Occupational Therapy

1940 - 1969

By Genevieve Cyrs, Claire Kelly, Allie Taylor, & Patricia WongBy Genevieve Cyrs, Claire Kelly, Allie Taylor, & Patricia Wong

The 1940s

• World War II- increased demand for OTs

• Changes in Occupational Therapy Education

• The Structure and Focus of Occupational Therapy

• Medical Advancements

• Important Individuals: Clare Spackman, Helen Willard, Wilma West

World War II

• Large numbers of injured soldiers• Women working

Growth in OT schools

• Accreditation• Expansion- 1947: USC introduces

first Master’s Degree program• Revision of Essentials for

accreditation 1943: More flexibility in areas of

therapeutic training 1949: Increased biological sciences

requirement

Occupational Therapy

• Move away from Arts & Crafts Movement Positive attitude towards work

• Patients are motivated through personal interests & material goods Goals:

• 1. Meet person’s interests and abilities• 2. Use activity with physical/mental

objective

Medical Model

• Disability is deficiency or abnormality• Disability is negative• Disability is in the individual body• Remedy for disability-related problems: cure or normalization• Change strategy: surgery, medication, medical technology and intervention• Agent of remedy: the professional • Independence seen as individual physical,

cognitive, and mental ability to perform and capacity to make decisions (Willard & Spackman, p. 871)

OT Practical Design

• Medical model & influence on field of occupational therapy

• Self-repair activity discounted in favor of conceptions in psychology, physiology and anatomy

• Redefinition of mission & emergence of a new paradigm

Advances in Medicine

• Antibiotics- penicillin and streptomyocin

• Vaccinations• Improvement in healthcare quality• Federal government funds

research and passes laws regarding delivery of healthcare

• Life expectancy increases

• Head of orthopedics occupational therapy at the Walter Reed General Hospital 1943-4

Wilma West

Helen Willard & Clare Spackman

1947: Publication of first OT textbook

IT’S QUIZ TIME!

The 1950s

• Post-war Effects

• Social Context: Women’s Roles, Civil Rights Movement

• Polio Epidemic

• The Structure and Focus of Occupational Therapy

•Treatment of Mental Health

• WFOT

• Important Individuals: Dr. Howard Rusk

Post-war Effects

• Baby boom• Economic prosperity

Women’s Roles

• Housewife- ideal of femininity• Discouraged from working • Continued to work, mostly in low

paying jobs (“pink-collared work”)

Civil Rights Movementearly 1950s

• Korean War- desegregation of armed forces

• 1954: Brown v. Board of Education- Supreme Court rules segregation unconstitutional, desegregation of schools

• Non-violent protests Civil disobedience

• 1955-56: Rosa Parks and Montgomery Bus boycotts

Poliomyelitis

• Known as Infantile Paralysis• Most cases of polio are symptom-free• When the virus enters the blood stream, it attacks the CNS

• causes muscle weakness & paralysis of the legs

• Bulbar polio affects nerves responsible for breathing, swallowing and speech

Polio in the Media

• In 1952, there were 57,000 cases of polio in the US

• Targeted children from 5-9 years old• 21,000 permanent

paralysis• 3,000 deaths

• 1955: the Salk Vaccine is distributed in mass quantities

• Children of the 1950s are today’s baby boomers

“Plague Season”

OT Practical Design

• The Mechanistic Paradigm emerges• More Freudian-based psychological

treatment of patients • Disability viewed as abnormal

expression of repression within• Incorporation of neurological knowledge

into practice

OT Methodology Change

• Practice of splinting and prescribing adaptive devices flourished

• Discrete analysis of requirement needed for activity

• Emphasis on the patient returning to healthy functioning

• Respect for objective measurement and scientific precision gained

• Functional knowledge related to internal processes and body structure applied

Dr. Howard Rusk

• Established the Institute of Rehabilitation and Physical Medicine

• Wrote and gave speeches about expanded idea of rehabilitation

• Increased medical and public knowledge of physical and occupational therapy

Working with Mental Patients

• Do not work on causative factors of behaviors—correct symptoms

• Do not stress activity over relationship with patient

• Use graduation & persuasion to overcome distasteful habits

• Select tasks within ability level to assure success

• Give patient choice of activity

• Develop patient’s sense of responsibility

• Hold “community sing”

