A Brief History of Occupational Therapy

Even though occupational therapy is a relatively new healthcare profession compared to other medical fields, the history of occupational therapy has a rich backstory.

Even if you aren’t a history buff, understanding how occupational therapy originated can help to develop a stronger sense of professional identity. This can help us all feel more connected to the profession and its values, even leading to a greater sense of purpose.

Knowing the history of any profession can help to see the possible futures for the career as well. As we look over the steps that it took for occupational therapy to get where it is today, we need to also think about what this tells us about the future. 

The Origin of Occupational Therapy

Occupational therapy has a difficult past to pin down. The underlying principles of occupational therapy are fairly intuitive and have been integrated into medical treatment for centuries. In the 18th century, patients suffering from mental illnesses were considered a threat to society. The majority of those affected were simply stuck in prison and hidden from society.

As human rights causes and moral treatment came onto the scene, more humane systems for treating mental diagnoses developed. One of these developments was asylums that provided a safe space where those with mental illnesses could freely engage in their meaningful occupations. In these spaces, a greater understanding was found on just how beneficial work and engagement was with real-life tasks.

Moving into the 1800s, the benefit of occupational engagement was understood more and more. ADL and IADL participation was encouraged alongside arts and crafts. William Rush Dunton Jr., known as “the father of occupational therapy,” was a strong advocate for occupational engagement and eventually formed the National Society for Promotion of Occupational Therapy (now known as the American Occupational Therapy Association, or AOTA). This allowed for more clients to receive Occupational Therapy services.

Occupational therapy has never quite fit in with other medical treatments. All too often today, OT is simply grouped with physical therapy due to the similarities in name, treatment processes, and treatment settings.

However, from the start, OT did not fit neatly into the medical model. Instead of simply copying physical therapy’s treatment approach, OT pulled from many different places to develop the most beneficial way to functionally help clients. This involved aspects of physical therapy, nursing care, social work, psychiatry, orthopedics, and more. Immediately, occupational therapy stood out as a unique and holistic practice.

However, it wasn’t until the early 1900’s that occupational therapy as we know it began to come into existence. At this point, OT was more holistic than ever, but there was a lack of evidence-based practice and treatments were not fully understood. The majority of treatment was provided to those with severe mental health issues by promoting engagement in meaningful ADL and IADL tasks. A nurse by the name of Susan Tracy wrote the book Studies in Invalid Occupations which outlined the benefits of occupational participation in mental health treatment.

Around the year 1915, Eleanor Clark Slagle organized the first educational program for occupational therapists, coming to be known as “the mother of occupational therapy.” This proved to be a major turning point in occupational therapy’s development and recognition as a legitimate medical field.

The Development of Occupational Therapy

World War I was a pivotal time for the development of occupational therapy. The US military recognized the benefit of “reconstruction aides” providing OT services to those dealing with mental health and physical dysfunction challenges. During this and the subsequent second World War, a great push was made for occupational therapy services to be provided to wounded soldiers. It was during this time that a drastic shift was made from simply utilizing arts and crafts to using activities of daily living in the treatment of a variety of conditions. This push and advancement greatly served to solidify the value of occupational therapy on the world scene.

As OT became more established, the profession and its principles continued to spread around the world. The implementation of occupational therapy assistants also served as a catalyst, greatly increasing the availability and ease of access for OT services.

The mindset of occupational therapists continued to grow, broadening to include a number of additional treatment modalities. One of the most notable of these is the work of A. Jean Ayers and her study of sensory integration. Occupational therapy now leads the industry in the study and treatment of sensory integration dysfunctions.

The Future of Occupational Therapy

Due to the relatively recent nature of occupational therapy, we can see changes being made every year. Further treatment modalities come onto the scene and enter the scope of occupational therapy. Because we have such a broad spectrum of potential treatments, many advancements surely lie ahead.

AOTA holds a view for the future, known as Vision 2025. The vision lays out the core tenants, or pillars, which will be promoted and upheld as we journey into the future:

• Effective: Occupational therapy is evidence based, client centered, and cost-effective.
• Leaders: Occupational therapy is influential in changing policies, environments, and complex systems.
• Collaborative: Occupational therapy excels in working with clients and within systems to produce effective outcomes.
• Accessible: Occupational therapy provides culturally responsive and customized services.

Equity, Inclusion, and Diversity: We are intentionally inclusive and equitable and embrace diversity in all its forms.

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Within these pillars, there are many things we can do individually to help the occupational therapy community grow. One of the most powerful ways we can do this is through advocacy and promotion. Providing the most effective treatments will help other medical professionals see the value and benefit of OT.

Being leaders, speaking up, and promoting OT for clients that would benefit is an essential first step to getting those clients what they need. Collaborating with fellow professionals will help us establish a more firm position in the medical field. Providing accessible services equally to all will make OT more prolific and help as many people as possible.

Let us continue to reflect on our history thoroughly rooted in mental health and holistic treatment of a number of different conditions. Looking to the future, we can know that there will be change. Let us all continue to embrace this change to further benefit our clients and those around the world receiving OT services.

So tell us: What is your favorite part of the history of occupational therapy? What do you see in occupational therapy’s future? Let us know in the comments.

Additional References and Resources:

OT Centennial (AOTA, 2022)

History of Occupational Therapy (Quinnipiac University)

A History of the Occupational Therapy Profession (PEIOT Society)

The Evolution of Occupational Therapy Through the Years (St. Catherine University)

This post was originally published on September 6, 2019 and last updated on May 13, 2023.