Function In Manager Occupational Therapy

Occupational therapy, often abbreviated as "OT" , promotes health by enabling people to perform meaningful and purposeful occupations. These include (but are not limited to) work, leisure, self care, domestic and community activities. Occupational therapists work with individuals, families, groups and communities to facilitate health and well-being through engagement or re-engagement in occupation. Occupational therapists are becoming increasingly involved in addressing the impact of social, political and environmental factors that contribute to exclusion and occupational deprivation.

The World Federation of Occupational Therapists provides the following definition of Occupational Therapy: "Occupational therapy is as a profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment to better support participation." Occupational therapists use careful analysis of physical, environmental, psychosocial, mental, spiritual, political and cultural factors to identify barriers to occupation. Occupational therapy draws from the fields of medicine, psychology, sociology, anthropology, ethnography, architecture and many other disciplines in developing its knowledge base. A new discipline of occupational science has been developed to enhance the evidence base of the profession.

History of occupational therapy

The earliest evidence of using occupations as a therapeutic modality can be found in ancient times. One-hundred years before the birth of Christ, Greek physician Asclepiades initiated humane treatment of patients with mental illness via the use of therapeutic baths, massage, exercise, and music. Later, the Roman Celsus prescribed music, travel, conversation and exercise to his patients. Unfortunately, by medieval times, the concept of humane treatment of people considered to be insane was rare, if not nonexistent.

In eighteenth century Europe, revolutionaries such as Philippe Pinel and Johann Christian Reil reformed the hospital system. Instead of the use of metal chains and restraint, their institutions utilized rigorous work and leisure activities in the late 1700s. Although it was thriving abroad, interest in the reform movement waxed and waned in the United States throughout the nineteenth century. At the turn of the 20th century, as physicians became increasingly interested in chronic disease, enthusiasm for the reform of the mental healthcare system was revived in the states. Work therapy found its way to America.

The health profession of occupational therapy as we know it was conceived in the early 1910s. Focus was on promoting health in “invalids.” Early professionals merged highly valued ideals, such as having a strong work ethic and the importance of crafting with one’s own hands, with scientific and medical principles. Early adversaries viewed wood carving and crafting by ill patients trivial.

The emergence of occupational therapy challenged the views of mainstream scientific medicine. Instead of focusing on purely physical etiologies, they argued that a complex combination of social, economic, and biological reasons cause dysfunction. Principles and techniques were borrowed from many disciplines—including but not limited to nursing, psychiatry, rehabilitation, self-help, orthopedics, and social work—to enrich the profession’s scope. Between 1900 and 1930, the founders defined the realm of practice and developed theories of practice. In a short 20-year span, they successfully convinced the public and medical world of the value of occupational therapy and established standards for the profession.

A substantial lack of primary sources of information has left today’s occupational therapists with many questions concerning the founders of the field. Information is collected from early training institutions and hospitals, professional writings of practitioners, World War I records from government agencies, newspaper articles, and personal testimonials.

One of the most notable figures in the infancy of occupational therapy was Eleanor Clark Slagle. Slagle was part of the generation of women who challenged women’s “rightful” place as a volunteer and strived for females to have a place in the professional world. At age forty, she was trained in curative occupations and recreations at the Chicago School of Civics and Philanthropy and later took a position at Hull House, where crafts were used to promote mental health.

It is speculated that Slagle’s interest in healthcare stemmed from her personal life, as her father, brother, and nephew all suffered from various disabilities. Seeing the daily struggles of people with disabilities and illnesses may have sparked Slagle to enroll in the Chicago School in 1911. In 1912, renowned psychiatrist Adolph Meyer appointed Slagle to direct a new department of occupational therapy at John Hopkins Hospital. There, she learned habit training—a method of re-educating patients on decent habits of living via substituting healthful habits for bad habits.

Another psychiatrist, William Rush Dunton, Jr., worked diligently to raise the status of psychiatry in medicine in the first decades of the 20th century. He viewed occupational therapy as complementary to psychiatry, as it had the promise of meshing humanitarian values with science. Dunton became interested in the work of European moral therapy advocates. He accepted a position at the Sheppard Asylum, where it was standard practice in the early 1900s for patients to participate in activities such as bowling, gymnastics, art, etc. Dunton and his contemporaries called for the development of a theory to underlie the treatment known as “moral therapy” and “diversional occupation,” among other names. He called for therapists to devise outcome measures so that the neophyte profession would be given the attention and respect he felt it deserved.

Another important figure in the early days of occupational therapy was Susan Tracy, a nurse by trade, who organized activity-oriented classes for nurses at the Adams Nervine Asylum. In 1910, she published a textbook that was widely used for over 30 years. She is credited with expanding the realm of occupational therapy from psychiatric institutions to the homes of patients, which is an important setting in which today’s occupational therapists work. Upon breaking ties with the asylum, she set up her own institution, entitled the Experiment Station for the Study of Invalid Occupations. This training center educated nurses so they could gain control over their practice and not default to being dominated by physicians. By practicing privately in patients’ homes, this batch of occupational therapists expanded the domain of occupational therapy and began using OT to treat physical ailments as well as mental illness.

Herbert J. Hall was a physician with a strong work ethic and practical vision. He believed we could retract social ills by adapting the arts and crafts movement for medical purposes. A graduate of Harvard Medical School, he advised the government on wartime standards for occupational therapy during WWI. He introduced the concept of grading activities—now a hallmark of occupational therapy—to avoid exacerbating patient’s frustration and fatigue.

George Edward Barton, although trained as an architect, was instrumental in the organization of occupational therapy as a profession. A man of many talents and broad interests, he had friends of varied backgrounds. (Barton was the librettist of the first American opera produced at the Metropolitan Opera House in New York.) Barton knew from his own personal experience the effects illness could take on the body and spirit. He was diagnosed with tuberculosis in 1901. Later, while working as the principal architect of the Myron Stratton Home (Colorado Springs, Colorado) Barton contracted frostbite, which became gangrene. He subsequently had a partial amputation, and was also partially paralyzed on his left side. He went to Clifton Springs, New York, to recuperate. In addition to his physical weakness, he suffered from emotional depression. After intensive self-administered occupational therapy, his ailments were “cured”, if not completely, at least to the point where he was again able to contribute to society. He opened Consolation House in 1914, as the name suggests, as a sanctuary for people with physical disabilities. He played an integral part in forming the first national society by gathering together like-minded thinkers who became the profession’s leaders.

The first meeting of the National Society for the Promotion of Occupational Therapy was held in March 1917. Barton, Secretary Isabel Gladwin Newton (whom he later married), Eleanor Clark Slagle, William Rush Dunton Jr., Thomas B. Kinder, and Susan Cox Johnson were the only six in attendance. By the fall of 1919, at the third meeting, 300 attendees participated. In 1921, the name of the organization was changed to the American Occupational Therapy Association, and the first professional journal, the Archives of Occupational Therapy, began publication.


World War I forced the new profession to clarify its role in the medical domain and to standardize training and practice. In addition to clarifying its public image, OT also established clinics, workshops, and training schools nationwide. Due to the overwhelming number of wartime injuries, “reconstruction aides” (an umbrella term for physical therapists and occupational therapists) were recruited by the

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