History of Occupational Therapy 1900-1939: ARTS AND CRAFTS MOVEMENT AND THE INFLUENCE OF WWI

Time line 1900: US Population Increases 1917: US enters WWI Progressive era fuels reform Increase of women in the work place 1917: US enters WWI 1919: WWI ends (Treaty of Versailles) 1920: Women gain the right to vote 1929: Great depression B population grew from 16 million to 75 million due to increase in immigration Factories and assembly lines increased women in the work place During WWI every therapist was called upon to help treat injured soldiers Gaining the right to vote - amendment 19 change the role of women

Women’s Movement and Influence Goal: establish selves outside of domestic sphere Argument for: Morally superior Naturally nurturing Alturistic Reform impulses Christian charity Helping the poor or “the suffering” Gender roles clearly defined within this period Men: leadership in the public sector Women: Establish institutes R

Hull House Established by Jane Addams and Ellen Gates Starr All female and secular society for political and professional training Believed in scientific method for learning about social issues Goal: Bridge gap between middle-class reformers and the poor Developed strong political ties with influential men and women in Chicago Meeting house for supporters of contemporary social movements Chicago Arts and Crafts Society R

Anti-Modernism Reaction to industrialism, emphasis on hand-made products Equated idle hands with immoral character Linked to the arts & crafts movement, appreciation for meaning in simplicity (Transcendentalism) R -idealization by the middle and upper classes in the US in late 1800s, early 1900s

“This emphasis on the work ethic and on the idea that idleness produces an immoral character appears to have been intimately linked to early occupational therapy philosophy and to the arts-and-crafts movement or anti-modernism” - (Gutman,1995, p.259) R

Arts and Crafts Movement British roots “humans, not machines, completed objects; therefore, work was not abstracted from life but had a place at its very core” -Ruskin Relevance to American happenings Machine “gimcrackery” H mid 19th century british professor, john ruskin “romantic,” who looked back to the time when humankind was simpler… and healthier! With industrialization, John ruskin and william morris. - machine gimcrackery- poor quality of products > anti-modernization

Arts & Crafts Reaches America Quality of design Natural materials Handmade designs Simple in design Quality of life “handicraft clubs” “arts-and-crafts societies” H By the 20th century Clubs and Societies- Middle and uppermiddle class Stability Moral values >>> slow paced life in a changing country/environment

Meanwhile in Medicine… Advances Shift towards a scientific foundation “Disease was understood in terms of physiological processes rather than in terms of suffering or personal disorientation; specialists concerned themselves with organs and tissues rather than the whole patient” (Levin, 1987, p. 249) H X-rays Labs Goal: remove sick from the environment

Alternative Medical Approach Dr. Herbert J. Hall Work cure Adolf Meyer, Mary Potter Brooks Meyer, and William Rush Dunton Curative occupation Goal-directed activity Julia Lathrop Susan Tracy Nursing H Work cure took place of commonly prescribed bed rest Based therapeutics only on the philosophy espoused by the Arts-and-crafts enthusiasts. Mary potter brooks meyer Social worker who developed occupational programs for ward patients Julia lathrop -applied arts-and-crafts ideology to chronically ill mental patients Susan Tracy occupations training course for nurses work Teaching strategies Supplies lists introduced an OT program for general medical patients at Michael Reese Hospital in Chicago

“These progressive physicians, Meyer, Hall, and Dunton, worked with social caretakers Lathrop and Tracy to link the holistic treatment of the past with the modern, scientific approaches” (Levin, 1987, p. 250) H

Sheltered Workshops Items sold in shops Three purposes Employ talented people who could earn a living by making authentic objects To give spiritual support to craftspeople who pursued crafts as an avocation To help employ the mentally and physically handicapped H Sheltered workshops- Hall and other physicians developed workshops where patients produced carefully designed, and hand made objects Hand towels, ceramic vases, cement pots

“The early occupational therapy link to the arts-and-crafts movement did not end with the demise of the therapeutic workshop.” H UNFORTUNATELy- workshops shifted from having a therapeutic purpose …. To a more cost-conscious point of view OT Purpose was lost in the workshops… NOT IN GENERAL- THERE WAS STILL OT

Slagle and Meyer Unite Belief that life should become as routine as possible Meyer’s research on the “unbalanced” cycles of schizophrenia Habit training= practice model Meyers and Slagle when at Henry Phipps Clinic at John Hopkins A -model developed in the arts and crafts movement, based on simplifying (routine) -life should become as routine as possible -using the schizophrenia patients Meyer observed that unbalance leads to a loss of organizing and stabilizing factors  manifested in absence of sleep, play, leisure -habit training developed by Meyers and Slagle, practice model that schedules an individual’s occupations into a 24 hour day, with the goal of the schedule becoming habitual, TEACH client to

Habit Training Habit Formation as a learning process Balance of occupational cycles A Concept of habit training developed by Eleanor Clarke Slagle -Meyers observations and Slagles model were combined to implement their treatment model of habit training Sequence of occupational cycles Habit Training