Video

• Mental Health Rehabilitation in 1950s

World Federation of Occupational Therapists

• Founded in 1952• 1959: WFOT entered into relations with

WHO

Mission:• To promote occupational therapy as an

art and science • To develop and use occupational

therapy worldwide• International cooperation

WFOT Focus

Program Areas:• Education & research• Standards & quality• International Cooperation• Executive programs• Promotion & development

USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark

WFOT 1952

WFOT 1969

USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark •

Belgium • France • Germany • Netherlands • Norway • Philippines • Portugal • Switzerland • Venezuela

1950s OT changes

• 1956: Certified Occupational Therapy Assistant (COTA) position created

• 1958: Pi Epsilon Theta founded at UNH

IT’S QUIZ TIME!

The 1960s

• Social Context: Civil Rights Movement Continues, Women’s Empowerment

• The Structure and Focus of Occupational Therapy

• Medicare/Medicaid

• Important Individuals: Gail Fidler, Mary Reilly, Wilma West, Elizabeth Yerxa, A. Jean Ayres

Civil Rights Movement

• Presidents Kennedy and Johnson set tone by making civil rights a priority of their administration

• Nonviolent protests continue 1960: sit-in protests

• 1964: Civil Rights Act passed- outlaws discrimination based on race

Women’s Liberation Movement

• 1964: Civil Rights Act- outlaws sex discrimination

• Empowerment of women More educated More economically secure More willing speak up about their

ideas

OT Practical Design

• Occupational therapy clarified in accordance with the medical model

• Pathological conditions better understood

• Use of technology to intercede with dysfunction increased

OT Practical Conflict

• Field in conflict• Occupational therapy had turned from

holistic foundation toward concrete scientific rationale

• Interventions mechanized, losing meaning in favor of achieving purpose

Call for a new Paradigm?

• Occupational therapy valued with respect to conformity with the medical model

• Many therapists had difficulty adjusting to the approach of the medical model

• Practitioners not united• A realization that the profession needed to

ameliorate its differences was recognized

Wilma West

• President of AOTA from 1961 to 1964

• Wanted to address changing needs of society and adapt OT accordingly

• Wanted OT to have a new role of “health agent”

• Founded American Occupational Therapy Foundation (AOTF)

Mary Reilly

• Active in the 1960s• Re-evaluation of mechanistic

model• Advocated a more interdisciplinary

approach

1960s Changes

• More work with pediatrics and developmental delays

• Beginning of de-institutionalization Working to integrate formerly

institutionalized clients into society as independent and productive members

Medicare/Medicaid

• Established in 1965- Inpatient occupational therapy services covered

Elizabeth Yerxa

• “the scientific attitude is not incompatible with concern for the client as a human being but may be one of the best foundations for acting upon that concern”

• Advocate of client choices

Gail Fidler

• Wanted to recognize the professional commitment to learning, critical thinking, and creativity

• Advocated teaching more than just technical skills

A. Jean Ayres

• Developed sensory integration approach

• Influenced by Piaget

Influences from the 40s-60s that we see today

• Occupation-based therapy• Client has choices• De-institutionalization

IT’S QUIZ TIME!

Thank you!

Any questions?

References

Abrams, R.M. (2006). America transformed: Sixty years of revolutionary change, 1941-2001. New York, NY: Cambridge University Press.

Cole, M.B. & Tufano, R. (2007). Applied theories in occupational therapy: a practical approach. Retrieved from http://books.google.com

Dunton Jr., W. R. & Licht, S. (1957). Occupational Therapy: Principles and Practice (2nd ed.). Springfield, IL: Bannerstone House.

Fidler, G. S. & Fidler, J. W. (1954). Introduction to Psychiatric Occupational Therapy. New York City: Macmillan Publishing Co.

Fidler, G. S. & Fidler, J. W. (1963). Occupational Therapy: A Communication Process in Psychiatry. New York City: Macmillan Publishing Co.

Gilbert, J. (1981). Another chance: Postwar America, 1945-1968. Philadelphia, PA: TempleUniversity Press.

Gillon, S.M. (2007). The American paradox: A history of the United States since 1945. Boston, MA: Houghton Mifflin Company.

Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s

occupational therapy (11th ed., pp. 202-215). Philadelphia, PA: Lippincott Williams & Wilkins.

