2. Time line
1900: US Population Increases
Progressive era fuels reform
Increase of women in the work place
1917: US enters WWI
1919: WWI ends (Treaty of Versailles)
1920: Women gain the right to vote
1929: Great depression
3. Women’s Movement and Influence
Goal: establish selves outside of domestic sphere
Arguments for women in professional roles:
Morally superior
Naturally nurturing
Alturistic
Reform impulses
Christian charity
Helping the poor or “the suffering”
Gender roles clearly defined within this period
Men: Leadership in the public sector
Women: Establish institutes
4. Hull House
Established by Jane Addams
and Ellen Gates Starr
All female and secular society
Goal: Bridge gap between
middle-class reformers and the
poor
Education
Improvement using skills training
Meeting house for supporters of
contemporary social
movements
Chicago Arts and Crafts Society
5. “This emphasis on the work ethic and on the idea
that idleness produces an immoral character
appears to have been intimately linked to early
occupational therapy philosophy and to the
arts-and-crafts movement or anti-modernism” -
(Gutman,1995, p.259)
6. Anti-Modernism
Reaction to industrialism, emphasis on hand-made
products
Equated idle hands with immoral character
Linked to the arts & crafts movement, appreciation
for meaning in simplicity (Transcendentalism)
7. Arts and Crafts Movement
British roots
“humans, not machines, completed objects;
therefore, work was not abstracted from life but had
a place at its very core” -Ruskin
Relevance to American happenings
Machine “gimcrackery”
8. Arts & Crafts Reaches America
Quality of design
Natural materials
Handmade designs
Simple in design
Quality of life
“handicraft clubs”
“arts-and-crafts societies”
9. Meanwhile in Medicine…
Advances
Shift towards a scientific foundation
“Disease was understood in terms of physiological
processes rather than in terms of suffering or
personal disorientation; specialists concerned
themselves with organs and tissues rather
than the whole patient” (Levin, 1987, p. 249)
10. Alternative Medical Approach
Dr. Herbert J. Hall
Work cure
Adolf Meyer, Mary Potter
Brooks Meyer, and William
Rush Dunton
Curative occupation
Goal-directed activity
Julia Lathrop
Susan Tracy
Nursing
11. “These progressive physicians, Meyer, Hall, and
Dunton, worked with social caretakers Lathrop and
Tracy to link the holistic treatment of the past
with the modern, scientific approaches” (Levin,
1987, p. 250)
12. Sheltered Workshops
Items sold in shops
Three purposes
Employ talented people who could earn a living by making
authentic objects
To give spiritual support to craftspeople who pursued crafts as
an avocation
To help employ the mentally and physically handicapped
13. “The early occupational therapy link to the arts-and-
crafts movement did not end with the demise of the
therapeutic workshop.”
14. Slagle and Meyer Unite
Belief that life should become as routine as
possible
Meyer’s research on the “unbalanced” cycles of
schizophrenia
Habit training= practice model Meyers and Slagle
when at Henry Phipps Clinic at John Hopkins
15. Habit Training
Habit
Balance of Formation
occupational as a
cycles learning
process
Sequence of Ha
bi
occupational tT
ra
in
cycles in
g
16. Roots of Rehabilitation in War
US Army rehabilitation program based on
English reconstruction model
“Bedside occupation and curative workshops”
Army Division of Orthopedics
British colonel Robert Jones’
Orthopedic rehabilitation back in war
Society’s social & moral responsibility
17. Reconstruction Aides
1918: Walter Reed Hospital (DC), Orthopedic
Department uses physiotherapists &
occupational therapists
“The employment of reconstruction aides [is]
inadvisable […] it is not desirable to employ
women in this type of work in military
hospitals”
Commanding officers begin to call for more
18. Evolution of reconstruction aides
Requirements established for R.A. position
Educational training (medical disabilities, anatomy,
physiology)
Demonstrate 3 fields occupation (crafts)
Reasons for pursuing career:
Economic necessity
Contribute something to society
Experienced
ACTIVITIES OF MEANING, PURPOSE
19. The Fight of Reconstruction Aides
ORTHOPEDISTS
RECONSTRUCTION
AIDES: VOCATIONAL
Physiotherapists, OTs EDUCATORS
NURSES
21. Elizabeth Upham
Started 1st OT program at Milwaukee Downer
College
Taught
Intensive work in crafts
Lectures covering medical, psychology, sociology, economics
and theory
Hospital practice training
22. Elizabeth Upham
Believed in moral character improvement through
purposeful activity
Established the program to align OT with stronger
medical affiliation and offered more structured
course work to gain more credibility for the
profession
23. Elizabeth Upham
Suggested a person “who becomes an independent
wage-earner adds to the resource of the country,
while every one who cannot increases the drain of
dependents” (p.259, Gutman, 1995).
24. Organizations
National Society for promotion of Occupational
Therapy
First meeting in 1917
Only six people attended: George E. Barton, Isabel Newton,
Eleanor Clark Stagle, William Dunton Jr, Thomas Kinder and Susan
Cox Johnson
By 3rd meeting in 1919 300 people attended
Changed name to AOTA in 1921
25. Academia
First issue of Archives of Occupational Therapy
published in 1922 by AOTA
Later became known as American Journal of
Occupational Therapy (AJOT)
26. Federal Industrial Rehabilitation Act
Passed in 1923
Mandated hospitals that were caring for people with
industrial injuries or illness to use OT
Program goal is to allow disabled individuals to be
“restored to useful, remunerative employment and to self-
respecting, self-supporting lives” (Clark, 1945, p. 504)
27. Contributions we see now…
Women’s Movement
Arts and Crafts Movement
Multidisciplinary
Holistic
AOTA
Standardization
Curriculum
Balance
28. References
Crark, D. (1945). Industrial hygiene and the expandable federal state vocational
rehabilitation program. American Journal of Public Health, 35, 504
Ajenda Interactive Media (2009). Jane Addams Hull House Association: History.
