Occupational Therapy’s Roots 1792: Moral Treatment Movement
1862: Arts and Crafts Movement
- This movement was started by William Tuke as a way to make sure that the mentally ill were cared for in a humane manner in York, England. Quickly, it spread to the rest of Europe and the United States.
1917: Creation of the National Society for the Promotion of Occupational Therapy
- Created by William Morris and John Ruskin, who believed that the machines and factory work of the Industrial Revolution limited human happiness, this movement focused on creative arts and crafts and served as the basis for occupational therapy.
1918: Soldier’s Rehabilitation Act
- The six founders organized and focused their activities on promoting the professional development of its members and assuring consumer access to quality services.
1921: Society’s name changed to American Occupational Therapy Association (AOTA)
- This act created a program for injured soldiers to participate in rehabilitation after the war, where occupational therapists were influential in helping soldiers adjust to post-war lives.
1939: World War II
- As the profession continued to grow in popularity, and in need, one of the new roles of the organization was to set the standards for the profession.
1942: The Rehabilitation Movement
- After the Great Depression halted the growth of the field, WWII created an increased need for professionals, which led to war emergency courses that allowed OTs to be trained quickly.
1945: Registered Occupational Therapists Requirements
- As opposed to only working with the mentally ill or those with tuberculosis, OTs began treating physical disabilities due to injuries sustained in battle.
1955: New Technologies and Drugs
- Beginning in 1945, completing an exam was mandatory to become a registered, practicing occupational therapist.
- The increased use of prosthetics, splinting, and wheelchairs during the 1950s, and the creation of neuroleptic drugs led to the founding of community mental health programs created a greater need for OTs that continues to this day.
1980: Gary Kielhofner
- This act covered select occupational therapy services, which led to an increased demand for OTs.
2002: The Commission on Continuing Competence and Professional Development (CCCPD)
- He founded the Model of Human Occupation (MOHO), an evidence-based model that is a leading theory in the field, which strives to explain the science behind occupation. In addition, he worked with HIV/AIDS patients to help them participate in meaningful occupations.
2008: Revised OT Framework
- This commission was created to set guidelines for continuing education and professional development and enforces standards that practitioners meet for continuing competence and professional development.
2017: Master’s Degrees in Occupational Therapy
- Called the Occupational Therapy Practice Framework: Domain and Process, this framework includes the language used in the profession and focuses on occupation as the core of the field.
- Occupational therapy programs transitioned to being master’s degrees, which students must have to take the certification exam.
Occupational Therapy Techniques Through the Ages
Though not formally created until 1917, occupational therapy techniques have been practiced for thousands of years. Below are some of the specific techniques and methods that have been used in the past and how they’re being used now.
Unfortunately, though many of these techniques can have a positive impact when used to treat specific ailments, many were used in an inhumane manner because of our incomplete understanding of diseases, mental illness, and cures.
Instead, doctors at the time used these techniques in excess after finding some benefit, or used them as a way to control and try to ‘cure’ mental illness, homosexuality, and other incurable behaviors.
However, through more research and analysis, modern medicine has found a benefit of many of these techniques when used for specific ailments and with more regulation, which is why they have become popular again with occupational therapists.
Hydrotherapy consists of a broad range of approaches and therapeutic methods, such as pressure and temperature, that can stimulate blood circulation and treat the symptoms of certain diseases. Many civilizations, including the Egyptians, Greeks, and Romans used hydrotherapy by bathing with essential oils and flowers, or in public bathhouses.
In many Asian cultures, specifically the Chinese and Japanese, hydrotherapy centered around hot springs were used for baths.
Hydrotherapy Current Techniques
Hydrotherapy is used to help a variety of ailments because of the lack of resistance and reduced strain on muscles. Some of the current techniques include:
- Exercising in a pool, especially while recovering from injuries or for senior citizens
- Hot air baths and steam baths
- General baths of hot and/or cold water
- Sitz (sitting), spinal, head, and foot baths
There are plenty more techniques used for hydrotherapy depending on the ailment. For instance, sometimes a complete, full body immersion is needed, whereas other times only an arm, hip, or leg whirlpool is needed.
Dr. Kellogg’s Hydrotherapy The inventor of the corn flake was also the chief medical officer of the Battle Creek Sanitarium, where he used hydrotherapy in many forms, including through a cap that people wore while sleeping and by reintroducing the sitz bath.
What Can Hydrotherapy Treat?
Because water can reduce a human’s body weight by 90%, many people who may not be able to lift themselves regularly, can in water. Therefore, some of the injuries or ailments hydrotherapy can treat are:
- Cerebral Palsy
- Recovery from injury or surgery, especially joints
- Reduce injury in the acute stages
By stimulating blood flow and reducing swelling, hydrotherapy has a variety of uses that can help patients suffering from a different ailments. Plus, steam and humidity have been proven to help respiratory systems and ease coughing and congestion due to a cold.
Technique: Heliotherapy (Phototherapy)
Also referred to as phototherapy or light therapy, heliotherapy is the use of sunlight or other light wavelengths to treat certain ailments. Developed in the late 1800s by a French doctor, Dr. Niels Finsen, who showed that solar radiation could help treat smallpox and tuberculosis, heliotherapy techniques quickly spread across Europe.
With plenty of benefits, such as improving sluggishness and helping to treat lupus vulgaris, which is caused by tuberculosis common during the time of Dr. Finsen, the trend fell out of favor in the mid-1900s as newly created antibiotics treated germs better than sunlight and doctors realized that too much sunlight did more harm than good.
