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A brief history of OT in Canada (an Albertan focus)

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Developed by Anita Hamilton for teaching purposes at the UofA …

Developed by Anita Hamilton for teaching purposes at the UofA
in conjunction with Lynne Adamson
With support from Sharon Brintnell and Genevieve Pepin

Published in: Education, Health & Medicine

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  • March 1917 a group of people in the USA including doctors, nurses, architects, social workers, secretaries and teachers of arts and crafts were brought together by the notion that occupation could play an important role in healing and health (Dunton, 1918a, 1918b, as cited in Gordon, 2009) Formed the National Society for the Promotion of Occupational Therapy (NSPOT) later known as AOTA
  • While a social worker, Slagle became interested in the new field of occupational therapy, and in 1917 she conducted occupational therapy training courses at Hull House in Chicago. From 1918 to 1922, she directed occupational therapy research for the state of Illinois and then organized a therapy program for the state ’s mental hospitals. In 1922 she was named New York state director of occupational therapy, a post she held until her death. She demonstrated the first large-scale occupational therapy program for a state hospital system and also founded an annual training institute for state therapists that became a model for similar programs throughout the United States.
  • Goldwin Howland was born in Toronto, Ontario, in 1875 into a prominent family involved in both business and politics. Howland ’s grandfather, Sir William Pearce Howland, was the 2nd Lieutenant Governor of Ontario and a Father of Confederation. Howland’s father, William Holmes Howland, was a mayor of Toronto and through his mission of social reform helped Toronto acquire its nickname of “Toronto the Good”. Goldwin Howland’s wife, Margaret Carrington, was also involved in social reform efforts and volunteered with several charitable organizations. Howland’s family was likely an influence on his interest in helping those less fortunate. In 1900, Howland graduated with his bachelor of medicine from the University of Toronto, and later studied in London and Berlin in the field of neurology.  He became a prominent neurologist in Toronto, and eventually had the distinction of being named the first consulting neurologist in Canada. Howland ’s beginning interest in occupational therapy was likely sparked during his medical service in the First World War, where he was exposed to the rehabilitation of soldiers provided by occupational therapists, at that time called “ward aides” or “occupation aides”.  Howland must have found the therapy particularly useful, as he created an occupational therapy department at the Toronto General Hospital after the war in 1919. It was the first hospital in Canada to provide such service. During the 1920 ’s, Howland became a crucial force in the advancement and development of the profession of occupational therapy in Canada. He sat on the advisory board of the Ontario Society for Occupational Therapy (OSOT), and was the chairman of their first Educational Committee. He helped to establish the occupational therapy course at the University of Toronto in 1926. With the creation of the Canadian Association of Occupational Therapists (CAOT) also in 1926, he became its first president and remained in this position until 1948. Perhaps his most important contribution while President was the establishment of the Canadian Journal of Occupational Therapy in 1933. His goal for the journal was to unite the efforts of therapists across Canada, as well as to promote the benefits of the profession to others.
  • I ’ m Miss Marjorie Taylor, and here you see me wearing my first uniform. I volunteered as a ‘ Reconstruction aid ’ because I had heard that women were being sent to France to help out with wounded soldiers, many of whom were suffering from this new thing called ‘ neuroses ’ , which showed in ‘ tremors, facial tics, strange twistings of the head and body, partial paralysis, deafness, dumbness, stuttering, extreme depression, and many other symptoms ” (AOTA, 1991). I travelled to France in 1918, where I was appalled by both the scene I confronted, and the conditions we lived in. No one knew anything about occupational therapy, and only a few believed in this thing called ‘ reconstruction ’ . We had no facilities, no equipment, except our own tools and materials we had brought with us. We scavenged amongst the daily rubbish to find tins, timber, brown paper, anything that we could use for our painting, gardening, and craft activities. We had to prove that keeping these sad and deranged men busy would help to make them better. Slowly we converted the military men, and they started to support our efforts. Christensen, E. (1991). A proud heritage: the American Occupational Therapy Association at seventy-five . Rockville, Maryland: The American Occupational Therapy Association, Inc.  page 31
  • 1918: Foundations for the first Occupational Therapy training program developed at the university of Toronto for “ War Aides ” initially a 6 week program, which developed into a 3 month program. Developed by H.E.T. Haultain on behalf of the military. 1920: Canadian Society of Occupational Therapists of Manitoba and the Ontario Society of Occupational Therapists were founded 1922: TAOT founded 1926: (Canadian Association of Occupational Therap y ) CAOT formed 1932-34: OT program suspended at U of T for two years, September 1933 CJOT first edition 1939: CAOT gets its first office, WWII starts
  • I was injured in fighting in New Guinea, 1942, and transferred to the Army Hospital in Australia. This is a photo with my occupational therapist, Miss Hamel (Susie), in the occupational therapy workshop, taken in February, 1943. At first I couldn ’ t understand why she insisted that I make this basket (she said it would be a good gift for my mother, and I thought yes, this could be for Mothers ’ Day). Susie said I had to sit on the stool, and concentrate on using both arms to weave the cane. At first I hated this, my right arm was so shot to pieces that the pain was unbearable, and I hated the workshop and the basket. At least I could chat to the other blokes, and we had several cigarette breaks, when the occupational therapists or the workshop instructor wasn ’ t looking. But I also had to admit that I wouldn ’ t want to miss this morning activity – I was always the first waiting outside the door in the morning. Deep down I knew that my physical strength was improving, and that cane certainly makes a man use his hands. I had to balance on the stool, even though I was unsteady walking, and slowly I began to feel useful again.