Retrieved from http://www.hullhouse.org/aboutus/history.html
Gutman, S.A.(1995). Influence of the U.S. military and occupational therapy
reconstruction aides in World War I on the development of occupational therapy. The
American Journal of Occupational Therapy, 49 (3), 256-262.
Levine, R. (1987). The influence of the arts-and-crafts movement on the professional
status of occupational therapy. The American Journal of Occupational Therapy, 41 (4),
248-254.
Quiroga, V. A. M. (1995). Occupational therapy: the first 30 years 1900-1930. Bethesda,
Maryland: American Occupational Therapy Association.
Reed, K.L,& Sanderson, S.N. (1999). Concepts of occupational therapy. p.238-241.
Philadelphia: Lippincott Williams & Wilkins
Photos found in Google Image Searches (sheltered workshops, industrial revolution
factories, arts and crafts clip art and societies, academic OT, american journal of
occupational therapy)
Photos from http://www.aota.org/About/39983.aspx
Editor's Notes
B population grew from 16 million to 75 million due to increase in immigration Factories and assembly lines increased women in the work place During WWI every therapist was called upon to help treat injured soldiers Gaining the right to vote - amendment 19 change the role of women
R
R All female and secular society for political and professional training Believed in scientific method for learning about social issues Developed strong political ties with influential men and women in Chicago
R
R -idealization by the middle and upper classes in the US in late 1800s, early 1900s
H mid 19th century british professor, john ruskin “ romantic,” who looked back to the time when humankind was simpler… and healthier! With industrialization, John ruskin and william morris. - machine gimcrackery- poor quality of products > anti-modernization
H By the 20th century Clubs and Societies- Middle and uppermiddle class Stability Moral values >>> slow paced life in a changing country/environment
H X-rays Labs Goal: remove sick from the environment
H Work cure took place of commonly prescribed bed rest Based therapeutics only on the philosophy espoused by the Arts-and-crafts enthusiasts. Mary potter brooks meyer Social worker who developed occupational programs for ward patients Julia lathrop -applied arts-and-crafts ideology to chronically ill mental patients Susan Tracy occupations training course for nurses work Teaching strategies Supplies lists introduced an OT program for general medical patients at Michael Reese Hospital in Chicago
H
H Sheltered workshops- Hall and other physicians developed workshops where patients produced carefully designed, and hand made objects Hand towels, ceramic vases, cement pots
H UNFORTUNATELy- workshops shifted from having a therapeutic purpose …. To a more cost-conscious point of view OT Purpose was lost in the workshops… NOT IN GENERAL- THERE WAS STILL OT
A -model developed in the arts and crafts movement, based on simplifying (routine) -life should become as routine as possible -using the schizophrenia patients Meyer observed that unbalance leads to a loss of organizing and stabilizing factors manifested in absence of sleep, play, leisure -habit training developed by Meyers and Slagle, practice model that schedules an individual’s occupations into a 24 hour day, with the goal of the schedule becoming habitual, TEACH client to
A Concept of habit training developed by Eleanor Clarke Slagle -Meyers observations and Slagles model were combined to implement their treatment model of habit training
A -Goldthwait & Brackett (Harvard trained orthopedists) form the Army Division Orthopedics -Robert James has seen realities of war and how many injuries believes orthopedics can make men suitable to stay in war (medical/curitative) or AT LEAST more functional in society (so not burden), believes it is society’s obligation to help these people, it will help lessen economic strain on the country -see orthopedics and rehab positions as link between “acute medical care and physical restoration”
A -War Dept. wants to employ enlisted men as reconstruction aides (very plausible due to lack of men to fill roles) -decide to employ women but no commission or rank -reconstruction aides begin to prove selves as commanding officers begin to request more reconstruction aides
A -as reconstruction aides became more prolific standards, be able to help people cultivate occupation “bedside” -many women cine from families common women to work, higher education (or at least pursued), experience caring for friend or relative with severe illness or disability, leadership roles in past
A UNBELIEVABLY POLITICAL -treated poorly -orthopedists want full control -see themselves as highest positions and want reconstruction aides to be extensions of themselves (ROM activities etc) -believe they have the ability to “prescribe” occupation (either in war or if solider must return to community) -conflicts b/w reconstuction aides and vocational educators: May 1918, war department makes Division of Physical Reconstruction, place reconstruction aides in -devalues occupational therapy become linked only to obtaining a vocational future just like vocational educators -November 1918- influenza called on to assist begins drift back medical slant -by end of war occupational therapist spending much more time with orthopedists
B
B
B
B
B
B
B Also known as the “civilian industrial rehabilitation act” This act did not have immediate, change. In 1937 80% of Occupational Therapists were still in the mental health field not in physical disability which was the aim of this act. (p. 504, (1945), industrial hygiene and the expandable federal state vocational rehabilitation program, American Journal of Public Health, 35,clark, D.)
R -habit training=balance, OTs working with a “client-centered” approach to help clients arrange their lives to achieve balance and satisfaction through meaningful occupations and organization meaningful to them
