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This article discusses occupational therapy (OT) in the United Kingdom.
| This article has multiple issues. Please help improve it or discuss these issues on the talk page . (Learn how and when to remove these messages)
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This article discusses occupational therapy (OT) in the United Kingdom.
Every year around 1,500 new students embark on training to become registered occupational therapists. To qualify as an occupational therapist one is required undertake an approved programme of study at one of the 31 UK universities offering occupational therapy education. There are a variety of full and part-time programmes available in occupational therapy the UK, most are Bachelor of Science (with Honours) degrees; some are Postgraduate Diplomas, others are Master's degrees. [1]
All programmes must be approved by the Health and Care Professions Council (HCPC) as meeting their minimum standards. This approval is mandatory in order for the graduates to be registered to practice. In contrast, accreditation is a voluntary process which confers further recognition of a programme by the Royal College of Occupational Therapists (RCOT). Those universities that continue to be accredited have committed to working in partnership with the professional body (the RCOT) to maintain high standards of education and practice, and to steer the profession's development within the UK and abroad. [1]
The content of programmes varies but all combine both practice and academic study. Academic components may include anatomy and physiology, psychology and sociology, occupational therapy knowledge and skills, creative and management skills, therapeutic interventions, environmental adaptations and research methods and applications.
In the late 19th and early 20th centuries, the establishment of public health measures to control infectious diseases included the building of fever hospitals. Patients with tuberculosis were recommended to have a regime of prolonged bed rest followed by a gradual increase in exercise. [2] Dr Philip, a Scottish physician, prescribed graded activity from complete rest through to gentle exercise and eventually to activities such as digging, sawing, carpentry and window cleaning. During this period a farm colony near Edinburgh and a village settlement near Papworth in Cambridgeshire were established, both of which aimed to employ people in appropriate long-term work prior to their return to open employment.
During and after the First World War, casualties amongst young men resulted in an acute shortage of manpower in the workforce. The need to re-establish these men in open employment facilitated the growth of OT in the treatment of those with physical disabilities. [3] Curative workshops were opened within military hospitals, based on similar workshops already established in the United States, and were equipped with tools and machinery to exercise joints and muscles. Based on these workshops the first occupational therapy department in Scotland was opened in 1936 at the Astley Ainslie Institution in Edinburgh, where at the same time the first Occupational Therapy Training Centre was opened.
Margaret Barr Fulton became the first occupational therapist to work in the United Kingdom in 1925. She qualified at the Philadelphia School in the United States and was appointed to the Aberdeen Royal Hospital for mental patients where she worked until her retirement in 1963. During that time, she gained an international reputation for her department and for her part in the development of both the Scottish Association (SAOT) and the World Federation of Occupational Therapists (WFOT). OT was introduced into England by Dr Elizabeth Casson who had visited similar establishments in America. In 1929 she established her own residential clinic in Bristol, Dorset House, for "women with mental disorders", and worked as its medical director. It was here in 1930 that she founded the first school of occupational therapy in the UK, Dorset House, The Promenade, Clifton. Its first Principal was Constance Tebbit (later Owens) who returned from training as an occupational therapist in Philadelphia to take up her post. She later went on to set up the Liverpool School of Occupational Therapy. [4] She opened Dorset House School of Occupational Therapy in Bristol in 1930. Her interest in occupational therapy continued with involvement in the Association of Occupational Therapists (AOT), established in 1936. The Second World War added impetus to the development of occupational therapy as the profession played a vital role in the rehabilitation and re-establishment of wounded soldiers into the workforce.
Occupational therapists work from an understanding that there is a relationship between the things that people do and their health and well-being [5] This is a list of some of the characteristics of occupations, as discussed in literature in the last decade:
It has been suggested that occupation can be defined simply as "doing, being and becoming", [14] a simple definition which captures the notion of subjectively meaningful activity which results in some kind of transformation in the "doer".
The word occupation has a relatively precise usage in the fields of occupational therapy and occupational science but other disciplines (such as anthropology, psychology, leisure studies) have an interest in the human activities. It can be argued that all activities are meaningful, given that they are socially situated, symbolic constructs, and so the understanding of an activity as an occupation rests, perhaps on personal meaningfulness.
Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles. OTs have training in the physical, psychological, and social aspects of human functioning deriving from an education grounded in anatomical and physiological concepts, and psychological perspectives. They enable individuals across the lifespan by optimizing their abilities to perform activities that are meaningful to them ("occupations"). Human occupations include activities of daily living, work/vocation, play, education, leisure, rest and sleep, and social participation.
Occupational therapy (OT) is a healthcare profession that involves the use of assessment, intervention, consultation, and coaching to develop, recover, or maintain meaningful occupations of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to support mental health and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in activities that occupy an individual's time. It is an independent health profession sometimes categorized as an allied health profession and consists of occupational therapists (OTs) and occupational therapy assistants (OTAs). OTs and OTAs have different roles, with OTs licensed to complete comprehensive occupational therapy evaluations. Both professionals work with people who want to improve their ability to participate in meaningful occupations.
Occupational science is a discipline dedicated to the study of humans as "doers" or "occupational beings". As used here, the term "occupation" refers to the intentional or goal-directed activities that characterize daily human life as well as the characteristics and patterns of purposeful activity that occur over lifetimes.
Sensory integration therapy (SIT) was originally developed by occupational therapist A. Jean Ayres in the 1970s to help children with sensory-processing difficulties. It was specifically designed to treat Sensory Processing Disorder. Sensory Integration Therapy is based on A. Jean Ayres's Sensory Integration Theory, which proposes that sensory-processing is linked to emotional regulation, learning, behavior, and participation in daily life. Sensory integration is the process of organizing sensations from the body and environmental stimuli.
Elizabeth Casson OBE was a British medical doctor and an occupational therapy pioneer. Initially training as a secretary, Casson began studying medicine at the University of Bristol when she was 32. She received her medical degree in 1926, becoming the first woman to receive one from the University of Bristol. She also attained the Gaskell prize from the Royal Medico-Psychological Association and a diploma in psychological medicine from the University of London.
The American Occupational Therapy Association (AOTA) is the national professional association established in 1917 to represent the interests and concerns of occupational therapy practitioners and students and improve the quality of occupational therapy services. AOTA membership is approximately 63,000 occupational therapists, occupational therapy assistants, and students.
Anna Jean Ayres was an American occupational therapist, educational psychologist and advocate for individuals with special needs. She became known for her work on sensory integration (SI) theory.
Vision rehabilitation is a term for a medical rehabilitation to improve vision or low vision. In other words, it is the process of restoring functional ability and improving quality of life and independence in an individual who has lost visual function through illness or injury. Most visual rehabilitation services are focused on low vision, which is a visual impairment that cannot be fully corrected by regular eyeglasses, contact lenses, medication, or surgery. Low vision interferes with the ability to perform everyday activities. Visual impairment is caused by factors including brain damage, vision loss, and others. Of the vision rehabilitation techniques available, most center on neurological and physical approaches. According to the American Academy of Ophthalmology, "Provision of, or referral to, vision rehabilitation is now the standard of care for all who experience vision loss.."
Cultural humility is the “ability to maintain an interpersonal stance that is other-oriented in relation to aspects of cultural identity that are most important to the [person].” Cultural humility is different from other culturally-based training ideals because it focuses on self-humility rather than being an other-directed "they/them" way of achieving a state of knowledge or awareness. It is helpful to see as others see; what they themselves have determined is their personal expression of their heritage and their “personal culture”. Cultural humility was formed in the physical healthcare field and adapted for therapists, social workers, and medical librarians, to learn more about experiences and cultural identities of others and increase the quality of their interactions with clients and community members.
Substance use disorders (SUD) can have a significant effect on one's function in all areas of occupation. Physical and psychosocial issues due to SUD can impact occupational performance. Unfulfilled life roles and disruption in meaningful activity can result from lack of structure or routine, poor motivation, limited skills, and poor social networks. These deficits may also contribute to stress, affecting the ability to cope with challenges. While SUD can affect a client's participation in therapy and ability to follow recommendations, occupational therapists are trained to facilitate occupational participation and performance.
