Occupational therapy
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'''Occupational Therapy''', often abbreviated '''OT''', is the "use of productive or creative activity in the treatment or rehabilitation of physically, cognitively, or emotionally disabled people" (American Heritage Dictionary).<ref>American Heritage Dictionary [http://www.bartleby.com/61/19/O0021900.html]</ref> A more technical definition is: the use of meaningful [[wikt:occupation|occupation]] 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.<ref name="Townsend"/> Occupational Therapists work with a variety of individuals who have difficulty accessing or performing meaningful occupations. Perhaps the simplest definition: "Occupational Therapy is activity analysis and adaptation".
Most commonly, Occupational Therapists and Occupational Therapy Assistants work with people with disabilities to enable them to maximize their skills and abilities. Occupational Therapy gives people the "skills for the job of living" necessary for "living life to its fullest."<ref name="AOTA"/> This also reflects the intent of the OBRA law of 1993 to provide clients with rehabilitation to their "maximum functional ability."
Services typically include:
* Customized intervention programs to improve one's ability to perform daily activities.
* Comprehensive home and job site evaluations with adaptation recommendations.
* Performance skills assessments and treatment.
* Adaptive equipment recommendations and usage training.
* Guidance to family members and caregivers.<ref name="AOTA">American Occupational Therapy Association, Inc. (2005).</ref>
== 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 programm
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 [http://www.otboard.org.nz 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, p. 88).
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 [http://www.aut.ac.nz/schools/rehabilitation_and_occupation_studies/ Auckland University of Technology] and [http://www.otagopolytechnic.ac.nz/schools-departments/occupational-therapy.html 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 was not 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 [[Doctor of Philosophy|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 [http://www.nzaot.com 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===
{{Unreferencedsection|date=September 2007}}
Most registered [[occupational therapist]]s (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.
A master’s degree or higher in occupational therapy is the minimum requirement for entry into the field. In 2007, 124 master’s degree programs offered entry-level education, 66 programs offered a combined bachelor’s and master’s degree, and 5 offered an entry-level doctoral degree. Most schools have full-time programs, although a growing number are offering weekend or part-time programs as well. Coursework in occupational therapy programs include the physical, biological, and behavioral sciences as well as the application of occupational therapy theory and skills. Programs also require the completion of 6 months of supervised fieldwork.
People considering this profession should take high school courses in biology, chemistry, physics, health, art, and the social sciences. College admissions offices also look favorably on paid or volunteer experience in the health care field. Relevant undergraduate majors include biology, psychology, sociology, anthropology, liberal arts, and anatomy.
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]] <ref name="Hocking">Hocking, C (2004). Making a difference: The romance of occupational therapy. South African Journal of Occupational Therapy, 34(2), 3-5.</ref> , [[pragmatism]] <ref name="Breines">Breines, E (1990). Genesis of occupation: A philosophical model for therapy and theory. Australian Occupational Therapy Journal, 37(1), 45-49.</ref> and [[humanism]] which are collectively considered the fundamental ideologies of the past century <ref name="McColl"> McColl, M A, Law, M., Stewart D., Doubt, L., Pollack, N and Krupa, T (2003). Theoretical basis of occupational therapy (2nd Ed). New Jersey, SLACK Incorporated. </ref> <ref name="Chapparo"> Chapparo, C. and Ranka. J. (2000). Clinical reasoning in occupational therapy in Higgs J and Jones M (2000) Clinical reasoning in the health professions. 2nd ed. Oxford, Butterworth Heinemann Ltd. </ref> <ref name =”Yerxa”> Yerxa, E J (1983). Audacious values: the energy source for occupational therapy practice in G. Kielhofner (1983) Health though occupation: Theory and practice in occupational therapy. Philadelphia, FA Davis. </ref>.
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 <ref name="Townsend">Townsend, Elizabeth A. and Helene J Polatajko. (2007). Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-Being & Justice Through Occupation. Ottawa: CAOT Publications ACE.</ref>.
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 <ref name="Turner"> Turner, A. (2002). History and Philosophy of Occupational Therapy in Turner, A., Foster, M. and Johnson, S. (eds) Occupational Therapy and Physical Dysfunction, Principles, Skills and Practice. 5th Edition. Edinburgh, Churchill Livingstone, 3-24..</ref> <ref name="Punwar"> Punwar, A.J. (1994). Philosophy of Occupational Therapy in Occupational Therapy, Principles and practice. 2nd Ed. Williams and Wilkins, Baltimore, 7-20. </ref>. As a result, client centeredness and occupation are re-emerging as dominant themes in the profession, perhaps indicating growing maturity and self confidence <ref name="Douglas"> Douglas, F M (2004). Occupational still matters: A tribute to a pioneer. British Journal of Occupational Therapy, 67(6), 239. </ref> <ref name="Whiteford"> Whiteford, G. and Fossey, E. (2002). Occupation: The essential nexus between philosophy, theory and practice. Australian Occupational Therapy Journal, 49(1), 1-2.
