Occupational therapy is a health profession focused on enabling people to participate in the activities of daily life. It is centered on the idea that engaging in purposeful activities, or “occupations,” can promote health and enhance well-being across the lifespan. This specialized field assists individuals in recovering from injury or illness, maintaining function despite disability, and adapting their environment to achieve maximum independence. The history of occupational therapy is a gradual evolution rooted in a shift in how society viewed and treated individuals with mental and physical challenges.
Philosophical Roots in Moral Treatment
The intellectual groundwork for occupational therapy was established centuries before the profession formally organized, stemming from the late 18th and early 19th-century Moral Treatment movement. This movement advocated for a humane approach to treating mental illness, moving away from the harsh confinement and purely custodial care that was common in asylums. Proponents of this new philosophy believed that structured, purposeful engagement could serve as a powerful therapeutic tool for the mind and body.
A French physician named Philippe Pinel was a prominent figure, championing the use of occupation, literature, and physical exercise to manage emotional distress among patients in France. Around the same time in England, Quaker philanthropist William Tuke established the York Retreat, which was founded on principles of kindness and encouraging patients to participate in activities like farming and crafts. Both men shared the belief that treating individuals with respect and involving them in goal-directed use of their time would lead to better outcomes.
This concept of using occupation as a restorative force spread to the United States and was influential in American hospitals during the mid-19th century. Although the application of Moral Treatment declined toward the end of the 1800s, the underlying idea that meaningful activity could heal resurfaced. The subsequent Arts and Crafts Movement, which emphasized the value of traditional craftsmanship and engaging the hands, helped bridge the gap between the philosophical roots and the medical application of purposeful activity.
The Formal Founding of the Profession
The formal establishment of occupational therapy occurred in the United States during the early 20th century, a time of significant social and medical change. The profession officially began on March 15, 1917, when a small, diverse group of individuals met in Clifton Springs, New York, to form the National Society for the Promotion of Occupational Therapy (NSPOT).
The founders, often referred to as the “Founding Six,” came from various backgrounds, including psychiatry, architecture, and social work, united by the belief that occupation held therapeutic value. These individuals included:
- Architect George Edward Barton, who hosted the founding meeting at his rehabilitation center, Consolation House
- Psychiatrist Dr. William Rush Dunton Jr., who became known as the father of occupational therapy
- Nurse and teacher Susan Cox Johnson
- Vocational secretary Thomas Kidner
- George Barton’s secretary Isabel Newton
- Eleanor Clarke Slagle, considered the mother of the profession
The group’s most influential figure was Eleanor Clarke Slagle, who is considered the mother of the profession for her advocacy of “habit training” and her work in establishing the first professional training school. The NSPOT’s initial objectives were to promote and study curative occupations for convalescents and invalids, encouraging research and cooperation among those dedicated to rehabilitation. The founders intentionally chose the name “occupational therapy” to encompass both the use of meaningful activity and its application within a medical context.
Post-War Growth and Standardization
The nascent profession quickly found need for its services with the onset of World War I, which brought soldiers home with physical injuries and psychological conditions like “shell shock.” The United States War Department appointed civilian women, known as “Reconstruction Aides,” to work in military hospitals both at home and abroad. These early practitioners used crafts and vocational skills to help wounded servicemen restore function, increase morale, and prepare for a return to civilian life.
This wartime experience dramatically increased the visibility and acceptance of the therapeutic value of occupation in the medical community. Following the war, the organization underwent a name change in 1923, becoming the American Occupational Therapy Association (AOTA). The AOTA then focused on standardizing the emerging field.
Efforts were made to establish educational requirements, leading to the adoption of the Essentials of an Acceptable School of Occupational Therapy in 1935, in collaboration with the American Medical Association. This document helped define accredited programs and set a professional baseline for practice. World War II further accelerated the demand for therapists, leading to the creation of emergency training courses to meet the urgent need for rehabilitation specialists.