Roots of Rehabilitation in War US Army rehabilitation program based on English reconstruction model “Bedside occupation and curative workshops” Army Division of Orthopedics British colonel Robert Jones’ Orthopedic rehabilitation  back in war Society’s social & moral responsibility A -Goldthwait & Brackett (Harvard trained orthopedists) form the Army Division Orthopedics -Robert James has seen realities of war and how many injuries  believes orthopedics can make men suitable to stay in war (medical/curitative) or AT LEAST more functional in society (so not burden), believes it is society’s obligation to help these people, it will help lessen economic strain on the country -see orthopedics and rehab positions as link between “acute medical care and physical restoration”

Reconstruction Aides 1918: Walter Reed Hospital (DC), Orthopedic Department uses physiotherapists & occupational therapists “The employment of reconstruction aides [is] inadvisable […] it is not desirable to employ women in this type of work in military hospitals” Commanding officers begin to call for more A -War Dept. wants to employ enlisted men as reconstruction aides (very plausible due to lack of men to fill roles) -decide to employ women but no commission or rank -reconstruction aides begin to prove selves as commanding officers begin to request more reconstruction aides

Evolution of reconstruction aides Requirements established for R.A. position Educational training (medical disabilities, anatomy, physiology) Demonstrate 3 fields occupation (crafts) Reasons for pursuing career: Economic necessity Contribute something to society Experienced ACTIVITIES OF MEANING, PURPOSE A -as reconstruction aides became more prolific  standards, be able to help people cultivate occupation “bedside” -many women cine from families common women to work, higher education (or at least pursued), experience caring for friend or relative with severe illness or disability, leadership roles in past

The Fight of Reconstruction Aides ORTHOPEDISTS RECONSTRUCTION AIDES: Physiotherapists, OTs VOCATIONAL EDUCATORS A UNBELIEVABLY POLITICAL -treated poorly -orthopedists want full control -see themselves as highest positions and want reconstruction aides to be extensions of themselves (ROM activities etc) -believe they have the ability to “prescribe” occupation (either in war or if solider must return to community) -conflicts b/w reconstuction aides and vocational educators: May 1918, war department makes Division of Physical Reconstruction, place reconstruction aides in -devalues occupational therapy become linked only to obtaining a vocational future just like vocational educators -November 1918- influenza  called on to assist  begins drift back medical slant -by end of war occupational therapist spending much more time with orthopedists NURSES

After WWI Medical orientation in OT -curriculums First occupational therapy program -Milwaukee B

Elizabeth Upham Started 1st OT program at Milwaukee Downer College Taught Intensive work in crafts Lectures covering medical, psychology, sociology, economics and theory Hospital practice training B

Elizabeth Upham Believed in moral character improvement through purposeful activity Established the program to align OT with stronger medical affiliation and offered more structured course work to gain more credibility for the profession B

Elizabeth Upham Suggested a person “who becomes an independent wage-earner adds to the resource of the country, while every one who cannot increases the drain of dependents” (p.259, Gutman, 1995). B

Organizations National Society for promotion of Occupational Therapy First meeting in 1917 Only six people attended; FIRST NAME??Barton, Isabel Newton, Eleanor Clark Stagle, William Dunton Jr, Thomas Kinder and Susan Cox Johnson By 3rd meeting in 1919 300 people attended Changed name to AOTA in 1921 B

Academia First issue of Archives of Occupational Therapy published in 1922 by AOTA Later became known as American Journal of Occupational Therapy (AJOT) B

Federal Industrial Rehabilitation Act Passed in 1923 Mandated hospitals that were caring for people with industrial injuries or illness to use OT program goal is to allow disabled individuals to be “restored to useful, remunerative employment and to self-respecting, self-supporting lives” (Clark, 1945, p. 504) B Also known as the “civilian industrial rehabilitation act” This act did not have immediate, change. In 1937 80% of Occupational Therapists were still in the mental health field not in physical disability which was the aim of this act. (p. 504, (1945), industrial hygiene and the expandable federal state vocational rehabilitation program, American Journal of Public Health, 35,clark, D.)

Contributions we see now… Multidisciplinary Holistic Mostly women Curriculum Standardization Balance AOTA R -habit training=balance, OTs working with a “client-centered” approach to help clients arrange their lives to achieve balance and satisfaction through meaningful occupations and organization meaningful to them

References Crark, D. (1945). Industrial hygiene and the expandable federal state vocational rehabilitation program. American Journal of Public Health, 35, 504 Gutman, S.A.(1995). Influence of the U.S. military and occupational therapy reconstruction aides in World War I on the development of occupational therapy. The American Journal of Occupational Therapy, 49 (3), 256-262. Levine, R. (1987). The influence of the arts-and-crafts movement on the professional status of occupational therapy. The American Journal of Occupational Therapy, 41 (4), 248-254. Reed, K.L,& Sanderson, S.N. (1999). Concepts of occupational therapy. p.238-241. Philadelphia: Lippincott Williams & Wilkins HIIIIIIIIIIII RASHNIIIIIIIIIIIIIIII