Occupational therapy (OT) is the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. It is an allied health profession performed by occupational therapists and Occupational Therapy Assistants. OTs often work with people with mental health problems, disabilities, injuries, or impairments.
The American Occupational Therapy Association defines an occupational therapist as someone who "helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, injury rehabilitation, and providing supports for older adults experiencing physical and cognitive changes."
Typically, occupational therapists are university-educated professionals and must pass a licensing exam to practice. Occupational therapists often work closely with professionals in physical therapy, speech therapy, audiology, nursing, social work, clinical psychology, and medicine.
US Navy Occupational therapists providing treatment to outpatients
The earliest evidence of using occupations as a method of therapy can be found in ancient times. In c. 100 BCE, Greek physician Asclepiades treated patients with a mental illness humanely using therapeutic baths, massage, exercise, and music. Later, the Roman Celsus prescribed music, travel, conversation and exercise to his patients. However, by medieval times the use of these interventions with people with mental illness was rare, if not nonexistent.
In 18th-century Europe, revolutionaries such as Philippe Pinel and Johann Christian Reil reformed the hospital system. Instead of the use of metal chains and restraints, their institutions used rigorous work and leisure activities in the late 18th century. This was the Moral Treatment era, developed in Europe during the Age of Enlightenment, where the roots of occupational therapy lie. Although it was thriving in Europe, interest in the reform movement fluctuated in the United States throughout the 19th century. It re-emerged in the early decades of the 20th century as Occupational Therapy.
The Arts and Crafts movement that took place between 1860 and 1910 also impacted occupational therapy. In the US, a recently industrialized country, the arts and crafts societies emerged against the monotony and lost autonomy of factory work. Arts and crafts were used as a way of promoting learning through doing, provided a creative outlet, and served as a way to avoid boredom during long hospital stays.
Eleanor Clarke Slagle (1870-1942) is considered to be the “mother” of occupational therapy. Slagle, who was one of the founding members of the National Society for the Promotion of Occupational Therapy (NSPOT), proposed habit training as a primary occupational therapy model of treatment. Based on the philosophy that engagement in meaningful routines shape a person's wellbeing, habit training focused on creating structure and balance between work, rest and leisure. Although habit training was initially developed to treat individuals with mental health conditions, its basic tenets are apparent in modern treatment models that are utilized across a wide scope of client populations.
In 1915 Slagle opened the first occupational therapy training program, the Henry B. Favill School of Occupations, at Hull House in Chicago. Slagle went on to serve as both AOTA president and secretary. In 1954, AOTA created the Eleanor Clarke Slagle Lectureship Award in her honor. Each year, this award recognizes a member of AOTA “who has who has creatively contributed to the development of the body of knowledge of the profession through research, education, and/or clinical practice.”
The health profession of occupational therapy was conceived in the early 1910s as a reflection of the Progressive Era. 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. The National Society for the Promotion of Occupational Therapy (NSPOT), now called the American Occupational Therapy Association (AOTA), was founded in 1917 and the profession of Occupational Therapy was officially named in 1921. William Rush Dunton, one of the founders of NSPOT and visionary figure in the first decades of the profession struggled with "the cumbersomeness of the term occupational therapy", as it lacked the "exactness of meaning which is possessed by scientific terms". Other titles such as "work-cure","ergo therapy"(ergo being the greek root for "work"), and "creative occupations" were discussed as substitutes, but ultimately, none possessed the broad meaning that the practice of occupational therapy demanded in order to capture the many forms of treatment that existed from the beginning.
The emergence of occupational therapy challenged the views of mainstream scientific medicine. Instead of focusing purely on the medical model, occupational therapists 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 physical therapy, 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 supporting theories. By the early 1930s, AOTA had established educational guidelines and accreditation procedures.
The early twentieth century was a time in which the rising incidence of disability related to industrial accidents, tuberculosis, World War I, and mental illness brought about an increasing social awareness of the issues involved. The entry of the United States into World War I was also a crucial event in the history of the profession. Up until this time, occupational therapy had been concerned primarily with the treatment of people with mental illness. However, U.S. involvement in the Great War 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. With entry into World War II and the ensuing skyrocketing demand for occupational therapists to treat those injured in the war, the field of occupational therapy underwent dramatic growth and change. Occupational therapists needed to be skilled not only in the use of constructive activities such as crafts, but also increasingly in the use of activities of daily living.