  • Stan I ’ m a bit like Bill, being a result of the second world war. Here you see me with an occupational therapy student, Nina, who is helping me set up a weaving loom. You ’ ll see that I ’ m an ‘ amputee ’ – meaning I have lost part of my leg, blasted off in battle, as they say. After the initial time in hospital, I couldn ’ t cope with the idea of fronting up to the workshop, to practise using this strange device attached where I once had a leg. And to make it worse, here was a young girl trying to say I had to start weaving – and I ’ m a farmer, I shear the wool, not weave or knit it! But a man follows orders, and so day after day, this was my therapy. I gradually learned to stand, to walk and to move those foot pedals on the loom. Later I even learned to drive again, before returning home to the farm. Other blokes were doing woodwork, and some were even doing work around the hospital, you know, like gardening, clerical work or painting.
  • Helen Willard This is me, Helen holding the basket at a hospital in Illinois where I pioneered the idea that keeping patients involved in their life interests would assist in the rehabilitation process. You will know me through my text book, which I wrote with colleague, Clare Spackman to ensure that future generations of occupational therapists would build their learning on research and continue to record the dramatic changes in the profession. It is a learning tool to help you learn the shared principles and concepts of occupational therapy, and we prepared it “ with great pride in the past and confidence in the future of the profession ” (Willard & Spackman, 1971, p.vi).
  • 1939 Mary Wilson began the occupational therapy program in 1939 at the British Red Cross Convalescent Hospital for Brain Injuries, Middleton Park, England, noted as being "the first of its kind" (Occupational Therapy, English Hospital Appointment, 1941). 1939-45 CAOT stance on OTs working in rehabilitation of injured soldiers “Occupational therapy is therapeutic, not diversional or recreational, and thus, persons trained in short courses would not have the necessary background to work in war situations” 1943 enlistment occupational therapists could enlist in the Royal Canadian Army Medical Corps (RCAMC), in the division of the Nursing Corps. By the end of the war, of the 82 therapists, (including Thelma Dinsdale Cardwell), who had served in the Army, Navy or BEMS, 47 therapists had served overseas (Robinson, 1981). 1943 DVA Olive Whillans travelled the country supervising occupational therapists in Toronto, Montreal, Quebec City, Winnipeg, Halifax, Saint John, London, Vancouver and Calgary (e.g. Millar, 1942; Whillans, 1943) to support OTs providing occupational therapy in the hospitals of the Department of Pensions and National Health (Canada), later the Department of Veterans' Affairs (DVA). 1947 CJOT extends to four editions annually
  • In 1943 Muriel enlisted in the Royal Canadian Army Medical Corps, serving first as sole therapist at the Hamilton Military Hospital. This was followed by an overseas posting to the 22nd Canadian General Hospital in the United Kingdom as charge occupational therapist. Returning to Canada, she served at the Montreal Military Hospital as assistant to the charge therapist. Following discharge from the Army in 1946, Muriel organized the first occupational therapy department at Runnymede Hospital for the Chronically Ill in Toronto, and in 1948 she became supervisor of the occupational therapy department at The Hospital for Sick Children, Toronto. During her years at this hospital, Muriel attended the Warm Springs Foundation in Georgia and was awarded the post-graduate certificate in neuro-muscular disorders. In 1954 Muriel returned to Warm Springs as Director of Occupational Therapy and Instructor in the Post-Graduate School. Muriel accepted the challenge of organizing and directing the special Canadian Association of Occupational Therapists (CAOT) course in occupational therapy at Kingston in 1959 and served as Director of the School throughout its existence. When Queen ’s University established the occupational therapy educational program in 1967, Muriel was appointed Senior Lecturer, and at the time of her death in 1972 she was Assistant Professor and Senior Teacher in the Occupational Therapy Programme, School of Rehabilitation Therapy, Queens University, Kingston, Ontario. Muriel gave many years of service to the Canadian Association of Occupational Therapists, as a member of various committees, as chairman of several including the Education Committee, and as an elected member of the Board of Directors. As the Canadian Association of Occupational Therapists delegate to the World Federation of Occupational Therapists, she represented Canada on its Council and during part of her term served as Chairman of the World Federation of Occupational Therapists Publications Committee. In addition to these contributions, she was the author of numerous articles published in the Canadian Journal of Occupational Therapy and in the journals of other health-related professions. Her enthusiasm for the advancement of occupational therapy and the stimulation which she provided were sources of inspiration of students, therapists and personal friends. Copied directly from: http://www.caot.ca/default.asp?pageid=1357
  • Thelma was a major leader in the profession of Occupational Therapy, both in Canada and internationally. Graduating with a Diploma in Occupational Therapy from the University of Toronto in 1942, she held several clinical positions before her service as Lieutenant (OT) in the Royal Canadian Army Corps, in the U.K. 1944-45. Her academic career began upon her return to Toronto in 1945 and with one brief absence, she remained at U of T until she took early retirement in 1983. She held the position of Acting Director of Occupational Therapy from 1981-1983. She was the first OT, non-physician , woman to become president of the Canadian Association of Occupational Therapists (CAOT) in 1966.. She was President of the World Federation of Occupational Therapists from 1967 to 1972, and co-founder, Canadian Occupational Therapy Foundation and its Vice-President from1983 to 1985. Thelma was made a life member of the CAOT and Ontario Society of Occupational Therapists. She was a recipient of the Queen ’s Silver Jubilee medal in 1977, and Honorary Fellow, World Federation of Occupational Therapists. She was honoured by the Occupational Therapy Department at the University of Toronto and her many colleagues in the profession through the establishment of the Thelma Cardwell Lecture Series , at the University of Toronto in 1977. Her LLD was given by Dalhousie University.