Occupational injustice derives from the concept of occupational justice, which originated in 1997 with social scientists/ occupational therapists Ann Wilcock of Australia and Elizabeth Townsend of Canada. As a particular application of social justice, occupational injustice occurs when a person is denied, excluded from or deprived of opportunity to pursue meaningful occupations or when unchosen occupations are imposed upon them thus limiting life satisfaction. The construct of occupational rights stems from human rights but focuses on the inherent right of individuals to participate in occupations, construed as their personally meaningful and goal-directed use of time. Through this participation, occupational rights contribute to fulfillment and self-actualization. Groups of people that may be vulnerable to experiencing occupational injustices include cultural, religious, and ethnic minority groups, child labourers, the unemployed, prisoners, persons with substance use disorder, residents of institutions, refugees, and/or women.
Thomas B. Kidner (1866–1932) was one of the founders of the National Society for the Promotion of Occupational Therapy (NSPOT) later renamed the American Occupational Therapy Association (AOTA). He served as president of the society from 1923 to 1928.
Sensory processing disorder is a condition in which multisensory input is not adequately processed in order to provide appropriate responses to the demands of the environment. Sensory processing disorder is present in many people with dyspraxia, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). Individuals with SPD may inadequately process visual, auditory, olfactory (smell), gustatory (taste), tactile (touch), vestibular (balance), proprioception, and interoception sensory stimuli.
Frances Moran Rutherford was an artist, an occupational therapist and educator who was instrumental in gaining recognition for occupational therapy in New Zealand.
Elnora M. Gilfoyle is a retired American occupational therapist, researcher, educator, and university administrator. She worked at several hospitals before accepting a professorship at Colorado State University, later serving as Dean of the College of Applied Human Sciences and Provost/Academic Vice President at that university. She is also a past president of the American Occupational Therapy Association. With research interests in child development, developmental disabilities, and child abuse, she has led studies on the state and federal levels. The co-author of two books and many articles, she was inducted into the Colorado Women's Hall of Fame in 1996.
Gary Wayne Kielhofner was an American social scientist and influential occupational therapy theorist who rose to prominence as a scholar during his time as Professor and Wade-Meyer Chair of the Department of Occupational Therapy at the University of Illinois at Chicago. He is best known for his conceptual practice model, which is known globally as The Model of Human Occupation (MOHO). The model was first published as a series of articles in The American Journal of Occupational Therapy by Kielhofner and others but later extensively developed over Kielhofner's career and disseminated in numerous books and articles. Kielhofner lectured widely and consulted regularly in the United States and abroad, particularly throughout Scandinavia, the United Kingdom,, Ireland, Italy, France, Germany, Spain, Portugal, Japan, Hong Kong, Israel, and Central and South America. An active network of proponents across the international occupational therapy community continues to study and evolve his model through the MOHO Clearinghouse maintained at the University of Illinois at Chicago (UIC).
Evelyn Mary Macdonald was a British occupational therapist who helped establish occupational therapy in the United Kingdom, Argentina and Greece. She founded the Association of Occupational Therapists. Miss Macdonald was Principal of Dorset House, the oldest and largest School in Great Britain for 33 years. She was an appointed member of the Cope Committee which led to the statutory regulation of the Professions Supplementary to Medicine in 1960. Macdonald was the first Chair of the Occupational Therapists Board. She was an author, an early advocate of cooperation between the allied health professions and a historian of the Association.
Alice Catherine Jantzen was an American occupational therapist. She was the first president of the American Occupational Therapy Foundation (AOTF), and chair of the occupational therapy department at the University of Florida from 1958 to 1976.
Helen Smith Willard was an American occupational therapist and college professor. She was a professor of occupational therapy at the University of Pennsylvania, and co-authored Principles of Occupational Therapy (1947), an important textbook in the field. She was president of the American Occupational Therapy Association (AOTA) from 1958 to 1961.
Clare Spencer Spackman was an American occupational therapist. She and Helen S. Willard) co-wrote Principles of Occupational Therapy (1947), a textbook widely used in the field. She was president of the World Federation of Occupational Therapists from 1957 to 1962, and a professor at the University of Pennsylvania.
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