Everything about Occupational Therapy totally explained
Occupational therapy, often abbreviated
OT, is the "use of productive or creative activity in the treatment or rehabilitation of physically or emotionally disabled people" (American Heritage Dictionary). A more technical definition is that OT is the use of meaningful to assist people who have difficulty in achieving a healthy and balanced lifestyle and to enable an inclusive society so that all people can participate to their potential in daily occupations of life.
History of occupational therapy in Aotearoa/New Zealand
The early use of occupation to support, treat and rehabilitate people in Aotearoa New Zealand is evident in services for returned soldiers after World War 1 ((Hobcroft 1949)). There are glimpses in mental health services during the 1930's too (Skilton 1981). However the first qualified occupational therapist Margaret Buchanan arrived in New Zealand in 1941 (Buchanan 1941). Initially employed in the then Auckland Mental Hospital she was rapidly involved not only in the development of occupational therapy services there, but also the development of the first training programmes and advice to government. Initially those trained had previous health or education backgrounds (Skilton 1981). A formal two year training programme was established by 1940 (NZNJ 1940), and state registration provided for in the Occupational Therapy Act 1949 with the New Zealand Occupational Therapy Registration Board 1950 but since replaced by the
Occupational Therapy Board of NZ
through the Health Practitioners Competence Assurance Act 2003. From its early services in mental health and returned serviceman settings occupational therapy expanded into general rehabilitation, work with children with disabilities and services for the elderly (Wilson 2004) p88.
Educational programmes moved from the health sector to the education sector in 1971 (New Zealand Occupational Therapy Registration Board 1970b 17th July). OT career training is now provided by the Schools of Occupational Therapy at the
Auckland University of Technology
and
Otago Polytechnic
in Dunedin. An advanced diploma in occupational therapy was first made available in 1989 (Packer 1991) and bachelor programmes have been available since the 1990's. However, it wasn't until a review of the Education Act that it was possible for masters degree programmes to be made available, as they now are through both schools . The first New Zealand occupational therapist to complete a PhD in the country in a programme related to occupational therapy was Linda Robertson who completed her PhD in 1994 (NZJOT 1996). The development of distance education technology has enabled large numbers of therapists to participate in post-graduate distance education.
An association for practitioners was formed in 1948 (New Zealand Registered Occupational Therapists Association 1949) and since renamed as the
New Zealand Association of Occupational Therapists (Inc) or NZAOT
. The NZAOT provides a bi-annual conference, representation at government levels, a journal and a monthly newsletter.
History of occupational therapy in the United States of America
Occupational therapy began as a profession in the United States in 1917 with the founding of the Society for the Promotion of Occupational Therapy (now, The American Occupational Therapy Association, Inc.). The creation of the society was impelled by a belief in the curative properties of human occupation (or everyday purposeful activity). It had previously been employed as part of the moral treatment movement in the large state supported institutions for mental illness that were widespread in the United States. Occupational therapy has played a prominent role in epidemics, providing treatment for patients with tuberculosis, polio, and HIV/AIDS. In 1975, following the enactment of legislation known as the
Education for All Handicapped Children Act (PL 94-142), thousands of occupational therapists were employed by public schools to provide therapeutic services (known as related services) to enable children with disabilities to participate in regular school settings. Originally, therapists from approved training programs were certified, or registered by the
American Occupational Therapy Association. A baccalaureate degree was required for certification beginning in the 1940s. Fifty years later, accredited programs were required to be at the Master's degree level. The 1990s saw the evolution of doctoral programs in occupational therapy. Educational programs in occupational therapy are now accredited by the
Accreditation Council for Occupational Therapy Education, and national certification is granted under the auspices of the
National Board for Certification in Occupational Therapy. More recently, a new discipline within occupational therapy has opened up known as
occupational science. Many students in 5-year masters program now receive their undergraduate degree in this discipline and go on to receive a Masters degree in occupational therapy during their 5th year.
Occupational therapy educational requirements
Occupational therapy practitioners are skilled professionals whose education includes the study of human growth and development with specific emphasis on the physical, emotional, psychological, sociocultural,
cognitive and environmental components of illness and injury.
Occupational therapy education in the USA
Most registered
occupational therapists (OTR) practicing in the field today possess a Bachelor of Science degree in occupational therapy. However, by 2007, all OTRs will enter the field with a Masters (M.A., M.S., or MOT) or a professional Doctoral degree (OTD). A
certified occupational therapy assistant (COTA) generally earns an associate degree.