  • Isobel graduated from the occupational therapy program at the University of Toronto in 1939. After an exciting practice career , she took on the Directorship of the program and held that position from 1967 to 1981, when she retired and was made a Professor Emerita. She has contributed to the profession as an Associate Editor of CJOT, and serving on the CAOT Board of Directors as both director and officer, and representing Canada on the Council of the WFOT. In 1981, Isobel was appointed the first archivist of CAOT. In 1983, with two occupational therapy colleagues, she founded the Canadian Occupational Therapy Foundation (COTF). Professor Robinson ’s work has been recognized with numerous honours and awards including the Muriel Driver Lectureship, which was bestowed on her in 1981. Along with long time colleagues and friends, Thelma Cardwell, Sharon Brintnell and Helen Madill, Professor Robinson authored and produced the video Fifty Years of Occupational Therapy in Canada. Her LLD is from University of Alberta.
  • 1952 WFOT “Preparatory Commission” Canada played a significant role in the establishment of the World Federation of Occupational Therapists, 1959 University of Manitoba 1960 University of Alberta 1961 UBC 1961, the name was changed from the Canadian Association of Occupational Therapy, to the Canadian Association of Occupational Therapists . 1966 Thelma Cardwell was elected as president of CAOT, becoming the first occupational therapist to hold this position in the Association. 1970 The University of Western Ontario it was during the 1960s that research became a stronger theme in the profession.
  • Willard, H.S. & Spackman, C.S. (1971). Occupational therapy. 4th Edn. Philadelphia: J.B.Lippincott. page 363.
  • There had been profound growth in the profession in many ways since the Second World War, with growing ranks among occupational therapists, the introduction of occupational therapy assistants, and the accompanying increase in educational programs. However, all this growth and change came at a cost, and some within the profession of occupational therapy felt that the profession had lost its moorings and had drifted from its originally charted course. Mary Reilly (1962) was one such voice (Figure 21.7). Reilly believed that the profession had lost its focus on occupation and challenged the profession to work more diligently toward understanding occupation from an interdisciplinary perspective, including recent findings in sociology, psychology, philosophy, economics, and biology. She called for a return to the founding belief of occupational therapy “that man through the use of his hands as they are energized by mind and will, can influence the state of his own health” (Reilly, 1962, p. 2). Citing recent research on sensory deprivation, Reilly (1962) postulated that the human nervous system requires a wide variety of stimuli to maintain healthy sensory processing and that occupation is the vehicle through which we may experience this basic need.
  • 1971 CAOT undergoes a review using KPM as consultants: decision to move to Ottawa (takes 20 years to achieve) revised Association structure and the formation of a National Panel of Consultants 1974 First board of National Directors 1974 WFOT Congress and Council meeting in Vancouver! 1975 The first Muriel Driver Memorial Lecture was delivered by Joy Huston Bassett 1977 The Maxwell report: Occupational Therapy: The Diffident Profession (Maxwell, 1977), explored concerns about the future of the profession and the potential roles of occupational therapy aides, assistants and technicians. Two sociologists, James and Mary Maxwell from Queen's University, completed their report in 1977, which informally became known as the Maxwell Report after its authors. The report's title drew on Thelma Cardwell's inaugural presidential address in which she encouraged occupational therapists to become more political and assertive: "We are too diffident a group, both individually and collectively" (Cardwell, 1966). Business decision-making: cost of membership, Journal appearance and increase advertising rates, 1970s OT education no longer in combined programs (except UBC which changed in 1983); All programs became degree programs and basic requirement for practice; Foreign trained OTs wanting to work in Canada; Women returning to work post-marriage and wanting refresher courses. Models: The profession was maturing and increasing efforts were being placed on articulating, expanding and researching viable theoretical foundations for practice. Medicare was now established nationally, and despite calls for occupational therapists to consider other models and practice settings, the medical model was firmly entrenched.
  • Sharon is a graduate from the University of Toronto program in physical and occupational therapy, and is an outstanding member of the faculty at the University of Alberta. She has been President of CAOT, Director of the Occupational Performance Analysis Unit, consultant to the National Institute of Disability Management and Research (NIDMAR) and has qualified in the Alberta Court of Queen ’s Bench as an expert in occupational performance and functional assessments. Professor Brintnell has played a major role in the creation and ongoing development of the Occupational Therapy Guidelines for Client-Centered Practice; chairing the volume on mental health and being a contributing author to Enabling Occupation: An Occupational Therapy Perspective, the next generation of the Guidelines. In 1983, largely through the efforts of Sharon Brintnell, a grant was received through the R.S. McLaughlin Examination and Research Centre in Edmonton to support funding for a national certification examination in Occupational Therapy. Her tremendous contributions were recognized when she was awarded the Muriel Driver Memorial Lecturership in 1985. Since 2000, she has been honorary treasurer of the World Federation of Occupational Therapists (WFOT), where she is playing an active role in occupational therapy development world-wide. Professor Brintnell is particularly interested in the impact of disability and handicap on productivity roles, the application of international community development strategies in community-based Rehabilitation (CBR) and international models of occupational therapy education and service.
