OT History

Question 1

Author who first mentioned the medically prescribed use of work (physician)

Answer 1

Philippe Pinel

Question 2

Only* physician to use occupation therapy in treatment of physical dysfunction in this era

Answer 2

Clement-Joseph Tissot (1747-1826)

Question 3

First* physician to establish a program of occupation therapy in a hospital, McLean Asylum (later Hospital)

Answer 3

Rufus Wyman

Question 4

Who wrote the first book on Occupation Therapy, 1840

Answer 4

François Leuret

Question 5

Early use of OT

Answer 5

Egyptians and Greeks (2000 bc, 420 bc)

Question 6

• wrote about “adaptation” and how occupation may influence and enhance human happiness

Answer 6

Adolf Meyer, 1866-1950

Question 7

whose goal of treatment was to create “orderly rhythm and sense of a day simply and naturally spent”

Answer 7

Adolf Meyer, 1866-1950

Question 8

“all people are entitled to compassion” is from which movement?

Answer 8

The Moral Treatment Movement

Question 9

State three social movements contributed to the development of modern occupational therapy

Answer 9

Mental Hygiene (Moral Treatment); Arts & Crafts; Settlement House

Question 10

What was the first occupational therapy professional association in Canada?

hint: think where was it located

Answer 10

Canadian Society of Occupational Therapy of Manitoba and
the Ontario Society of Occupational Therapy (OSOT)

Manitoba and Ontario each launched societies in 1920. Manitoba folded and re-opened at a later date as the Manitoba Society of Occupational Therapists, making OSOT the oldest occupational therapy organization in Canada. The Canadian Association of Occupational Therapists was established in 1926.

Question 11

The first formal education for occupational therapists in Canada was a program for who?

*what was their job title?

Answer 11

“ward aides”

Question 12

The first formal education for occupational therapists in Canada was a program for ward aides. What increased job demand for ward aides?

Answer 12

The rising number of soldiers returning from overseas during World War I requiring rehabilitation increased the demand for ward aides (known as reconstruction aides in the US).

Question 13

What did the ward aides program include training on?

Answer 13

The federal Department of Soldiers’ Civil Re-establishment (created in 1918) organized ward aide training programs at The University of Toronto in 1918 and 1919 and at McGill University in 1919. The program included bedside vocational training, occupational therapy, and diversional occupation. The war aides helped build the profession of occupational therapy.

Question 14

The University of Toronto was the home of the first occupational therapy program, a two-year diploma, launched in 1926 with 25 students. Both the ward aides and occupational therapy programs tended to attract what demographic?

Answer 14

women from upper middle class families who wanted a post-secondary education and interested in serving the sick and injured.

Question 15

The ward aides program at University of Toronto was what duration?

Answer 15

The first course was 6 weeks in duration but it was quickly increased to 3 months. Many of the students had previous training as teachers, nurses, social workers, or handicraft instructors.

Question 16

Due to a shortage of OTs, CAOT launched a ‘special course’ in Kingston, ON in 1959. Study duration was how long?

Answer 16

The program was 18 months (10 months academic preparation, 8 months clinical practice) and the first class admitted 11 students (9 women and 2 men, from five provinces in Canada). At the time, there were three combined occupational therapy/physical therapy programs in Canada, at the University of Toronto (it combined the two programs in 1950), McGill University (1950), and Université de Montréal (1954). But it was apparent the demand for occupational therapists could not be met, so CAOT established its own compressed program while continuing to lobby universities. The “Special Course in Occupational Therapy” was strategically placed in Kingston, ON, to influence Queens University to establish a program. It was directed by Muriel Driver and ran from 1959 to 1967 when Queens launched a 3 year diploma program in occupational therapy.

Question 17

Which historic celebrity is just 1 degree of separation from occupational therapy?