There was a struggle to keep people in the profession during the post-war years. Emphasis shifted from the altruistic war-time mentality to the financial, professional, and personal satisfaction that comes with being a therapist. To make the profession more appealing, practice was standardized, as was the curriculum. Entry and exit criteria were established, and the American Occupational Therapy Association advocated for steady employment, decent wages, and fair working conditions. Via these methods, occupational therapy sought and obtained medical legitimacy in the 1920s. The 1920s and 1930s were a time of establishing standards of education and laying the foundation of the profession and its organization. Eleanor Clarke Slagle proposed a 12-month course of training in 1922, and these standards were adopted in 1923. Educational standards were expanded to a total training time of 18-months in 1930 to place the requirements for professional entry on par with those of other professions. The first textbook was published in United States for occupational therapy in 1947, edited by Helen S. Willard and Clare S. Spackman. The profession continued to grow and redefine itself in the 1950s. The profession also began to assess the potential for the use of trained assistants in the attempt to address the ongoing shortage of qualified therapists, and educational standards for occupational therapy assistants were implemented in 1960. The 1960s and 1970s were a time of ongoing change and growth for the profession as it struggled to incorporate new knowledge and cope with the recent and rapid growth of the profession in the previous decades. New developments in the areas of neurobehavioral research led to new conceptualizations and new treatment approaches, possibly the most groundbreaking being the sensory integrative approach developed by A. Jean Ayers.
The profession has continued to grow and expand its scope and settings of practice. Occupational science, the study of occupation, was created in 1989 as a tool for providing evidence-based research to support and advance the practice of occupational therapy, as well as offer a basic science to study topics surrounding "occupation". In addition, occupational therapy practitioner's roles have expanded to include political advocacy (from a grassroots base to higher legislation); for example, in 2010 PL 111-148 titled the Patient Protection and Affordable Care Act had a habilitation clause that was passed in large part due to AOTA's political efforts as noted in AOTA's Centennial website (AOTA, 2017) at http://www.otcentennial.org/events/2010. Furthermore, occupational therapy practitioners have been striving personally and professionally toward concepts of occupational justice and other human rights issues that have both local and global impacts. The World Federation of Occupational Therapist's Resource Centre has many position statements on occupational therapy's roles regarding their participation in human rights issues at http://www.wfot.org/ResourceCentre.aspx.
The philosophy of occupational therapy has evolved over the history of the profession. The philosophy articulated by the founders owed much to the ideals of romanticism, pragmatism and humanism, which are collectively considered the fundamental ideologies of the past century.
One of the most widely cited early papers about the philosophy of occupational therapy was presented by Adolf Meyer, a psychiatrist who had emigrated to the United States from Switzerland in the late 19th century and who was invited to present his views to a gathering of the new Occupational Therapy Society in 1922. At the time, Dr. Meyer was one of the leading psychiatrists in the United States and head of the new psychiatry department and Phipps Clinic at Johns Hopkins University in Baltimore, Maryland.
William Rush Dunton, a supporter of the National Society for the Promotion of Occupational Therapy, now the American Occupational Therapy Association, sought to promote the ideas that occupation is a basic human need, and that occupation is therapeutic. From his statements came some of the basic assumptions of occupational therapy, which include:
These assumptions have been developed over time and are the basis of the values that underpin the Codes of Ethics issued by the national associations. The relevance of occupation to health and well-being remains the central theme.
In the 1950s, criticism from medicine and the multitude of disabled World War II veterans resulted in the emergence of a more reductionistic philosophy. While this approach led to developments in technical knowledge about occupational performance, clinicians became increasingly disillusioned and re-considered these beliefs. As a result, client centeredness and occupation have re-emerged as dominant themes in the profession. Over the past century, the underlying philosophy of occupational therapy has evolved from being a diversion from illness, to treatment, to enablement through meaningful occupation.