  • WFOT André Forget was President of the WFOT from 1980-1986. Barbara Posthuma was elected Honorary Secretary of the WFOT in 1986 1981 International Year of Disabled Persons, Look Beyond . The song was written and performed by singer/songwriter, university lecturer and occupational therapist, Pat McKee. The Association developed guidelines for practice and revised standards for the education of occupational therapy students. The implementation of the National Certification Examination (NCE) enhanced the accountability of the profession. Due to the efforts by Sharon Brintnell a grant was received through the R.S. McLaughlin Examination and Research Centre in Edmonton to support funding of the project (Hawkes, 1985). First examination sat on July 7, 1986. Graduate programs, first developed in the 80's, Canada's first MScOT program offered at the University of Alberta in 1986, provided a foundation for Canadian occupational therapy research development. Occupational therapy practice, as noted in the Canadian Journal of Occupational Therapy (CJOT) articles and Muriel Driver lectures, reflected a return to the profession's historical emphasis on a holistic, mind-body-spirit perspective guided by the central organizing concepts of occupation and client-centred practice. 1987: first National OT week 1989 CAOT formed the client-centred practice committee
  • Elizabeth June Yerxa further extended this call to address our professional goals and status (Figure 21.8). Yerxa (1967/2005) noted that “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.” (p. 128). However, she warned that occupational therapy had often not met the challenge of the profession, simply being content to apply knowledge at the level of technical skills and interventions. Yerxa believed that the profession must focus on its unique assets, such as allowing the client to exercise choice in the engagement of “self-initiated, purposeful activity” (1967/2005, p. 134). Ultimately, the goal of practice is to provide “authentic occupational therapy” (1967/2005, p. 138). In achieving this goal, we may be truly committed to the client's goals, with a sincere involvement in their healing experience while establishing a mutual and meaningful relationship with our clients during their recovery process. This certainly remains a gold standard of practice to this day.
  • The task forces developed three publications: Guidelines for the Client-Centred Practice of Occupational Therapy , Intervention Guidelines for the Client-Centred Practice of Occupational Therapy and Toward Outcome Measures in Occupational Therapy (DNHW & CAOT, 1983; 1986; 1987). These publications were later consolidated into the 1991 edition of Occupational Therapy Guidelines for Client-Centred Practice (Guidelines) (CAOT, 1991).
  • discussed the need for the profession to continue to develop a paradigm of occupation that takes into account the active nature of the human adaptive process with attention to ongoing research concerning developmental and social theory. This need continues to be a focus of Gary Kielhofner's (2002) work in the form of the model of human occupation. Since publication of the first edition of his book in 1985, Kielhofner and his colleagues have been working to further the scientific understanding of the human need for occupation and its application to the practice of occupational therapy. The model of human occupation has kept an eye on the past, striving for a holistic perspective in the endeavor to understand human occupation, while incorporating contemporary theories and concepts. The model of human occupation respects the past while incorporating current knowledge formations.
  • Gary Kielhofner, in his CAOT Annual Conference keynote address, The Demise of Diffidence: An Agenda for Occupational Therapy (1985), reinforced the Association's efforts at building a strong profession through the development of core principles, values, and theories and stated that, "efforts must extend well beyond direct intervention" (p. 165). He called for outcomes, clarification of occupational therapy service, increased clinical and basic research, identification and support for the basic values of the profession, and the organization of a knowledge base around a single unifying concept of occupation. Madill highlighted the area of health promotion as outlined in the report, Achieving Health for All: A Framework for Health Promotion (Epp, 1986) as "an opportunity that can't be missed" (1987a, p.110). In keeping with the health promotion policy directives at the time, Barb Quinn (1988) identified the need for expanded roles beyond that of clinician to those of consultant, educator, and planner. She also predicted the need for more trained and supervised auxiliary staff to support the work of occupational therapists in a growing diversity of service areas. Occupational therapists were encouraged to expand their scope of influence to the attention of "administrators, politicians, the public and other health professionals by taking a global interest in the world around us" (Campbell, 1983, p. 158). As Brintnell stated in the 60th anniversary edition of CJOT , "Occupational therapy practice cannot be divorced from social issues that affect the lives of clients" (1986, p.43). She challenged therapists to expand their awareness of population growth trends and health and social service delivery patterns. In keeping with this theme, Madill later presented the expectation that, "By the end of the decade, the profession's opinion is being sought during the development of national health and social services policy" (1988, p. 116).
  • CAOT's strong positioning with the Federal Government in the previous decade was rewarded in 1990 with funding of $1.25 million from the Seniors Independence Program of Health & Welfare Canada for the Seniors Health Promotion Project entitled Responding to the Challenge of Aging Population . Both the Occupational Therapy Guidelines for Client-Centred Practice and the Canadian Occupational Performance Measure (COPM) gained international recognition throughout the 90's. By 2001, the COPM was used in over 25 countries, and either the measure and manual or the measure were translated into 20 languages. (Law, October 1, 2001, personal communication). From 1994 until 1997, the CAOT Client-Centred Practice Committee developed new guidelines through a national collaboration of occupational therapists representing administrative, clinical, consulting, educational and research perspectives from across Canada (CAOT, 1997). The result: Enabling Occupation: An Occupational Therapy Perspective . Pressure to provide evidence of occupational therapy's value by linking outcomes with costs mounted over the decade as competition increased for both public and private funding in health care. CAOT responded by publishing a special issue of CJOT on evidence-based practice in 1998 and conducting a study to explore occupational therapists perception of evidence-based practice (Dubouloz, Egan, Vallerland & von Zweck, 1999). A Joint Position Statement on Evidence-Based Occupational Therapy (CAOT, Association of Canadian Occupational Therapy University Programs, Association of Canadian Occupational Therapy Regulatory Organizations and President's Advisory Council, 1999) was developed soon afterwards along with further resources such as A Programme Evaluation Workbook for Occupational Therapists: An Evidence-based Practice Tool (1999).
