Occupational Therapy
1940 - 1969
By Genevieve Cyrs, Claire Kelly, Allie Taylor, & Patricia Wong
The 1940s
• World War II- increased demand for OTs
• Changes in Occupational Therapy
Education
• The Structure and Focus of Occupational
Therapy
• Medical Advancements
• Important Individuals: Clare Spackman,
Helen Willard, Wilma West
World War II
• Large numbers of
injured soldiers
• Women working
Growth in OT schools
• Accreditation
• Expansion- 1947: USC introduces first
Master’s Degree program
• Revision of Essentials for
accreditation
 1943: More flexibility in areas of
therapeutic training
 1949: Increased biological sciences
requirement
Occupational Therapy
• Move away from Arts & Crafts
Movement
 Positive attitude towards work
• Patients are motivated through
personal interests & material goods
 Goals:
• 1. Meet person’s interests and abilities
• 2. Use activity with physical/mental objective
Medical Model
• Disability is deficiency or abnormality
• Disability is negative
• Disability is in the individual body
• Remedy for disability-related problems: cure or
normalization
• Change strategy: surgery, medication, medical
technology and intervention
• Agent of remedy: the professional
• Independence seen as individual physical,
cognitive, and mental ability to perform and
capacity to make decisions
(Willard & Spackman, p. 871)
OT Practical Design
• Medical model & influence on field of
occupational therapy
• Self-repair activity discounted in favor
of conceptions in psychology,
physiology and anatomy
• Redefinition of mission & emergence
of a new paradigm
Advances in Medicine
• Antibiotics- penicillin and
streptomyocin
• Vaccinations
• Improvement in healthcare quality
• Federal government funds research
and passes laws regarding delivery of
healthcare
• Life expectancy increases
Wilma West
• Head of orthopedics occupational therapy
at the Walter Reed General Hospital 1943-4
Helen Willard & Clare Spackman
1947: Publication of first OT
textbook
IT’S QUIZ TIME!
The 1950s
• Post-war Effects
• Social Context: Women’s Roles, Civil Rights
Movement
• Polio Epidemic
• The Structure and Focus of Occupational
Therapy
•Treatment of Mental Health
• WFOT
• Important Individuals: Dr. Howard Rusk
Post-war Effects
• Baby boom
• Economic prosperity
Women’s Roles
• Housewife- ideal of femininity
• Discouraged from working
• Continued to work, mostly in low
paying jobs (“pink-collared work”)
Civil Rights Movement
early 1950s
• Korean War- desegregation of armed forces
• 1954: Brown v. Board of EducationSupreme Court rules segregation
unconstitutional, desegregation of schools
• Non-violent protests
 Civil disobedience
• 1955-56: Rosa Parks and Montgomery Bus boycotts
Poliomyelitis
• Known as Infantile Paralysis
• Most cases of polio are
symptom-free
• When the virus enters the
blood stream, it attacks the
CNS
• causes muscle weakness &
paralysis of the legs
• Bulbar polio affects nerves
responsible for breathing,
swallowing and speech
Polio in the Media
“Plague Season”
• In 1952, there were 57,000
cases of polio in the US
• Targeted children from 5-9
years old
• 21,000 permanent
paralysis
• 3,000 deaths
• 1955: the Salk Vaccine is
distributed in mass
quantities
• Children of the 1950s are
today’s baby boomers
OT Practical Design
• The Mechanistic Paradigm emerges
• More Freudian-based psychological
treatment of patients
• Disability viewed as abnormal expression of
repression within
• Incorporation of neurological knowledge
into practice
OT Methodology Change
• Practice of splinting and prescribing adaptive
devices flourished
• Discrete analysis of requirement needed for
activity
• Emphasis on the patient returning to healthy
functioning
• Respect for objective measurement and scientific
precision gained
• Functional knowledge related to internal processes
and body structure applied
Dr. Howard Rusk
• Established the Institute of
Rehabilitation and Physical Medicine
• Wrote and gave speeches about
expanded idea of rehabilitation
• Increased medical and public
knowledge of physical and
occupational therapy
Working with Mental
Patients
• Do not work on causative factors of behaviors—correct
symptoms
• Do not stress activity over relationship with patient
• Use graduation & persuasion to overcome distasteful
habits
• Select tasks within ability level to assure success
• Give patient choice of activity
• Develop patient’s sense of responsibility
• Hold “community sing”
Video
• Mental Health Rehabilitation in
1950s
World Federation of Occupational
Therapists
• Founded in 1952
• 1959: WFOT entered into relations with
WHO
Mission:
• To promote occupational therapy as an
art and science
• To develop and use occupational therapy
worldwide
• International cooperation
WFOT Focus
Program Areas:
• Education & research
• Standards & quality
• International Cooperation
• Executive programs
• Promotion & development
WFOT 1952
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark
WFOT 1969
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark •
Belgium • France • Germany • Netherlands • Norway • Philippines • Portugal • Switzerland • Venezuela
1950s OT changes
• 1956: Certified Occupational Therapy
Assistant (COTA) position created
• 1958: Pi Epsilon Theta founded at
UNH
IT’S QUIZ TIME!