In addition, during the initial rise of popularity there were a couple devices that were created that replicated sunlight but were used during colder months, such as:
- Finsen Lamp
- Electric Light Bath Cabinet (created by Dr. Kellogg)
Heliotherapy Current Techniques
Some of the current techniques in heliotherapy are:
- Natural sunlight
- Ultraviolet lamps (such as the Finsen Lamp)
- Infrared sauna
In addition, during the early 1900s many hospitals were redesigned to allow in more therapeutic sunlight. For example, during WWI, Dr. Oskar Bernhard used sun therapy to treat wounds and prevent tetanus and gangrene.
These techniques were used through the 1900s to treat skin diseases, the nervous system, musculoskeletal system, circulatory system, and respiration.
Creating Vitamin D You skin makes vitamin D from casual sun exposure from as little as five to 15 minutes of sunshine per day, two to three times per week on the face and hands.
What Can Heliotherapy Treat?
Though sustained exposure to sunlight may pose some health risks, there are many benefits to heliotherapy and is currently used to treat:
- Acne, psoriasis, and other skin diseases
- Seasonal Affective Disorder (SAD)
- Irradiates the blood of cancer patients
Heliotherapy also has other benefits, such as:
- Reducing body odor
- Reducing bacteria count by as much as 50% from infections
- Lowering blood pressure
- Regulating blood sugar
- Healthier cholesterol levels
- DNA repair
Technique: Electroshock Therapy or Electroconvulsive Therapy (ECT)
Created in 1938 as a way to induce seizures to relieve symptoms of mental illnesses, electroconvulsive therapy (ECT) quickly spread in popularity and was in nearly half of American mental hospitals by the early 1940s.
Though the benefits were apparent for some types of mental illness, quickly ECT was used in dangerous ways. For instance, in the 1950s ECT was used as a “treatment” to cure homosexuality, which was viewed as a disease.
Also in the ‘50s, ECT, and the threat of it, were used in mental hospitals to control difficult patients and to maintain order, as well as for the medicinal benefits.
ECT Current Techniques
As opposed to the past where ECT was delivered at higher doses of electricity without anesthesia, modern techniques are done in a much more humane manner.
For example, treatments are much safer today and administered in a controlled setting, with a certified anesthesiologist, so that patients may experience the most benefit with the lowest possible risk.
In fact, ECT is safe to be used during pregnancy when medications can’t be taken because of potential harm to the developing fetus and in older adults who can’t tolerate the side effects of drugs.
Cuckoo Fact Ken Kesey served as an experimental subject and aide in the psychiatric ward of a hospital. Those experiences led to him writing the 1962 novel One Flew Over the Cuckoo’s Nest, which was turned into a movie starring Jack Nicholson in 1975.
What Does ECT Treat?
Administered to an estimated 100,000 people a year, ECT is used to treat patients with:
- Severe depression
- Acute mania
- Certain schizophrenic syndromes
- Agitation and aggression in people with dementia
In general, ECT may be a good treatment option for those who haven’t tolerated medications or other forms of therapy haven’t worked. However, there is some difference of opinion in the field about the negative side effects, such as memory loss, and the length of time the benefits of treatment last.
Technique: Leech Therapy and Bloodletting
Used in ancient Egypt, Greece, and many other cultures, bloodletting and leech therapy were usually the first type of treatment used for everything from headaches to plague to smallpox to gout. Also called hirudotherapy, leech therapy remained popular throughout the Middle Ages and even later.
In fact, in 1840 a lecturer at the Royal College of Physicians stated, “Blood-letting is a remedy which, when judiciously employed, is hardly possible to estimate too highly.”
Many physicians abandoned leeches with the advent of antibiotics in the 1930s, though medical research and the use of leeches never stopped in some parts of the world, including Germany and Russia.
Leech Therapy Current Techniques
Leeches secrete peptides and proteins that work to prevent blood clots, which are also known as anticoagulants that keeps blood flowing to wounds to help them heal.
These anticoagulants are spread through the leech’s saliva as they pierce a person’s skin with their teeth. The leeches are allowed to extract blood for 20-45 minutes at a time, which equals roughly 15 milliliters per leech.
This technique has regained popularity during recent years because it is a simple and inexpensive way to prevent complications in various treatments.
Did You Know? On December 13, 1799 George Washington woke with a bad sore throat, fever, and began to decline rapidly. As a proponent of bloodletting, he asked to be bled the next day and physicians apparently drained between 5 and 7 pints in less than 16 hours. On December 17, Washington passed away.
What Can Leech Therapy Treat?
There are a number of medical situations that leech therapy can help with, including those with:
- Risk limb amputation due to diabetes
- Diagnosed with heart disease
- Soft tissue loss due to cosmetic surgery
Leech therapy has also been recommended to treat blood clots and varicose veins. However, there are some situations in which leech therapy should be avoided, such as:
- People with anemia
- Blood clotting issues
- Comprised arteries
- Children under the age of 18
- Women who are pregnant
Occupational Therapy and Obesity As occupational therapy was created to help people engage in daily life activities that they find meaningful, OTs strive to apply their knowledge to help clients who may be experiencing:
- Adverse circumstances
Obesity in America According to the Center for Disease Control and Prevention (CDC), approximately 78.6 million Americans, or one third of U.S. adults, were classified as obese in 2014.
How OT Can Help with Obesity
Unfortunately, obesity continues to increase in the United States and prohibits people from performing daily life activities. Bariatrics is the branch of medicine that addresses the causes, prevention, and treatment of obesity.
As a result, occupational therapists can help individuals with obesity change their lifestyle, engage in meaningful activities, and manage their weight by focusing on:
- Health promotion
- Disease prevention
As a result, occupational therapists may be able to help those who are obese live a more fulfilling life by creating better habits and decisions when it comes to their diet.
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