  • Elizabeth graduated from the University of Toronto with a Diploma in Physical and Occupational Therapy in 1967 and a Bachelor of Science in Occupational Therapy in 1979. She received a Master ’s degree in Adult Education from Saint Francis Xavier University, Antigonish, Nova Scotia, and her Ph.D., from Dalhousie University in 1994. She is a founding member of the School of Occupational Therapy at Dalhousie University, Halifax, Nova Scotia, and later became Director. In 1993 she was the Muriel Driver Memorial Lecturer. She has been Chairperson of CAOT’s Client-Centered Practice Committee since 1990, has been a key contributor to all the generations of the Occupational Therapy Guidelines for Client-Centered, including Enabling Occupation: An Occupational Therapy Perspective. Most recently she has been co-authoring, with Dr. Helene Polatajko, the sequel to the enabling document for the Canadian Association of Occupational Therapists. This was a national initiative that captured the latest developments in occupational therapy practice, research and education through national consultation, and is destined to shape occupational therapy practice, not only in Canada, but around the world. Elizabeth is a past Thelma Cardwell Lecturer at U of T.
  • The autonomous therapist During the 1990's many occupational therapists moved from traditional, hospital settings to community-based practices embracing new roles, such as consultants to municipalities and case managers in insurance companies. In some instances this was due to drastic cuts in public health spending resulting in hospital closures and increased stress from expanding caseloads, but it also occurred as services were transferred to the community and alternative funding for private practices increased. Some occupational therapists were leaving health care altogether and using their enabling occupation perspective to carve out new opportunities. CAOT membership statistics report that in). In 1993, CAOT President Carole Mirkopoulos described this shift as a "de-institutionalization of the profession." 1996, CAOT revised its Academic Accreditation Standards to address the expanded practice environment of occupational therapists and the new teaching methods and philosophies appearing in the educational programs
  • Death of Thomas B. Kidner JournalPsychiatric QuarterlyPublisherSpringer NetherlandsISSN0033-2720 (Print) 1573-6709 (Online)IssueVolume 6, Number 3 / September, 1932DOI10.1007/BF01586392Page569Subject CollectionMedicineSpringerLink DateMonday, May 16, 2005
  • Transcript

    • 1. Occupational therapyOccupational therapythen and nowthen and nowTracing the origins of occupational therapy:Mapping the futureDeveloped by Anita HamiltonDeveloped by Anita Hamiltonin conjunction with Lynne Adamsonin conjunction with Lynne AdamsonWith support from Sharon Brintnell andWith support from Sharon Brintnell andGenevieve PepinGenevieve Pepin
    • 2. Aims:Aims:►Provide information about history of theProvide information about history of theprofessionprofession►Encourage thinking about your place in theEncourage thinking about your place in theprofessionprofession’’s futures future►Create awareness of the development ofCreate awareness of the development ofphilosophical and theoretical perspectivesphilosophical and theoretical perspectives
    • 3. Why bother with history?Why bother with history?►Occupational therapyOccupational therapy’’s place in a widers place in a widerworld - medical, social, historicalworld - medical, social, historical►Conceptual development - theories guidingConceptual development - theories guidingcurrent practicecurrent practice►Learning from historyLearning from history►Your place in history and the futureYour place in history and the future
    • 4. When did thinking aboutWhen did thinking aboutoccupation begin?occupation begin?►2600BCChinese believed that “disease was causedby organic inactivity and thus used physicaltraining for the promotion ofhealth…”(Hopkins 1988, p 16).►1000BCPersians used physical training to prepareyoung men for military duty
    • 5. Philosophy and occupationPhilosophy and occupation►Greek philosophers Socrates (400B.C) and Plato (347 B.C)- the relationship between physical statusand mental health Hippocrates (359 B.C), Galen (200 A.D)- founders of medicine,- recommended exercise as a means ofrecovering from illness
    • 6. Play and work…Play and work…►Play, games and recreationPart of all primitive life - toys, drawings, sculpturesfound in excavations - Egypt, Babylonia, China,Aztecs, Incas►3400 BCEgyptian men of leisure still engaged in outdoorwork, not idle all day►17ADLivy - “Toil and pleasure in their nature oppositesare linked together in a kind of necessaryconnection”
    • 7. Inca leisure occupationsInca leisure occupationsSource: http://www.mexicolore.co.uk/uploadimages/133_00_2.jpg
    • 8. 1780s France1780s France►Moral treatmentPinel introduced work in an asylum for theinsane: “humane treatment”►Injury and diseaseFrench cavalry used crafts and recreationalactivities for disabilities of muscles andjoints following disease or injury
    • 9. Source: http://www.epicidiot.com/thisday/images/pinel.jpg
    • 10. Developing sciencesDeveloping sciences►The Enlightenment: 18The Enlightenment: 18ththCenturyCentury Moving from tradition, irrationality,Moving from tradition, irrationality,superstition and tyrannysuperstition and tyranny emphasised reason, science and rationalityemphasised reason, science and rationality