Three commonly mentioned philosophical precepts of occupational therapy are that occupation is necessary for health, that its theories are based on holism and that its central components are people, their occupations (activities), and the environments in which those activities take place. However, there have been some dissenting voices. Mocellin, in particular, advocated abandoning the notion of health through occupation as he proclaimed it obsolete in the modern world. As well, he questioned the appropriateness of advocating holism when practice rarely supports it. Some values formulated by the American Occupational Therapy Association have been critiqued as being therapist-centric and do not reflect the modern reality of multicultural practice.
In recent times occupational therapy practitioners have challenged themselves to think more broadly about the potential scope of the profession, and expanded it to include working with groups experiencing occupational injustice stemming from sources other than disability. Examples of new and emerging practice areas would include therapists working with refugees, children experiencing obesity, and people experiencing homelessness.
An occupational therapist works systematically with a client through a sequence of actions called the occupational therapy process. There are several versions of this process as described by numerous scholars. All practice frameworks include the components of evaluation (or assessment), intervention, and outcomes.This process provides a framework through which occupational therapists assist and contribute to promoting health and ensures structure and consistency among therapists.
The Occupational Therapy Practice Framework (OTPF) is the core competency of occupational therapy in the United States.The OPTF framework is divided into two sections: domain and process. The domain includes environment, client factors, such as the individual's motivation, health status, and status of performing occupational tasks. The domain looks at the contextual picture to help the occupational therapist understand how to diagnose and treat the patient. The process is the actions taken by the therapist to implement a plan and strategy to treat the patient.
The Canadian Model of Client Centered Enablement (CMCE) embraces occupational enablement as the core competency of occupational therapy and the Canadian Practice Process Framework (CPPF) as the core process of occupational enablement in Canada.The Canadian Practice Process Framework (CPPF) has eight action points and three contextual element which are: set the stage, evaluate, agree on objective plan, implement plan, monitor/modify, and evaluate outcome. A central element of this process model is the focus on identifying both client and therapists strengths and resources prior to developing the outcomes and action plan.
According to the American Occupational Therapy Association’s (AOTA) Occupational Therapy Practice Framework: Domain and Process, 3rd Edition (OTPF-3), an occupation is defined as any type of meaningful activity in which one engages in order to “occupy” one's time. These occupations can be goal-directed, task-oriented, purposeful, culturally relevant, role specific, individually tailored, and/or community-oriented, depending on one’s values, beliefs, context, and environment. The following are examples of such occupations:
According to the 2015 Salary and Workforce Survey by the American Occupational Therapy Association, occupational therapists work in a wide-variety of practice settings including: hospitals (26.6%), schools (19.9%), long term care facilities/skilled nursing facilities (19.2%), free-standing outpatient (10.7%), home health (6.8%), academia (6.1%), early intervention (4.6%), mental health (2.4%), community (2), and other (15%). Recently, there is a trend of OTs moving towards working in the hospital setting and in the long-term care facilities/skilled nursing facilities setting, comprising 46% of the OT workforce.
The Canadian Institute for Health Information (CIHI) found that between 2006-2010 nearly half (45.6%) of occupational therapists worked in hospitals, 31.8% worked in the community, and 11.4% worked in a professional practice.
The broad spectrum of OT practice makes it difficult to categorize the areas of practice, especially considering the differing health care systems globally. In this section, the categorization from the American Occupational Therapy Association is used.
In 1951, Joan Erikson became director of activities for the “severely disturbed children and young adults” at the Austen Riggs Center. At that time, “occupational therapy” was used “for keeping patients busy on useless tasks.” Erikson “brought in painters, sculptors, dancers, weavers, potters and others to create a program that provided real therapy.”
Occupational therapists work with infants, toddlers, children, and youth and their families in a variety of settings including schools, clinics, and homes. Occupational therapists assist children and their caregivers to build skills that enable them to participate in meaningful occupations. These occupations may include: feeding, playing, socializing, and attending school.