To become eligible for the national examination for certification, students must complete a minimum of two (three maximum) supervised clinical internships in physical disabilities, pediatrics or mental health. Many college programs encourage students to pursue a third internship in an area of OT of their choosing. Upon successful completion of at least two internships, graduates must pass a national examination (NBCOT or National Board for Certification in Occupational Therapy). Most U.S. states also regulate occupational therapy practice (OTs must possess a license within their state).
The philosophy of occupational therapy
The
philosophy of occupational therapy has evolved over the history of the profession. The philosophy articulated by the founders owed much to the ideals of
romanticism ,
pragmatism and
humanism which are collectively considered the fundamental ideologies of the past century .
William Rush Dunton, the creator of the National Society for the Promotion of Occupational Therapy, now the American Occupational Therapy Association, sought to promote the ideas that occupation is a basic human need, and that occupation was therapeutic. From his statements, came some of the basic assumptions of occupational therapy, which include:
Occupation has an effect on health and well being.
Occupation creates structure and organizes time.
Occupation brings meaning to life, culturally and personally.
Occupations are individual. People value different occupations .
These have been elaborated over time to form the values which underpin the Codes of Ethics issued by each national association. However, the relevance of occupation to health and well-being remains the central theme. Influenced by criticism from medicine and the multitude of physical disabilities resulting from World War Two, occupational therapy adopted a more reductionistic philosophy for a time. While this approach lead to developments in technical knowledge about occupational performance, clinicians became increasingly disillusioned and re-considered these beliefs . As a result, client centeredness and occupation are re-emerging as dominant themes in the profession, perhaps indicating growing maturity and self confidence . Over the past century, the underlying philosophy of occupational therapy has evolved from being a diversion from illness, to treatment, to enablement through meaningful occupation . The values formulated by the American Association of Occupational Therapists have also been critiqued as being therapist centred and not reflecting the modern reality of multicultural practice .
Potential uses of occupational therapy
A wide variety of people may benefit from occupational therapy, these may include people with:
work-related injuries including lower back problems or repetitive strain injuries
physical, cognitive or psychological limitations following a stroke, brain injury or heart attack
rheumatoid and age-related conditions such as arthritis
neurodegenerative movement disorders such as multiple sclerosis, amyotrophic lateral sclerosis, or Parkinson's disease
birth injuries, learning difficulties, or developmental disabilities
mental health difficulties Alzheimer's, schizophrenia, ADHD and post-traumatic stress
substance abuse problems or eating disorders
Fetal alcohol syndrome due to central nervous system damage from prenatal alcohol exposure
obsessive compulsions, or diagnosed obsessive compulsive disorder (OCD)
burns, spinal cord injuries, or amputations
fractures or other injuries from falls, sports injuries, or accidents
visual, perceptual or cognitive impairments
developmental disabilities such as autism or cerebral palsy
domestic abuse issues
homelessness
refugees and asylum seekers
sensory processing disorders
Areas of occupational therapy
Occupational therapists work in a vast array of settings, these include:
Physical
Orthopedics (outpatient clinics)
Pediatrics
Cerebral Palsy
motor discoordination and clumsiness
Long-Term Care
Hand therapy
Cardiac rehabilitation
Burn Centers
Rehabilitation centers (TBI, Stroke (CVA), spinal cord injuries, etc.)
Hospitals (ranging from inpatient, subacute rehab, to outpatient clinics)
Forensic units
Homeless Shelters
Educational Settings
Refugee Camps
Community Settings
Industrial therapy (work hardening, work conditioning, job demand analysis)
Community
Community based practice means moving away from hospitals and rehabilitation clinics and working with atypical populations such as the homeless or at risk populations.
Examples of community-based practice settings:
Health promotion and lifestyle change
Intermediate care
Day centers
Schools
Child development centers
People's own homes, carrying out therapy and providing equipment and adaptations
Implementing gradual return to work programmes which include workplace and work station assessments
Home Care
Cognitive
Stroke rehabilitation
Traumatic brain injury
Multiple sclerosis
Parkinson's disease
Mental Retardation
Learning Disabilities
Mental health
Child and adolescent mental health services (CAMHS)
Forensic psychiatry
Prisons/sections
Mental health clinics
Psychiatric rehabilitation programs
CSP's
Club houses
Early Intervention for Psychosis servicesFurther Information
Get more info on 'Occupational Therapy'.
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