Answer 17

Amelia Earhardt worked alongside Helen P. LeVesconte in the Voluntary Aide Detachment at the Spadina Military Hospital during World War I. LeVesconte was a pioneering occupational therapist. From a privileged Toronto family, she volunteered with the VAD, where she became impressed with the work of the ward aides. She graduated in 1928 from the first occupational therapy class at University of Toronto; was director of the program from 1945 until her retirement in 1967. LeVesconte was particularly prominent in mental health occupational therapy, noting that after proper housing and feeding, occupational therapy was the most important factor in the recovery of people with nervous and psychiatric conditions. She maintained a friendship with Amelia Earhardt for many years beyond their volunteer days.

In the United States, you might also select a. Eleanor Roosevelt, who was an honoured guest of the American Occupational Therapy Association in 1937, where she paid tribute to Eleanor Clarke Slagle, co-founder of the AOTA, on the occasion of Slagle’s retirement.

Question 18

What was the motto adopted by CAOT that was incorporated into the insignia and designed to represent occupational therapy?

Answer 18

“Per Mentem Et Manus Ad Sanitatem — Through Mind And Hand To Health” was the motto adopted by CAOT and incorporated into the insignia designed to represent occupational therapy. It was designed originally in 1919 by Captain Stanley Fryer, an architect by profession, who at that time was Deputy Vocational Officer for Ontario, as a hat badge to be worn with the “distinctive green uniform” of the “ward aides,” then as a copper belt buckle for the uniform belt. The triangle represents mind, body, and spirit. The fist holding a hammer represents the nobility of work, and the rising sun behind it reflects the work lighting up mind, body, and spirit. In 1963 it was adapted by CAOT for the cover of CJOT.

Question 19

Why does knowing about the history of OT matter?

Answer 19

“..by examining our roots, we can our present more readily, and approach our future more confidently” (Friedland & Rais, 2005)

• Reflect on, learn from, critique, inspire (Trentham, 2011)

Provide context from which to shape our future - and you all are the future!

• broadly appreciate (and question) some of the historical influences on the development of occupational therapy as a profession.

Question 20

When was occupation first used to support recovery from illness or infirmity, or promote health? Name a year or an era.

Answer 20

If you knew (or guessed) the ancient Egyptians, you’re right! Occupation has been used since humankind’s earliest days.

2000 BC
Egyptians used music and games in treatment of mental ailments

Question 21

Describe the Mental Hygiene Movement.

Answer 21

Moral Treatment Era ideas (early 1800s)
- patients cared for, not shunned or punished
- Superintendents want patients occupied
for behavioural control for financial benefit
- Patients want something to do
patients work on hospital grounds and in workshops
“work” not appropriate for private patients who were given crafts activities overseen by nurses and attendants in “Lunatic Asylums” in North America, UK, Europe
(Friedland, 2014)

Question 22

Describe the Arts and Crafts Movement

Answer 22

Evils of industrial revolution

Social reforms needed (e.g., factory labour; workers’ education classes)

Spiritual malaise helped by creativity “art spirit”; “art for all”

• craftwork promoted by charitable and artistic (women’s) groups
• skills for self-sufficiency taught (e.g., weave material for clothing; make items for sale)

fine arts used at Retreats for stress-related illnesses

Question 23

Describe the Settlement House Movement?

Answer 23

Cities overwhelmed by immigration/migration; overcrowding, poor sanitation, no jobs
Great poverty and no social safety net
Social justice movement from UK (Toynbee Hall), to US (Hull House), and Canada
skills for daily living taught by the educated/wealthy class to the poor and to immigrant groups
public health measures
craftwork helped immigrants adjust, regain confidence

Question 24

who was Jessie Luther (c.1890) ?

Answer 24

possibly the first occupational therapist in Newfoundland

Graduate of Rhode Island School of Design; member Boston Arts and Crafts Society
Artist & Handicrafts Teacher
Hull House, Chicago (1901)
Co-developer “Work-Cure”
Community Developer, Grenfell Mission, Newfoundland (1906-1916)
Director of OT, Butler Psychiatric, Providence, RI from1905

Question 25

Describe the Origins of Occupational Therapy in North America

Answer 25

George Barton, an architect interested in occupation and vocational training as a cure for convalescents, coined the name occupational therapy to describe “curing by means of work” around 1912-14, published in 1915.