Occupational therapists work in the school setting as a related service for children with an Individual Education Plan (IEP). “Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes.” As a related service, occupational therapists work with children with varying disabilities to address those skills needed to access the special education program and support academic achievement and social participation throughout the school day (AOTA, n.d.-b). In doing so occupational therapists help children to fulfill their role as students and prepare them to transition to post-secondary education, career and community integration (AOTA, n.d.-b). Occupational therapists have specific knowledge to increase participation in school routines throughout the day, including: • Modification of the school environment to allow physical access for children with disabilities • Provide assistive technology to support student success • Helping to plan instructional activities for implementation in the classroom • Support the needs of students with significant challenges such as helping to determine methods for alternate assessment of learning • Helping students develop the skills necessary to transition to post-high school employment, independent living and/or further education (AOTA, n.d.-a)
The practice area of Health and Wellness is emerging steadily due to the increasing need for wellness-related services in occupational therapy. A connection between wellness and physical health, as well as mental health, has been found; consequently, helping to improve the physical and mental health of clients can lead to an increase in overall well-being.
Mental health and the moral treatment era have been recognized as the root of occupational therapy. According to the World Health Organization, mental illness is one of the fastest growing forms of disability. OTs focus on prevention and treatment of mental illness in all populations. In the U.S., military personnel and veterans are populations that can benefit from occupational therapy, but currently this is an under served practice area.
Mental health illnesses that may require occupational therapy include schizophrenia and other psychotic disorders, depressive disorders, anxiety disorders, eating disorders, trauma- and stressor-related disorders (e.g. post traumatic stress disorder or acute stress disorder), obsessive-compulsive and related disorders such as hoarding, and neurodevelopmental disorders such as autism spectrum disorder, attention deficit/hyperactivity disorder and learning disorders.
Occupational therapists work with older adults to maintain independence, participate in meaningful activities, and live fulfilling lives. Some examples of areas that occupational therapists address with older adults are driving, aging in place, low vision, and dementia or Alzheimer's Disease (AD). When addressing driving, driver evaluations are administered to determine if drivers are safe behind the wheel. To enable independence of older adults at home, occupational therapists perform falls risk assessments, assess clients functioning in their homes, and recommend specific home modifications. When addressing low vision, occupational therapists modify tasks and the environment. While working with individuals with AD, occupational therapists focus on maintaining quality of life, ensuring safety, and promoting independence.
Visual impairment is one of the top 10 disabilities among American adults. Occupational therapists work with other professions, such as optometrists, ophthalmologists, and certified low vision therapists, to maximize the independence of persons with a visual impairment by using their remaining vision as efficiently as possible. AOTA’s promotional goal of “Living Life to Its Fullest” speaks to who people are and learning about what they want to do, particularly when promoting the participation in meaningful activities, regardless of a visual impairment. Populations that may benefit from occupational therapy includes older adults, persons with traumatic brain injury, adults with potential to return to driving, and children with visual impairments. Visual impairments addressed by occupational therapists may be characterized into 2 types including low vision or a neurological visual impairment. An example of a neurological impairment is a cortical visual impairment (CVI) which is defined as “...abnormal or inefficient vision resulting from a problem or disorder affecting the parts of brain that provide sight”. The following section will discuss the role of occupational therapy when working with the visually impaired.
Occupational therapy for older adults with low vision includes task analysis, environmental evaluation, and modification of tasks or the environment as needed. Many occupational therapy practitioners work closely with optometrists and ophthalmologists to address visual deficits in acuity, visual field, and eye movement in people with traumatic brain injury, including providing education on compensatory strategies to complete daily tasks safely and efficiently. Adults with a stable visual impairment may benefit from occupational therapy for the provision of a driving assessment and an evaluation of the potential to return to driving. Lastly, occupational therapy practitioners enable children with visual impairments to complete self care tasks and participate in classroom activities using compensatory strategies.
Occupational therapists address the need for rehabilitation following an injury or impairment. When planning treatment, occupational therapists address the physical, cognitive, psychosocial, and environmental needs involved in adult populations across a variety of settings.
