History of Occupation

Necessary

meeting basic physiological and self maintenance needs

Committed

work or productivity but not remunerated

diffuse and unspecified

Contracted

paid productivity

formal education

Free time

left over

can include obligations

Neolithic Era (6500 BC)

occupation was focused around survival

organizing aspects of daily life existed in roles, habits, and rituals

“work” occurred near or at home, order, and productivity

Neolithic Era (6500 BC): Gender roles and expectations

women kept the home and focused on the child

men kept up with the farming and the hunting

Neolithic Era (6500 BC): Essential fluids

4 fluids represent the four season/four elements (releasing the evil)

black vile, yellow vile, blood, and phlegm

Greek and Roman Societies

physical and mental illness are considered the same (driving out that evil)

diagnosis based on astrology, dream interpretations, demons, and supernatural

Mesopotamia (1900 BC)

“Priest-Doctors” treated mental illness with “Magico-Religious Rituals”

exorcisms and incantations (driving out the evil/evil spirits

Age of Reason, or the Enlightenment (1600s): Thomas Willis

advocated “directing patients toward occupations that promoted cheerfulness and joy” such as music, dancing, hunting, fishing, and education

Insane Asylum of Europe (15-16th century)

individuals with mental disorders were misunderstood and treated cruelly

inhumane treatments to calm individuals; purge out the evil and craziness were popular at this time

blood letting, whippings, and beating interventions were replaced with kindness (idleness was replaced with occupation)

Moral treatment (late 18th century Pinel’s Freeing the Insane)

a social reform movement concerning care of the insane became known as moral treatment

represented optimism and hope for human treatment of insanity

Who is William Tuke?

Founder of the “Retreat” in York, England

“a place in which the unhappy might obtain refuge; a quiet haven in which one might find a means of reparation or of safety”

Expansion of Moral Treatment

activities were analyzed through observation toward individualized patient needs

building self-esteem through the judicious use of occupations

Who is Benjamin Rush (late 1700s)?

brought human treatment to the “deranged” people in the US through work and other “goal directed” activites

1860’s and The Decline of Moral Treatment (Civil War)

moral treatment disappeared (focused their industries on the war, no resources or energy to maintain moral treatment)

rapid influx of immigrants and poor overtaxing systems; inferior physical plants and insufficient staff

“Custodial Care”

belief that insane were “incurable” (we can help them vs. we can’t help them anymore)

Industrialization (19th century)

rapid economic growth and opportunity (lead people to the city)

energy sources, fast pace

changed our occupations (things that worked in agricultural might not work in industrial areas)

Arts and Crafts Movement (1870s)

going back to working with our hands

period of social reform against industrialization (mass production promoted the use of reproductions)

early OT vigorously adopted use of crafts (authenticity, producitiy. and civic action)

Who is William Morris

British poet, artist and architect rejected the opulence in favor of simplicity of good craftsmanship and good design

Jane Addams (1889)

Hull House and the 1 Generation

bridged the gaps between middle class reformers and the poor and immigrant groups of industrialized Chicago

Susan Tracy

occupational nurse

first person on paper to say occupations really help

1905

1st proponent of occupations for “invalids”

initiated training in occupations to student nurses (the value of occupation)

applying moral treatment to acute illness, “the application of “the most rational remedy to ordinary everyday sick people”

1917

when it was called occupation therapy

1921

move from “occupation therapy” to occupational therapy and provided definition

“The aim of occupation is to get the man well; that of vocational training is to get the man a job. Any well man will look for a job, but the sick man is looking for health”

Labor movement

emerged from the need to protect the common interest of industrial workers

organized labor unions fought for better wages, reasonable work hours and safer working conditions

the movement led efforts top stop child labor, give health benefits, and provide aid to workers who were injured or retired

World War 1

birth of the reconstruction movement

mobilizes medicine and needs we didn’t have before

reconstruction aides (precursors to modern day Occupational and Physical therapists)

1917

The National Society for the Promotion of Occupational Therapy, Clifton Springs, NY

The Emergence of Occupation Therapy (1910-20)

“curative” incorporated mind-body spirit (thinking, feeling, and doing)

holistic approach to care (how can we restore health)

What were the objective of the profession in 1910-20?

the advancement of occupation as a therapeutic measure

the study of the effects of occupation on human beings

the dissemination of scientific knowledge on occupation

The Birth of Occupational Therapy

resulted in a professional base, scholarship, and discourse emerging from its largely white, class-privileged founders

initially mobilized through the class-based social networks of its founders an the desire to secure a place as a profession rather than a job, led to the championing of professionalism over working-class identities

Who is the father of occupational therapy?

Sheppard - Enoch Pratt, Dr. William Dutton

work in the form of arts and crafts, was an important component of treatment for mental health

Adolph Meyer

temporal adaptation (time in “helpful and gratifying activity”)

rhythms of human endeavors

Philadelphia School of Occupational Therapy (1918-1981)

founded on October 3rd, 1918

admission requirements (women, at least 23 years old, born in the US, or allied Country, and with a suitable personality)

long affiliation with curative workshop (national treatment centers to rehabilitate people with mental/physical illness using occupations

Eugenics movements (1920s)

aimed at “improving the genetic composition of the human race”; advocated selective breeding to stop society’s transmission of “undesirable” traits

people subjected to sterilization had no choice because it was a government program

World War II (1940s)

catastrophic injury (aircraft) and amputation (beginning of prosthetics and orthotics)

started rehabilitation (upper extremity sling)

When did Willard and Spackmen create their first textbook?

1947

1950s (Electric shock treatment)

post war onward into OT focusing on ADL and leisure performance

began to see specialization in mental health, pediatrics, and physical disabilities

Introspective years (1960s-70s)

introduction of OT assistants

Development of OT theory: Mary Reilly

the profession lost its focus; challenged us to work more diligently toward understanding occupation from an interdisciplinary perspective

realized 30 years later in Occupational Science

Occupational behavior theory

Development of OT theory: Jerry Johnson

serve individual and societal needs; examine relationships with other professions in a changing world

1980s

tension between “reductionism” and reclaiming occupation

emergence from the “cloistered years” (deinstitutionalization)

huge growth due to expanding medical reimbursement for OT services

1990s

tremendous growth, reduction of funding streams, and reduced health care dollars

movement from acute care to long term and “sub-acute” care

late 90s (huge reductions in OT school applicants)

Occupational Science was spearheaded by?

Elizabeth Yerxa and faculty at USC in 1989

Occupational science

to study and understand the relationship between engaging in occupation and health

basic science with occupation as the core

21st Century

healthcare reform

serving the occupational needs of society

focus on health promotion and wellness

The profession today

access to Ot services in legislation (affordable care act, telehealth, and medicare)

expanding practice in nontraditional and community settings