    • 11. Occupational therapy beginningsOccupational therapy beginnings► 1880s The settlement house concept begins in England► 1892 Dr. Adolf Meyer, a psychiatrist, reported that "the properuse of time in some helpful and gratifying activity appeared to bea fundamental issue in the treatment of the neuropsychiatricpatient”► 1895 William Rush Dunton, Jr., "Father of OccupationalTherapy," psychiatrist fitted a metalworking shop for thetreatment of patients.► 1895 Mary Potter Brooks Meyer, (Meyers wife), a socialworker, introduced a systematic type of activity into the wards ofa state institution in Worcester, Massachusetts.► 1904 Dr. Herbert J. Hall began to prescribe occupation for hispatients as medicine to regulate life and direct interest. He calledthis the "work cure."► 1905 Susan E. Tracy noticed in her training as a nurse thebenefits of occupation in relieving nervous tension and makingbedrest more tolerable for patients.Source: http://www.recreationtherapy.com/history/rthistory2.htm ; Gordon, 2009, p.206)
    • 12. The founders of occupational therapyThe founders of occupational therapyBack row (L to R): William Rush Dunton, Isabelle Newton, and Thomas Bessell Kidner.Front row (L to R): Susan Cox Johnson, George Edward Barton, and Eleanor Clarke Slagle.(Gordon, 2009, p. 206)
    • 13. Eleanor Clarke SlagleEleanor Clarke Slagle► A Social Worker whobecame interested in thenew field of occupationaltherapy► Conducted Generaloccupational therapytraining at Hull House,Chicago► 1922 NY state director ofOT► First large-scale OTprogram for a state hospitalsystem
    • 14. Adolf MeyerAdolf MeyerMeyer (1922) noted that just asour heart beats in a rhythm,so do we respond to thegreater rhythms of day andnight, sleeping and waking,and hunger and satiation, allcentered on the fundamentalactivities of human life: “workand play and rest and sleep”(p. 8).These ideas remain astouchstones of occupationaltherapy thought and practiceto this day.Adolf Meyer, renowned psychobiologistand author of The Philosophy ofOccupation Therapy (1922).(Gordon, 2009, p. 207)
    • 15. Thomas B. KidnerThomas B. Kidner► Architect► Immigrated to Canada from England in 1900► 1915 Vocational Secretary of MilitaryCanadian Military Hospitals Commission► 1918 loaned by the Canadian government tothe US as advisor on the voc. rehab. ofwounded soldiers► Took an active interest in the organizationand development of the AmericanOccupational Therapy Association andserved for six years as its president.► From 1926 to the time of his death conducteda private consulting business in hospitalarchitecture.(No Author, 1932/1995)
    • 16. The Badge (1919)Foreshadows the 1990’sPer Mentem Et ManusAd SaniatemThrough Mind and HandTo HealthTriangle:Mind, Body and Spirit1919
    • 17. Goldwin HowlandGoldwin Howland► Born in Toronto, 1875► Family in business & politics► Studied medicine► Became a neurologist► Served in WWI as a medical officer Where he witnessed “War Aides” in action► Set up the first OT department in Canada in 1919► Became a crucial force in the advancement of OTin Canada► Part of group to establish the OT course at UofT in1926► Established the CJOT in 1933
    • 18. The influence of war…The influence of war…WWI 1914 - 1918WWI 1914 - 1918►Reconstruction Aides- “bedside occupations” for woundedsoldiers- Eleanor Clarke Slagle directed the trainingof 4000 aides for the American ArmedServices
    • 19. ““ReconstructionReconstruction”” as an ideaas an ideaReconstruction aides in official uniformcapes of grey with maroon lining(Gordon, 2009, p. 208) (Christensen, 1991, p.31)
    • 20. WWII 1941 - 1944WWII 1941 - 1944►Improved medicineImproved medicine- greater survival- greater survival- greater disability- greater disability►Occupational therapy focus shifted toOccupational therapy focus shifted toenable returned soldiers return toenable returned soldiers return toproductivity.productivity.The influence of war…The influence of war…
    • 21. Occupational therapy in CanadaOccupational therapy in Canadafill in the gaps…fill in the gaps…Name the pivotal events inoccupational therapy inCanada for these years: 1918 1920 1922 1926 1932-34 September 1933 1939
    • 22. If we were in……If we were in……19391939…………► OT offered its services for injuredOT offered its services for injuredsoldiers of World War II.soldiers of World War II.““A profession established during anA profession established during anearlier war was now grown, and readyearlier war was now grown, and readyto contribute again.to contribute again.””► Growing interest in vocational trainingGrowing interest in vocational trainingand industrial therapy programsand industrial therapy programs
    • 23. Therapeutic use of activityTherapeutic use of activity(Anderson & Bell, 1988, p.83)
    • 24. Adapted tasks for rehabilitationAdapted tasks for rehabilitation(Anderson & Bell, 1988, p.183)
    • 25. Wilma WestWilma WestWilma L. West, head of orthopedics occupational therapy, Walter Reed GeneralHospital, Washington, DC, 1943-1944, founder of the American OccupationalTherapy Foundation and president from 1972 to 1982. She was also president ofAOTA from 1961 to 1964 and Eleanor Clarke Slagle lecturer in 1967.(Gordon, 2009, p. 209)
    • 26. Helen WillardHelen Willard(Christensen, 1991, p.33)American Association pioneers Helen Willard andSidney Bottner at the E.D. Hines, Jr. Hospital,Maywood, Illinois, 1924.