Occupational therapy in adult rehabilitation may take a variety of forms:
Because of the rising need for occupational therapists in the U.S., many facilities are opting for travel occupational therapists—who are willing to travel, often out of state, to work temporarily in a facility. Assignments can range from 8 weeks to 9 months, but typically last 13–26 weeks in length. Most commonly (43%), travel occupational therapists enter the industry between the ages of 21–30.
Occupational therapists work with clients who have had an injury and are returning to work. OTs perform assessments to simulate work tasks in order to determine best matches for work, accommodations needed at work, or the level of disability. Work conditioning and work hardening are interventions used to restore job skills that may have changed due to an illness or injury. Occupational therapists can also prevent work related injuries through ergonomics and on site work evaluations.
The practice area of occupational justice relates to the “benefits, privileges and harms associated with participation in occupations” and the effects related to access or denial of opportunities to participate in occupations. This theory brings attention to the relationship between occupations and health. The skills of an occupational therapist enable them to serve as advocates for systemic change, impacting institutions, policy, and entire populations. Examples of populations that experience occupational injustice include:
For example, the role of an occupational therapist working with refugees could include:
As occupational therapy (OT) has grown and developed, community based practice has blossomed from an emerging area of practice to a fundamental part of occupational therapy practice (Scaffa & Reitz, 2013). Community based practice allows for OTs to work with clients and other stakeholders such as families, schools, employers, agencies, service providers, stores, day treatment and day care and others who may influence the degree of success the client will have in participating. It also allows the therapist to see what is actually happening in the context and design interventions relevant to what might support the client in participating and what is impeding her or him from participating. Community-based practice crosses all of the categories within which OTs practice from physical to cognitive, mental health to spiritual, all types of clients may be seen in community based settings. The role of the OT also may vary, from advocate to consultant, direct care provider to program designer, adjunctive services to therapeutic leader.
In contrast, occupational injustice relates to conditions wherein people are deprived, excluded or denied of opportunities that are meaningful to them.Types of occupational injustices and examples within the OT practice include:
Within occupational therapy practice, injustice may ensue in situations wherein professional dominance, standardized treatments, laws and political conditions create a negative impact on the occupational engagement of our clients. Awareness of these injustices will enable the therapist to reflect on his own practice and think of ways in approaching their client’s problems while promoting occupational justice.
Worldwide, there is a range of qualifications required to practice occupational therapy. Requirements can range from a bachelor’s degree (e.g. Australia), a master’s degree (e.g. Canada) and more recently an Occupational therapy doctorate (OTD) is becoming more common (e.g. United states). Additionally, in the United States, there is also an option to become a certified occupational therapy assistant (COTA), which can be achieved from completing an associates degree from an accredited educational program. It can be noted that the educational requirement to have a doctoral degree for practice in occupational therapy is not required until 2027 in the United States, and practitioners with a lesser degree achieved before 2027 will be grandfathered into practice. In conjunction with the educational component of occupational therapy education, there exists a fieldwork component for all educational programs which is a requirement to achieve a degree in OT. All OT education program include periods of clinical education and fieldwork practicing with evaluation and treatment of clients in various clinical settings. Some examples of fieldwork experience include but are not limited to working with stroke patients in rehabilitation hospitals, developmental treatment with children in the community, working with olders adults with dementia in skilled nursing homes, and mental health settings. The profession of occupational therapy is based on a wide theoretical and evidence based background. The OT curriculum focuses on the theoretical basis of occupation through multiple facets of science, including occupational science, anatomy, physiology, biomechanics, and neurology. In addition, this scientific foundation is integrated with knowledge from psychology, sociology and more. All of the educational programmes around the world need to meet the minimum standard of the World Federation of Occupational Therapy (WFOT). The WFOT concerns that occupational therapists will have access to further professional education, higher degrees and post professional training. Occupational therapists are also participating in research in various areas of practice. In the United States, Canada and other countries around the world, there is a licensure requirement. In order to obtain OT license, the Occupational therapists need to graduate from an accredited OT educational program, complete their fieldwork requirements and to apply and pass national certification examination.
