Updated: Jul 2
Where did occupational therapy (OT) come from?
Before we dive into the definition of Occupational Therapy, I would like to shed some light on the beginnings of the profession. Most professions have been in existence for a long time and progressed over centuries. OT is one of the more recent professions but has been around for a little over a century in the United States. OT emerged in the midst of the moral treatment era in the 1790s. The moral treatment was an approach to treat those with mental illness and was developed by Phillipe Pinel, a French physician, and William Tuke, an English Quaker. Both men believed in the humane treatment of people with mental health issues. Pinel advocated for the use of meaningful occupations to address emotions thus improving performance in activities of daily living. Further reading about the moral treatment can be found at Strategies for Better Functioning, LLC http://www.betterfunctioning.com/occupational-therapy/history-of-occupational-therapy/.
In the 1800s, America integrated the moral treatment approach in hospitals by using arts
and crafts to engage clients to promote relaxation and productivity. However, during World War 1 and 2, there was a shift from the use of arts and crafts to increased use of activities of daily living in order to return wounded soldiers to independence. The National Society for Promotion of Occupational Therapy (now known as AOTA) was formed by William Rush Dunton Jr., a psychiatrist, and educator. William who is also known as "the father of occupational therapy" stressed the importance of using daily activities for treatment. Check out https://www.myotspot.com/history-of-occupational-therapy for more detailed historical information.
Providers continued to treat people using activities of daily living (ADLs) and instrumental activities of daily living (IADLs). In the 1900s, the profession started to be recognized and needed, which led to the establishment of formal education. Eleanor Clark Slagle, "the mother of occupational therapy" is credited for starting the first education program. Professional organizations were already underway to further research and to provide support for practitioners.
Occupational therapy definition
Occupational Therapy (OT) is a health profession intended to help people do all the things they need to do, are required to do, and want to do to get through their day. This help can be provided via consultation, direct skills training, and education. The term “occupation” refers to the daily activities we purposefully engage in and that are meaningful to us. These activities or occupations are divided into areas. The areas include:
(1) Self-care tasks such as bathing, feeding, showering, getting around, and so on.
(2) Productive roles taking place
at home and in the community - such as home management, food preparation, shopping, taking care of children and pets, money management, driving, and safety
at school - homework, assignments, and extracurricular activities
at work - pursuing and maintaining employment, volunteer work, and preparing for retirement
(3) Pursuing interests, participating in leisure activities such as hobbies, and socializing
(4) Sleep or rest
(5) And finally, health management or our ability to manage our health is paramount to being able to engage in any activity
Information obtained from the Occupational Therapy Practice Framework: Domain and Process Fourth Edition.
Where can you find OT?
Occupational therapy services are provided in a variety of settings, across lifespans and ages. The service delivery within settings can be of a medical model, educational model, or community model. Adult to geriatric-specific settings include adult day programs, skilled nursing homes, independent and assisted living facilities, and workplace rehabilitation.
Pediatric-specific based settings include the neonatal unit, early intervention (home-based or educational for 0-3 years old), school-based, and prevocational programs. Hospitals, outpatient clinics, private clinics, home health, mental health community, health and wellness, transition or residential programs, academic & research, and hospice settings address both pediatric and adult populations. All of these settings focus on educating and helping the clients or patients improve, regain or develop skills for daily functional and meaningful living.
clients or patients include:
- People who have experienced physical trauma
- People who want to work on health and wellness
- People who could benefit from mental health treatment and prevention services
- Children or youth with developmental delays, autism, genetic syndromes, ADHD, learning disorders, praxis/motor planning deficits, anxiety, etc. BrainWings, LLC serves youth exclusively for OT and wellness services https://www.brainwingsmo.com/
- Adults in workplaces
What happens in Occupational Therapy?
OT helps people carry out daily activities that are important and meaningful to them. Therapy can include one-on-one or group training, modification of the environment, compensatory techniques or strategies, the use of adaptive equipment, and education/consultation services for prevention, and to improve independence and success.
In one-on-one or group training, there can be different levels of therapeutic activity used. (1) Preparatory - exercise or use of modalities e.g. using a swiss ball for arm range of motion and electrical stimulation, (2) Purposeful -activity mimicking the occupation such as stacking plates by size or using tweezers to pick up plastic letters, and (3) Occupation-based - the actual daily task such as organizing glasses and plates into a kitchen shelf or writing with a pencil. Compensatory strategies, adaptive equipment, and modifications can be used as needed. The end goal is always to engage the client/patient in occupation-based activities or the therapeutic use of daily activities in order to improve their functional independence. The focus of occupational therapy is to improve daily living skills if they are weak, develop skills if they are delayed, regain skills if one is injured, or provide education and strategies in order to promote health and prevent impairment.
What can I expect during the occupational therapy process?
There are two ways in which the process can be started. If there is a question as to whether an individual might benefit from services, screening can be done to determine if an OT evaluation is warranted. A referral can also be made if areas of deficits have been clearly identified. Prior to intervention, you should expect an evaluation that reviews your health history and discusses your abilities, limitations, and goals. With the client, family/parent, or caregiver input, therapy uses all the information gathered to create a custom plan to help you reach your goals. Other professional evaluations might also be considered in the evaluation process, e.g. psychological findings, speech therapy findings, visual or hearing exams, and so on.
On-going evaluation occurs, progress or lack thereof is noted, and goals are modified or discontinued as needed. Discharge planning occurs as the patient progresses and discharge takes place once goals are met.
In conclusion, OT strives to promote health and wellbeing by easing participation and performance in daily activities that are meaningful to an individual. Hopefully, this article has helped simplify the definition of occupational therapy.