    • 27. Advertisement forthe first edition ofWillard &SpackmansOccupationalTherapy.Price: $4.50(Gordon, 2009, p. 209)
    • 28. (Cockburn, 2001)
    • 29. The 1940sThe 1940s 1939: who was Mary Wilson? 1939-45: What was the CAOT stance on OT forwar rehab? 1943: Who got DVA services up and running? 1947: how many editions of CJOT were producedannually?Name the pivotal events inoccupational therapy in Canada forthese years:
    • 30. Muriel DriverMuriel Driver► 1943 Enlisted in the RCAMP Sole therapist for Hamilton Military Hospital Overseas posting in the UK► 1946 organized first OT dep’t at RunnymeadeHospital, Toronto► 1948 Supervisor of OT dep’t at Hospital forsick kids Toronto► 1959 director of the CAOT OT program atKingston► 1967 Senior Lecturer at Queens UniversityOT program► Many years of service to CAOT & WFOThttp://www.caot.ca/default.asp?pageid=1357(Cockburn, 2001)
    • 31. Thelma CardwellThelma Cardwell► Graduated from the U of T in 1942► Had a range of clinical positions before her serviceas a Lieutenant (OT) in the Royal Canadian ArmyCorps 1944-45► Lengthy academic career 1945-1983► President of CAOT 1966► President WFOT 1967-1972► Co-founder of the Canadian Occupational TherapyFoundation (funding scholarship and research)► Thelma Cardwell Lecture series named after her in1977
    • 32. Isobel RobinsonIsobel Robinson► Graduated from the U of T in 1939► Director of the Uof T program 1967 –1981► Associate editor of CJOT► CAOT board of directors► First archivist for CAOT► Co-founder of COTF► Muriel Driver lectureship 1981► Co-authored and produced thevideo “Fifty years of OccupationalTherapy in Canada”
    • 33. The 1950s and 1960sThe 1950s and 1960sName the pivotal events inoccupational therapy inCanada for these years: 1952 1959 1960 1961 1966 1970 What theme emerged in the1960s in the OTprofession?
    • 34. Kitchens as a place of interestKitchens as a place of interest(Anderson & Bell, 1988, p.171)(Cockburn, 2001)
    • 35. Working with childrenWorking with children(Willard & Spackman, 1971, p.363)
    • 36. Mary ReillyMary Reilly…challenged the professionto work more diligentlytoward understandingoccupation from aninterdisciplinaryperspective, includingfindings in oranizationaltheory, sociology,psychology, philosophy,economics, and biology.(Gordon, 2009, p.211)
    • 37. The 1970sThe 1970s► 1971► 1974► 1974► 1975► 1977► Examples of being more “businesslike” Changes to education of OTs Provincial Legislation Emerging talk about models of practiceName the pivotal events in occupationaltherapy in Canada for these years:
    • 38. Sharon BrintnellSharon Brintnell► Past president CAOT► Muriel Driver lectureship in 1985► Director of the OPAU at the UofA► Consultant to the National Institute ofDisability Management and Research► Pivotal role in development of OTguidelines for client-centred practice► Secured the grant to develop thenational certification examination inOT► Active role in developing OT in SaudiArabia, Indonesia,► Past honorary treasurer WFOT► Current president WFOT
    • 39. The 1980sThe 1980s► 1981 International Year of Disabled Persons► Revised standards for education of occupationaltherapy students► 1983 (May 17) Canadian Occupational TherapyFoundation (COTF) spearheaded by KarenGoldenberg► 1983-1986 Development of the NationalCertification Examination► Graduate programs Canadas first MScOT program offered at theUniversity of Alberta in 1986
    • 40. Elizabeth YerxaElizabeth Yerxa…warned that occupationaltherapy had often not met thechallenge of the profession…Yerxa believed that theprofession must focus on itsunique assets, such asallowing the client to exercisechoice in the engagement of“self-initiated, purposefulactivity”(Gordon, 2009, p.211)
    • 41. The 1980s continued…The 1980s continued…► Return to historicalemphasis on holistic mind-body-spirit perspectivefocusing on occupationand client-centred practice► 1987: First ever NationalOT week► 1983: Development ofnationally-based, genericguidelines for the practiceof occupational therapy
    • 42. Gary KielhofnerGary Kielhofner► …influenced by Reillyand Yerxa…► discussed the need forthe profession to continueto develop a paradigm ofoccupation that takes intoaccount the active natureof the human adaptiveprocess with attention toongoing researchconcerningdevelopmental and socialtheoryPicture source: http://tinyurl.com/nxecm8
    • 43. The 1980s were busy!The 1980s were busy!►The Guidelines represented the initialstage in formulating the Canadian Modelof Occupational Performance (CMOP)►CAOT formed the Client-Centred PracticeCommittee in 1989►This decade featured work in the areas ofsocial and political activism by theprofession and development of a strongprofessional identity
    • 44. The 1990sThe 1990s► Mary Law chaired a committee to develop anoutcome measure based on the Guidelines: Their work resulted in the development of theCanadian Occupational Performance Measure(COPM) in the 1990s.► Sharon Brintnell chaired a committee to developthe Occupational Therapy Guidelines For Client-Centred Mental Health Practice Published in 1993.
    • 45. The 1990sThe 1990s► Health promotion on the agenda► CMOP and COPM being used widely in Canadaand Internationally► COPM translated into 20 different languages► 1997: Enabling Occupation: An OccupationalTherapy Perspective was published► Evidence of “practice efficacy” being called for Emergence of the EBP era
    • 46. Elizabeth TownsendElizabeth TownsendFounding member of the schoolof occupational therapy atDalhousie UniversityChairperson of CAOT’s client-centred Practice Committeesince 1990Key contributor to the “EnablingOccupation” textsKey figure in the OccupationalScience movement in Canadaand InternationallyMuriel Driver Memorial Lecturer1993.
    • 47. 1990s –1990s – “de-institutionalization“de-institutionalizationof the profession”of the profession”►1990: 3.4% of the membership was self-employed; this figure jumped to 23.1% by2000 (CAOT, 2001)►October 26, 1995: CAOT moves to Ottawa►1996: The Profile of Occupational TherapyPractice in Canada developed to describeoccupational therapy practice in Canada.►1996: CAOT revised its AcademicAccreditation Standards
    • 48. Into the new millenniumInto the new millennium► 1998: WFOT Council Meeting was held in Ottawaand the Congress in Montreal (3500 delegates from 55 countries)► 1998: CAOT launches its first website► 2000: Occupational therapy was regulated in eachprovince.