Occupational therapists use theoretical frameworks to frame their practice. Note that terminology differs between scholars. An incomplete list of theoretical bases for framing a human and their occupations include the following:
Generic models are the overarching title given to a collation of compatible knowledge, research and theories that form conceptual practice. More generally they are defined as "those aspects which influence our perceptions, decisions and practice".
Occupation-Focused Practice Models
Frames of reference are so called as they are an additional knowledge base for the Occupational Therapist to develop their treatment and/or assessment of a patient or client group. Though there are conceptual models (listed above) that allow the therapist to conceptualise the Occupational Roles of the patient, it is often important to use further reference to embed Clinical Reasoning. Therefore, many Occupational Therapists (OTs) will use additional Frames of Reference to both assess and then develop therapy goals for their patients and/or service users.
The International Classification of Functioning, Disability and Health (ICF) is a framework to measure health and ability by illustrating how these components impact one's function. This relates very closely to the Occupational Therapy Practice Framework, as it is stated that "the profession's core beliefs are in the positive relationship between occupation and health and its view of people as occupational beings". The ICF is built into the 2nd edition of the practice framework. Activities and participation examples from the ICF overlap Areas of Occupation, Performance Skills, and Performance Patterns in the framework. The ICF also includes contextual factors (environmental and personal factors) that relate to the framework's context. In addition, body functions and structures classified within the ICF help describe the client factors described in the Occupational Therapy Practice Framework. Further exploration of the relationship between occupational therapy and the components of the ICIDH-2 (revision of the original International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which later became the ICF) was conducted by McLaughlin Gray.
It is noted in the literature that occupational therapists should use specific occupational therapy vocabulary along with the ICF in order to ensure correct communication about specific concepts. The ICF might lack certain categories to describe what occupational therapists need to communicate to clients and colleagues. It also may not be possible to exactly match the connotations of the ICF categories to occupational therapy terms. The ICF is not an assessment and specialized occupational therapy terminology should not be replaced with ICF terminology. The ICF is an overarching framework for current therapy practices.
Activities of daily living (ADLs or ADL) is a term used in healthcare to refer to people's daily self care activities. The concept of ADLs was originally proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, OH and has been added to and refined by a variety of researchers since that time. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status, particularly in regard to people post injury, with disabilities and the elderly. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.
Common ADLs include feeding ourselves, bathing, dressing, grooming, work, homemaking, cleaning oneself after defecating and leisure. A number of national surveys collect data on the ADL status of the U.S. population. While basic definitions of ADLs have been suggested, what specifically constitutes a particular ADL for each individual may vary. Adaptive equipment and devices may be used to enhance and increase independence in performing ADLs.American Journal of Occupational Therapy
The American Journal of Occupational Therapy is a bimonthly peer-reviewed medical journal that is published by the American Occupational Therapy Association. It covers research practice and health care issues in the field of occupational therapy.American Occupational Therapy Association
The American Occupational Therapy Association (AOTA) is the national professional association established in 1917 to represent the interests and concerns of occupational therapy practitioners and students and improve the quality of occupational therapy services. AOTA membership is approximately 63,000 occupational therapists, occupational therapy assistants, and students.
The National Society for the Promotion of Occupational Therapy was the founding name of the AOTA.Anna Jean Ayres
Anna Jean Ayres (January 18, 1920 – December 16, 1988) was an American occupational therapist, educational psychologist and advocate for individuals with special needs. She became known for her work on sensory integration (SI) theory.Elizabeth Casson
Elizabeth Casson (14 April 1881 – 17 December 1954) was a British doctor and an occupational therapy pioneer. Initially training as a secretary, Casson began studying medicine at the University of Bristol when she was 32. She received her medical degree in 1926, becoming the first woman to receive one from the University of Bristol. She also attained the Gaskell prize from the Royal Medico-Psychological Association and a diploma in psychological medicine from the University of London.
Casson set up a residential clinic for women with mental disorders at Dorset House in Bristol in 1929 with enough residential space for 800 patients, and she opened the first school of occupational therapy in the UK in the same building the following year. She took an active role in the therapeutic activities at Dorset House, even playing a part in the patient's production of Pride and Prejudice.