“It was necessary that it be interesting work and it was essential that it should be directed toward some desirable objective, an objective secondary to the primary purpose of healing” (Dunlop, 1933, p. 6)

Eleanor Clarke Slagle founded the first formal training course (6 weeks) in 1914/15: Henry B. Favill School of Occupation in Chicago

National Society for the Promotion of Occupation Therapy est. 1917 became the American Association of Occupational Therapy 1923

Thomas B. Kidner, a vocational officer from Canada, was one of the founders of the new national society.

Question 26

World War I: What did ward aides do?

Answer 26

“Ward Aides” - provided injured soldiers with occupations at the bedside, off-ward, and in the workshop

Question 27

World War I: Why did Ward Aides provide soldiers with occupations at the bedside and on the ward? What did occupations do for the soldiers?

Answer 27

• Restore the spirit
• Raise morale
• Build self-esteem
• Teach skills to decrease dependence
• Support re-integration to family life
• Support the economy through return to work

Question 28

Who was Ina Matthews (MacKinnon)?

Answer 28

• Wealthy Toronto family
• Volunteer ward aide in Sydney, NS at her sister’s “convalescent home”
• Unsung heroine of plan to re-establish injured soldiers into civilian life through work

Question 29

What observations do you have about early influences on the profession?

Think about the people who pioneered the services, the events that demonstrated need for occupation, cues from the photos you’ve seen…

Answer 29

You may have noticed an early emphasis on social justice through the mental hygiene and settlement house movements, on meaningful occupation in the arts and crafts movement and educational reform. Many physicians, social workers, and military officers were involved in setting up occupational therapy educational programs. Early ward aides were often socialites from well-to-do families, suggesting that women of privilege wanting to help the less fortunate shaped pre-war services and reintegration of soldiers to civilian life. Photos suggest a strong focus on “doing occupation” in both the training of occupational therapists and their practice.

Question 30

Describe Practice in the latter 20th century

Answer 30

Period of reductionism as medical specialties emerged

Evolution of educational and practice standards

CAOT registration examination for foreign educated OTs 1950-1960, replaced with ‘graduation from WFOT accredited program’

National entry to practice exam established for all in 1985

Regulation of practice – provinces started to create regulatory bodies in the public interest

Creation and revision of practice guidelines, outcome measures, theoretical models of practice and clinical reasoning, evidence-base

Return to our roots in occupation

Question 31

Describe OT Practice in the mid-20th century

Answer 31

World War II: Occupational therapists served in the armed forces overseas and at home (returning soldiers)

Post-War: Educational programs expanded in number and duration of training

University of Toronto expanded to 3 years in 1946, combined with PT in 1950
McGill University added occupational therapy to its PT program in 1950 ->4 yr BSc
Université de Montréal established combined OT/PT program 1954

First textbook written by occupational therapists = Willard & Spackman’s Occupational Therapy, 1947 (The 13th edition was published in 2018.)

Question 32

Describe OT practice in early 21st century

Answer 32

All provinces in Canada now regulate occupational therapy practice

(Not yet regulated in Yukon, Northwest Territories, or Nunavut)

Emergence of occupational science as a basic science on the study of occupation, interdisciplinary and in its own right, yet also informing occupational therapy

Increased focus on occupation-based practice and education

Adapting to shifting health, social, and educational service sectors

Systems issues demanding systems leadership and systems thinking

Question 33

Colonialism in Canada & Occupational Therapy: What can OTs learn from the TRC?

Answer 33

Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada (2015)

Summarizes findings arising from the historic relationship between Indigenous peoples and the Government of Canada

Loss of land, cultures, languages, livelihood, forced removal of children, systematic violence and abuse

“Addressing the calls to action requires occupational therapists to engage critically with the nature and underlying assumptions of occupational theories and concepts (Farias et al., 2016) and with the politics of power, legislation, regulations, policies, and societal norms through which Indigenous peoples’ experiences of health inequities are structured.” (Restall, et al., 2016, p. 265)