    • 49. Michael IwamaMichael Iwama► Developed the culturallysensitive Kawa model critical work on culture andcritical work on culture andits implications forits implications forknowledge, theory andknowledge, theory andpractice in Occupationalpractice in OccupationalTherapyTherapy"No matter what model one uses,its important to try to appreciatewhat daily life looks like through theeyes of the client." - Michael Iwama
    • 50. Into the new millenniumInto the new millennium►2001: CAOT members given unlimitedaccess to OTDBASE►2008: Profile of Occupational Therapy andeducation Accreditation standards revisedand updated►2008: Sharon Brintnell becomes presidentof WFOT►2009: Liz Taylor becomes president ofCAOT►2009: CAOT members given access toBJOT, JOS and Work (journals)
    • 51. Assistance to countries developingAssistance to countries developingoccupational therapy services,occupational therapy services,educational programs & CBReducational programs & CBR► Scotland (1920) CAOT► Venezuela (1955) E.S Brintnell► Vietnam (1980) WHO► Indonesia (1989-95) University of Alberta► Bosnia- Herzegovina(1997) Queens University► Russia (1992) University of Western Ontario
    • 52. Canadian Leadership to theCanadian Leadership to theprofessionprofessionWFOTPresidentThelma Cardwell (1967 -72)Andrée Forget (1981-86)Sharon Brintnell (2008-Vice PresidentGillian Crawford (1952-1954)Andrée Forget (1981-86)Secretary – TreasurerThelma Cardwell (1958 -1964)SecretaryBarbara Postuma (1986-1996)TreasurerSharon Brintnell (1998 – 2008)
    • 53. Alberta Leadership to theAlberta Leadership to theProfessionProfessionCAOTPresidentSharon Brintnell*Helen Madill*Elizabeth Taylor*Heather ChiltonLorna ReimerElizabeth TaylorSecretarySharon Brintnell*Elizabeth Taylor*AAROT#PresidentHelen Madill*Elizabeth Taylor**U of A Faculty Members#AAROT becomes ACOT and SAOT
    • 54. Occupational therapy hasOccupational therapy hasemerged as profession that is:emerged as profession that is:Strongly foundedClient-centredEvidence-basedCost-effectiveDiversifyingEvolving
    • 55. What about in…What about in… 2029?2029?► Where will you be?Where will you be?► What will the world be like?What will the world be like?► What will occupational therapyWhat will occupational therapybe offering to health care andbe offering to health care andbroader society?broader society?► What area of work will interestWhat area of work will interestyou?you?► How many of you will be…How many of you will be… managers of servicesmanagers of services educatorseducators influencing policy/a politicianinfluencing policy/a politician VirtualVirtual therapiststherapists
    • 56. ReferencesAnderson, B. & Bell, J. (1988). Occupational therapy: its place in Australia’shistory. Sydney: NSW Association of Occupational Therapists.Bearup, C. (1996). Occupational therapists in wartime. Adelaide: AustralianAssociation of Occupational Therapists (SA).Clark Greene, M., Lertvilai, M., & Bribriesco, K. (2001). Prospering throughchange: CAOT from 1991 to 2001. Occupational Therapy Now, 3(6), 13-19. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)Cockburn, L. (2001a). The greater the barrier, the greater the success:CAOT during the 1940s. Occupational Therapy Now, 3(2), 15-18.*access from the internet (http://www.caot.ca/default.asp?pageid=1041)Cockburn, L. (2001b). The professional era: CAOT in the 1950s & 1960s.Occupational Therapy Now, 3(3), 5-9. *access from the internet (http://www.caot.ca/default.asp?pageid=1041)Cockburn, L. (2001c). Change, expansion and reorganization: CAOT in the1970s. Occupational Therapy Now, 3(4), 3-6. *access from the internet(http://www.caot.ca/default.asp?pageid=1041)
    • 57. ReferencesChristensen, E. (1991). A proud heritage: the American Occupational TherapyAssociation at seventy-five. Rockville, Maryland: The American OccupationalTherapy Association, Inc.  Friedland, J., Robinson, I., & Cardwell, T. (2001). In the beginning: CAOT from1926-1939. Occupational Therapy Now, 3(1), 15-19. *access from the internet(http://www.caot.ca/otnow/jan01-eng/jan01-history.cfm)Gordon, D., M. (2009). The History of Occupational Therapy. In E. B. Crepeau, E.S. Cohn & B. A. Boyt Schell (Eds.), Willard and Spackmans OccupationalTherapy (11 ed., pp. 202-215). Philadelphia: Lippincott, Williams & Wilkins.No Author. (1932/2005). Death of Thomas B. Kidner. Psychiatric Quarterly 6(3),569. DOI: 10.1007/BF01586392Johnson, S. (2010). Where good ideas come from. Accessed fromhttp://www.ted.com/talks/steven_johnson_where_good_ideas_come_from.htmlon 20 September 2010. TED TalksTrentham, B. (2001). Diffident no longer: Building structures for a proudprofession. CAOT in the 1980’s. Occupational Therapy Now, 3(5), 3-7. *accessfrom the internet (http://www.caot.ca/default.asp?pageid=1041)University of Toronto (ND). Occupational Science and Occupational Therapy,Illustrious Occupational Therapy Graduates from U of T. accessed fromhttp://www.ot.utoronto.ca/about/past_ots.asp on September 18, 2009.Willard, H.S. & Spackman, C.S. (1971). Occupational therapy. 4th Edn.Philadelphia: J.B.Lippincott.

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