Casson moved control of the school to a non-profit company in 1948, remaining as vice-chairman and medical director. She created the Elizabeth Casson Trust in 1949, intended to improve occupation therapy education and treatment. In 1951, Casson was awarded an OBE for her work at Dorset House and was also made an honorary fellow of the World Federation of Occupational Therapists. A memorial lecture was set up in her name, and psychiatric unit was named after her at Callington Road Hospital.Elnora M. Gilfoyle
Elnora M. Gilfoyle (born 1934) is a retired American occupational therapist, researcher, educator, and university administrator. She worked at several hospitals before accepting a professorship at Colorado State University, later serving as Dean of the College of Applied Human Sciences and Provost/Academic Vice President at that university. She is also a past president of the American Occupational Therapy Association. With research interests in child development, developmental disabilities, and child abuse, she has led studies on the state and federal levels. The co-author of two books and many articles, she was inducted into the Colorado Women's Hall of Fame in 1996.Goniometer
A goniometer is an instrument that either measures an angle or allows an object to be rotated to a precise angular position. The term goniometry is derived from two Greek words, gōnia, meaning angle, and metron, meaning measure.
The first description of a goniometer, derived from the astrolabe, was apparently in 1538, by Gemma Frisius.Management of domestic violence
The management of domestic violence deals with the treatment of victims of domestic violence and preventing repetitions of such violence. The response to domestic violence in Western countries is typically a combined effort between law enforcement, social services and health care. The role of each has evolved as domestic violence has been brought more into public view.
Historically, domestic violence has been viewed as a private family matter that need not involve the government or criminal justice. Police officers were often reluctant to intervene by making an arrest, and often chose instead to simply counsel the couple and/or ask one of the parties to leave the residence for a period of time. The courts were reluctant to impose any significant sanctions on those convicted of domestic violence, largely because it was viewed as a misdemeanor offense.The modern view in industrialized countries is that domestic violence should be viewed as a public matter and all criminal authority should be involved; that once the violence is reported it should be taken seriously. Further, supports need to be put in place to restore the victim's safety and respect, which often includes the efforts of the person who did the harm.Nursing home care
Nursing homes, also known as old people's homes, care homes, rest homes, and convalescent homes, provide residential care for elderly or disabled people that often includes around-the-clock nursing care. Often these terms have slightly different meanings in the same or different English-speaking countries to indicate that the institutions are public or private or provide mostly assisted living or more or less nursing care and emergency medical care. A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home.in the nursing home facility nurses have the responsibility of caring for the patients medical needs and also the the responsibility of being in charge of other employees, depending on ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. Some nursing homes also provide short-term rehabilitative stays following surgery, illness, or injury. Services may include physical therapy, occupational therapy, or speech-language therapy. Nursing homes also offer other services, such as planned activities and daily housekeeping. Nursing homes may also be referred to as convalescent care, skilled nursing or a long-term facility. Nursing homes may offer memory care services.Occupational apartheid
Occupational apartheid is the concept in occupational therapy that different individuals, groups and communities can be deprived of meaningful and purposeful activity through segregation due to social, political, economical factors and for social status reasons.
Occupational apartheid may occur due to race, disability, age, gender, sexuality, religious preference, political preference, and creed. A war environment can also contribute to occupational apartheid in which the constraints of war prevent the people living in the midst of combat from accessing past occupations. Occupational therapists recognize that many people facing occupational apartheid do not have the opportunity to freely choose their occupations, and thus are disadvantaged. The health and wellbeing of these individuals, groups and communities is compromised through the deprivation of meaningful and purposeful activities.
