend

Founding member of the school of occupational therapy at Dalhousie University

Chairperson of CAOT’s client-centred Practice Committee since 1990

Key contributor to the “Enabling Occupation” texts

Key figure in the Occupational Science movement in Canada and Internationally

Muriel Driver Memorial Lecturer 1993.

1990s – 1990s – ““de-de-institutionalization of the institutionalization of the professionprofession””►1990: 3.4% of the membership was self-

employed; this figure jumped to 23.1% by 2000 (CAOT, 2001)

►October 26, 1995: CAOT moves to Ottawa►1996: The Profile of Occupational Therapy

Practice in Canada developed to describe occupational therapy practice in Canada.

►1996: CAOT revised its Academic Accreditation Standards

Into the new millenniumInto the new millennium

► 1998: WFOT Council Meeting was held in Ottawa and the Congress in Montreal (3500 delegates from 55 countries)

► 1998: CAOT launches its first website► 2000: Occupational therapy was regulated

in each province.

Michael IwamaMichael Iwama

► Developed the culturally sensitive Kawa model critical work on culture critical work on culture

and its implications for and its implications for knowledge, theory and knowledge, theory and practice in Occupational practice in Occupational TherapyTherapy

"No matter what model one uses, it's important to try to appreciate what daily life looks like through the eyes of the client." - Michael Iwama

Into the new millenniumInto the new millennium

►2001: CAOT members given unlimited access to OTDBASE

►2008: Profile of Occupational Therapy and education Accreditation standards revised and updated

►2008: Sharon Brintnell becomes president of WFOT

►2009: Liz Taylor becomes president of CAOT

►2009: CAOT members given access to BJOT, JOS and Work (journals)

Assistance to countries Assistance to countries developing occupational developing occupational

therapy services, educational therapy services, educational programs & CBRprograms & CBR

► Scotland (1920) CAOT

► Venezuela (1955) E.S Brintnell

► Vietnam (1980) WHO

► Indonesia (1989-95) University of Alberta

► Bosnia- Herzegovina (1997) Queens University

► Russia (1992) University of Western Ontario

Canadian Leadership to Canadian Leadership to the professionthe profession

WFOTPresidentThelma Cardwell (1967 -

72)Andrée Forget (1981-86)Sharon Brintnell (2008-

Vice PresidentGillian Crawford (1952-

1954)Andrée Forget (1981-86)

Secretary – Treasurer

Thelma Cardwell (1958 -1964)

SecretaryBarbara Postuma (1986 -

1996)

TreasurerSharon Brintnell (1998 –

2008)

Alberta Leadership to the Alberta Leadership to the ProfessionProfession

CAOT PresidentSharon Brintnell*Helen Madill*Elizabeth Taylor*Heather ChiltonLorna ReimerElizabeth Taylor

SecretarySharon Brintnell*Elizabeth Taylor*

AAROT#

PresidentHelen Madill*Elizabeth Taylor*

*U of A Faculty Members#AAROT becomes ACOT and SAOT

Occupational therapy Occupational therapy has emerged as has emerged as

profession that is:profession that is:Strongly founded

Client-centred

Evidence-based

Cost-effective

Diversifying

Evolving

What about in… What about in… 2029?2029?► Where will you be?Where will you be?► What will the world be like?What will the world be like?► What will occupational What will occupational

therapy be offering to health therapy be offering to health care and broader society?care and broader society?

► What area of work will What area of work will interest you?interest you?

► How many of you will be…How many of you will be… managers of servicesmanagers of services educatorseducators influencing policy/a politicianinfluencing policy/a politician VirtualVirtual therapists therapists

ReferencesAnderson, B. & Bell, J. (1988). Occupational therapy: its place in

Australia’s history. Sydney: NSW Association of Occupational Therapists.

Bearup, C. (1996). Occupational therapists in wartime. Adelaide: Australian Association of Occupational Therapists (SA).

Clark Greene, M., Lertvilai, M., & Bribriesco, K. (2001). Prospering through change: CAOT from 1991 to 2001. Occupational Therapy Now, 3(6), 13-19. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)

Cockburn, L. (2001a). The greater the barrier, the greater the success: CAOT during the 1940's. Occupational Therapy Now, 3(2), 15-18. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)

Cockburn, L. (2001b). The professional era: CAOT in the 1950's & 1960's. Occupational Therapy Now, 3(3), 5-9. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)

Cockburn, L. (2001c). Change, expansion and reorganization: CAOT in the 1970's. Occupational Therapy Now, 3(4), 3-6. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)

ReferencesChristensen, E. (1991). A proud heritage: the American Occupational Therapy

Association at seventy-five. Rockville, Maryland: The American Occupational Therapy Association, Inc.  

Friedland, J., Robinson, I., & Cardwell, T. (2001). In the beginning: CAOT from 1926-1939. Occupational Therapy Now, 3(1), 15-19. *access from the internet (http://www.caot.ca/otnow/jan01-eng/jan01-history.cfm)

Gordon, D., M. (2009). The History of Occupational Therapy. In E. B. Crepeau, E. S. Cohn & B. A. Boyt Schell (Eds.), Willard and Spackman's Occupational Therapy (11 ed., pp. 202-215). Philadelphia: Lippincott, Williams & Wilkins.

No Author. (1932/2005). Death of Thomas B. Kidner. Psychiatric Quarterly 6(3), 569. DOI: 10.1007/BF01586392

Johnson, S. (2010). Where good ideas come from. Accessed from http://www.ted.com/talks/steven_johnson_where_good_ideas_come_from.html on 20 September 2010. TED Talks

Trentham, B. (2001). Diffident no longer: Building structures for a proud profession. CAOT in the 1980’s. Occupational Therapy Now, 3(5), 3-7. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)

University of Toronto (ND). Occupational Science and Occupational Therapy, Illustrious Occupational Therapy Graduates from U of T. accessed from http://www.ot.utoronto.ca/about/past_ots.asp on September 18, 2009.

Willard, H.S. & Spackman, C.S. (1971). Occupational therapy. 4th Edn. Philadelphia: J.B.Lippincott.