Hammel, J., Charlton, J. Jones, R., Kramer, J., Wilson, T. (2009). From disability rights to empowered consciousness. In Crepeau, E.B., Cohn, E.S., &

Boyt Schell, B.A. (Eds.), Willard and Spackman’s Occupational Therapy (11th ed). (868-887). Philadelphia: Lippincott, Williams & Wilkins.

Kearney, Pamalyn. (2004). The influence of competing paradigms on occupational therapy education: A brief history. Retrieved from

http://www.newfoundations.com/History/OccTher.html.

Kielhofner, G. (1992).  Conceptual Foundations of Occupational Therapy.  Philadelphia: F.A. Davis Co.

Marcus, R.D., & Burner, D. (Eds.). (1972). America since 1945. New York, NY: St. Martin’s Press.

Reilly, M. (1985). The 1961 Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of 20th century medicine in AOTA

(Ed.), A Professional Legacy: The Eleanor Clarke Slagle Lectures in Occupational Therapy, 1955-1984, (pp. 87-105). Rockville:

AOTA. Retrieved from www.uab.edu.

Abrams, R.M. (2006). America transformed: Sixty years of revolutionary change, 1941-2001. New York, NY: Cambridge University Press.

Cole, M.B. & Tufano, R. (2007). Applied theories in occupational therapy: a practical approach. Retrieved from http://books.google.com

Dunton Jr., W. R. & Licht, S. (1957). Occupational Therapy: Principles and Practice (2nd ed.). Springfield, IL: Bannerstone House.

Fidler, G. S. & Fidler, J. W. (1954). Introduction to Psychiatric Occupational Therapy. New York City: Macmillan Publishing Co.

Fidler, G. S. & Fidler, J. W. (1963). Occupational Therapy: A Communication Process in Psychiatry. New York City: Macmillan Publishing Co.

Gilbert, J. (1981). Another chance: Postwar America, 1945-1968. Philadelphia, PA: TempleUniversity Press.

Gillon, S.M. (2007). The American paradox: A history of the United States since 1945. Boston, MA: Houghton Mifflin Company.

Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s

occupational therapy (11th ed., pp. 202-215). Philadelphia, PA: Lippincott Williams & Wilkins.

Hammel, J., Charlton, J. Jones, R., Kramer, J., Wilson, T. (2009). From disability rights to empowered consciousness. In Crepeau, E.B., Cohn, E.S., &

Boyt Schell, B.A. (Eds.), Willard and Spackman’s Occupational Therapy (11th ed). (868-887). Philadelphia: Lippincott, Williams & Wilkins.

Kearney, Pamalyn. (2004). The influence of competing paradigms on occupational therapy education: A brief history. Retrieved from

http://www.newfoundations.com/History/OccTher.html.

Kielhofner, G. (1992).  Conceptual Foundations of Occupational Therapy.  Philadelphia: F.A. Davis Co.

Marcus, R.D., & Burner, D. (Eds.). (1972). America since 1945. New York, NY: St. Martin’s Press.

Reilly, M. (1985). The 1961 Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of 20th century medicine in AOTA

(Ed.), A Professional Legacy: The Eleanor Clarke Slagle Lectures in Occupational Therapy, 1955-1984, (pp. 87-105). Rockville:

AOTA. Retrieved from www.uab.edu.

References

The American Occupational Therapy Foundation. (2009). Mission, Vision, Goals, & Strategic Plan. Retrieved from http://www.aotf.org/aboutaotf/missionvisiongoals.aspx

The History of Occupational Therapy. (n.d.) Retrieved from http://www.sensory-processing-disorder.com/history-of-occupational-therapy.html.

Willard, H.S., & Spackman, C.S. (Eds.). (1954). Principles of Occupational Therapy (2nd ed.). Philadelphia, PA: J.B. Lippincott Company.

Willard, H. S. & Spackman, C. S. (1963). Occupational Therapy (3rd ed.). Philadelphia: J.B. Lippincott Co.

Photographs/Video:

Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s occupational therapy (11th ed., pp. 202-215). Philadelphia, PA: Lippincott Williams & Wilkins.

http://history.amedd.army.mil/booksdocs/wwii/medtrain/ch5.htm

http://history.amedd.army.mil/corps/medical_spec/publication.html

http://history.amedd.army.mil/booksdocs/wwii/medtrain/fig18.jpg

http://www.rohcg.on.ca/about/history-romhc-1950-e.cfmRBPSQ

http://www.youtube.com/watch?v=BnjDoj