The 1960s
• Social Context: Civil Rights Movement
Continues, Women’s Empowerment
• The Structure and Focus of Occupational
Therapy
• Medicare/Medicaid
• Important Individuals: Gail Fidler, Mary
Reilly, Wilma West, Elizabeth Yerxa, A. Jean
Ayres
Civil Rights Movement
• Presidents Kennedy and Johnson set
tone by making civil rights a priority
of their administration
• Nonviolent protests continue
 1960: sit-in protests
• 1964: Civil Rights Act passed- outlaws
discrimination based on race
Women’s Liberation
Movement
• 1964: Civil Rights Act- outlaws sex
discrimination
• Empowerment of women
 More educated
 More economically secure
 More willing speak up about their ideas
OT Practical Design
• Occupational therapy clarified in
accordance with the medical model
• Pathological conditions better
understood
• Use of technology to intercede with
dysfunction increased
OT Practical Conflict
• Field in conflict
• Occupational therapy had turned from
holistic foundation toward concrete
scientific rationale
• Interventions mechanized, losing meaning
in favor of achieving purpose
Call for a new Paradigm?
• Occupational therapy valued with respect to
conformity with the medical model
• Many therapists had difficulty adjusting to the
approach of the medical model
• Practitioners not united
• A realization that the profession needed to
ameliorate its differences was recognized
Wilma West
• President of AOTA from 1961 to 1964
• Wanted to address changing needs of
society and adapt OT accordingly
• Wanted OT to have a new role of
“health agent”
• Founded American Occupational
Therapy Foundation (AOTF)
Mary Reilly
• Active in the 1960s
• Re-evaluation of mechanistic model
• Advocated a more interdisciplinary
approach
1960s Changes
• More work with pediatrics and
developmental delays
• Beginning of de-institutionalization
 Working to integrate formerly
institutionalized clients into society as
independent and productive members
Medicare/Medicaid
• Established in 1965- Inpatient
occupational therapy services covered
Elizabeth Yerxa
• “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”
• Advocate of client choices
Gail Fidler
• Wanted to recognize the professional
commitment to learning, critical
thinking, and creativity
• Advocated teaching more than just
technical skills
A. Jean Ayres
• Developed sensory integration
approach
• Influenced by Piaget
Influences from the 40s-60s
that we see today
• Occupation-based therapy
• Client has choices
• De-institutionalization
IT’S QUIZ TIME!
Thank you!
Any questions?
References
Abrams, R.M. (2006). America transformed: Sixty years of revolutionary change, 1941-2001. New York, NY: Cambridge University Press.
Cole, M.B. & Tufano, R. (2007). Applied theories in occupational therapy: a practical approach. Retrieved from http://books.google.com
Dunton Jr., W. R. & Licht, S. (1957). Occupational Therapy: Principles and Practice (2nd ed.). Springfield, IL: Bannerstone House.
Fidler, G. S. & Fidler, J. W. (1954). Introduction to Psychiatric Occupational Therapy. New York City: Macmillan Publishing Co.
Fidler, G. S. & Fidler, J. W. (1963). Occupational Therapy: A Communication Process in Psychiatry. New York City: Macmillan Publishing Co.
Gilbert, J. (1981). Another chance: Postwar America, 1945-1968. Philadelphia, PA: TempleUniversity Press.
Gillon, S.M. (2007). The American paradox: A history of the United States since 1945. Boston, MA: Houghton Mifflin Company.
Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s
occupational therapy (11th ed., pp. 202-215). Philadelphia, PA: Lippincott Williams & Wilkins.
Hammel, J., Charlton, J. Jones, R., Kramer, J., Wilson, T. (2009). From disability rights to empowered consciousness. In Crepeau, E.B., Cohn, E.S., &
Boyt Schell, B.A. (Eds.), Willard and Spackman’s Occupational Therapy (11th ed). (868-887). Philadelphia: Lippincott, Williams & Wilkins.
Kearney, Pamalyn. (2004). The influence of competing paradigms on occupational therapy education: A brief history. Retrieved from
http://www.newfoundations.com/History/OccTher.html.
Kielhofner, G. (1992). Conceptual Foundations of Occupational Therapy. Philadelphia: F.A. Davis Co.
Marcus, R.D., & Burner, D. (Eds.). (1972). America since 1945. New York, NY: St. Martin’s Press.
Reilly, M. (1985). The 1961 Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of 20th century medicine in AOTA
(Ed.), A Professional Legacy: The Eleanor Clarke Slagle Lectures in Occupational Therapy, 1955-1984, (pp. 87-105). Rockville:
AOTA. Retrieved from www.uab.edu.
References
The American Occupational Therapy Foundation. (2009). Mission, Vision, Goals, & Strategic Plan. Retrieved from
http://www.aotf.org/aboutaotf/missionvisiongoals.aspx
The History of Occupational Therapy. (n.d.) Retrieved from http://www.sensory-processing-disorder.com/history-of-occupational-therapy.html.
Willard, H.S., & Spackman, C.S. (Eds.). (1954). Principles of Occupational Therapy (2nd ed.). Philadelphia, PA: J.B. Lippincott Company.
Willard, H. S. & Spackman, C. S. (1963). Occupational Therapy (3rd ed.). Philadelphia: J.B. Lippincott Co.
Photographs/Video:
Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s
occupational therapy (11th ed., pp. 202-215). Philadelphia, PA: Lippincott Williams & Wilkins.
http://history.amedd.army.mil/booksdocs/wwii/medtrain/ch5.htm
http://history.amedd.army.mil/corps/medical_spec/publication.html
http://history.amedd.army.mil/booksdocs/wwii/medtrain/fig18.jpg
http://www.rohcg.on.ca/about/history-romhc-1950-e.cfmRBPSQ
http://www.youtube.com/watch?v=BnjDoj