In the light of day to day existence, every individual should be of equal status, no matter what their economic, political, health or social status. Occupational apartheid explains the reality that some people may be occupationally more equal than others.Occupational science
Occupational science is a discipline in the social and behavioral sciences dedicated to the study of humans as "doers" or "occupational beings". As used here, the term "occupation" refers to the goal-directed activities that characterize daily human life as well as the characteristics and patterns of purposeful activity that occur over lifetimes as these affect health and well-being.Occupational therapist
An occupational therapist (OT) works with a client to help them achieve a fulfilled and satisfied state in life through the use of "purposeful activity or interventions designed to achieve occupational outcomes which promote health, prevent injury or disability to develop, improve, sustain or restore the highest possible level of independence."A practical definition for OT can also be illustrated with the use of models such as the Occupational Performance Model (Australia), known as the OPM(A). At the core of this approach is the ideology that occupational therapists are concerned with the occupations of people and how these contribute to health. Specifically it is a person's occupational performance that influences their health and personal satisfaction of their individual needs. The OPM(A) is constructed on the following definition of Occupational Performance:
The ability to perceive, desire, recall, plan and carry out roles, routines, tasks and sub-tasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of the internal and/or external environment.
It can be seen that occupational performance, the roles it creates for a client, and the areas it can encompass are so far-reaching that an occupational therapist can work with a wide range of clients of various limitations who are being cared for in an array of settings. Occupational therapy is about helping people do the day-to-day tasks that "occupy" their time, sustain themselves, and enable them to contribute to the wider community. It is these opportunities to "do", which occupational therapy provides, that prove important and meaningful to the health of people.Occupational therapy in the United Kingdom
This article discusses occupational therapy (OT) in the United Kingdom.Rehabilitation (neuropsychology)
Rehabilitation of sensory and cognitive function typically involves methods for retraining neural pathways or training new neural pathways to regain or improve neurocognitive functioning that has been diminished by disease or trauma.
Three common neuropsychological problems treatable with rehabilitation are attention deficit/hyperactivity disorder (ADHD), concussion, and spinal cord injury. Rehabilitation research and practices are a fertile area for clinical neuropsychologists and others.Samuel Merritt University
Samuel Merritt University (SMU) is a private, non-profit, fully accredited health sciences institution located on the Summit campus of the Alta Bates Summit Medical Center in Oakland, California, United States. The University offers undergraduate degrees in nursing and graduate degrees in nursing, physical therapy, physician assistant, occupational therapy, and podiatric medicine. SMU is an affiliate of the Sutter Health Network and Alta Bates Summit Medical Center. It is the only provider of physical therapists, occupational therapists, and physician assistants and is the largest source of nurses in the greater East Bay. Formerly known as Samuel Merritt College, it was founded in 1909 as a hospital school of nursing.Sensory integration therapy
Sensory integration therapy is based on A. Jean Ayres' Sensory Integration Theory.Sensory processing disorder
Sensory processing disorder (SPD; also known as sensory integration dysfunction) is a condition where multisensory integration is not adequately processed in order to provide appropriate responses to the demands of the environment.
Sensory integration was defined by occupational therapist Anna Jean Ayres in 1972 as "the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment". Sensory processing disorder has been characterized as the source of significant problems in organizing sensation coming from the body and the environment and is manifested by difficulties in the performance in one or more of the main areas of life: productivity, leisure and play or activities of daily living.Sources debate whether SPD is an independent disorder or represents the observed symptoms of various other, more well-established, disorders. SPD is not recognized by the Diagnostic and Statistical Manual of the American Psychiatric Association, and the American Academy of Pediatrics has recommended that pediatricians not use SPD as a diagnosis.Splint (medicine)
A splint is defined as “a rigid or flexible device that maintains in position a displaced or movable part; also used to keep in place and protect an injured part” or as “a rigid or flexible material used to protect, immobilize, or restrict motion in a part”. Splints can be used for injuries that are not severe enough to immobilize the entire injured structure of the body. For instance, a splint can be used for certain fractures, soft tissue sprains, tendon injuries, or injuries awaiting orthopedic treatment. A splint may be static, not allowing motion, or dynamic, allowing controlled motion. Splints can also be used to relieve pain in damaged joints. Splints are quick and easy to apply and do not require a plastering technique. Splints are often made out of some kind of flexible material and a firm pole-like structure for stability. They often buckle or Velcro together. There is no difficult removal practice.St. Ambrose University
St. Ambrose University is a private, coeducational, liberal arts university affiliated with the Roman Catholic Diocese of Davenport. It is located in a residential area of Davenport, Iowa, United States.
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