</ref> <ref name="Polatajko"> Polatajko, H (2001). The evolution of our occupational perspective: The journey from diversion through therapeutic use to enablement. Canadian Journal of Occupational Therapy, 68(4), 203-207.
</ref>. 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 <ref name="Townsend"/>.
The two most commonly mentioned values are that occupation is essential for health and the concept of [[holism]]. However, there have been some dissenting voices. Mocellin in particular advocated abandoning the notion of health through occupation as obsolete in the modern world and questioned the appropriateness of advocating holism when practice rarely supports it <ref name="Mocellin1"> Mocellin, G. (1988). A perspective on the principles and practice of occupational therapy. British Journal of Occupational Therapy, 51(1), 4-7. </ref> <ref name="Mocellin2"> Mocellin, G. (1995). Occupational therapy: A critical overview, Part 1. British Journal of Occupational Therapy, 58(12), 502-506. </ref> <ref name="Mocellin3"> Mocellin, G. (1996). Occupational therapy: A critical overview, Part 2. British Journal of Occupational Therapy, 59(1), 11-16. </ref>. 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 <ref name="Kielhofner"> Kielhofner, G. (1997). Conceptual Foundations of Occupational Therapy. 2nd Ed. Philadelphia, F.A.Davis. </ref> <ref name="Hocking/Whiteford"> Hocking, C and Whiteford, G (1995). Multiculturalism in occupational therapy: A time for reflection on core values. Australian Occupational Therapy Journal, 42(4), 172-175. </ref>.
==Areas of Practice in Occupational Therapy==
Occupational therapists may work in both hospitals, ranging from inpatient, subacute, to outpatient clinics. Occupational therapists also have a role in healthcare teams in the community. There are many areas of practice in Occupational Therapy, which is often divided into Physical Health and Mental Health even though the division between the areas are often blurred.
=== Physical Health ===
*[[Pediatrics]]
*Acute rehabilitation (e.g. Spinal Cord Injuries)
*Rehabilitation centers (TBI, Stroke (CVA), Spinal Cord Injuries, etc.)
*Outpatient clinics (e.g. [[Orthopedics]])
===Mental health===
*[[CAMHS|Child and adolescent mental health services]] (CAMHS)
*Mental health clinics
*Prisons/sections ([[Forensic psychiatry]])
*Psychiatric rehabilitation programs
*CSP's
*Club houses
*Early Intervention for Psychosis Services
===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
*Workplaces
*Homeless Shelters
*Educational Settings
*Refugee Camps
== References ==
{{reflist|2}}
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Occupational Therapists, on the Internet at http://www.bls.gov/oco/ocos078.htm (visited July 11, 2008).
#Baum C., & Christiansen, C., (1997), The occupational therapy context: Philosophy - Principles - Practice. In C. Christiansen & C. Baum (Eds.), ''Occupational Therapy: Enabling Function and Well Being''. p. 36. Thorofare, NJ: SLACK
#Bing, R.K. (1981) Occupational therapy revisited: A paraphrastic journey. American Journal of Occupational Therapy, 35(8):499-518.
#Low, J. (1992). The reconstruction aides. American Journal of Occupational Therapy. Jan;46(1):38-43,
#Meyer, A. (1922). The philosophy of occupation therapy. Archives of Occupational Therapy, 1, 1-10.
Buchanan, M. (1941). "letter " Journal of Occupational Therapy 3(2): 12.
Hobcroft, N. (1949). "Life in the Occupational Therapy Department at Porirua." New Zealand Occupational therapy Newsletter Number Two. (May).
New Zealand Occupational Therapy Registration Board (1950). "Minutes of the New Zealand Occupational Therapy Registration Board." 20th June.
New Zealand Occupational Therapy Registration Board (1970b 17th July). "Minutes of the New Zealand Occupational Therapy Registration Board."
New Zealand Registered Occupational Therapists Association (1949). "AGM Minutes."
NZJOT (1996). New Zealand Journal of Occupational Therapy 47(1): 19.
NZNJ (1940). "Editorial " New Zealand Nursing Journal 33(11): 346.
Packer, T., & Stickney, Jan (1991). "Advanced Diploma in Occupational Therapy: A comparison of therapists before and after." Journal of New Zealand Association of Occupational Therapists Inc. 42(1): 3-7.
Skilton, H. (1981). Work for your life - the story of the beginning and early years of occupational therapy in New Zealand. Hamilton, Hudlo Printers.
Wilson, L. H. (2004). Role differentiation in a professionalising occupation: the case of occupational therapy, New Zealand Department of Management Dunedin University of Otago PhD.
==External links to occupational therapy associations and institutions==
===National Associations===
{|
|
* [http://www.ausot.com.au/ Australia]
* [http://www.ergotherapie.at/ Austria]
* [http://www.botabd.netfirms.com/ Bangladesh]
* [http://www.cot.co.uk/ Britain]
* [http://www.caot.ca Canada]
* [http://www.hurt.hr Croatia]
* [http://www.ergoterapie.org/ Czech Republic]
|
* [http://www.etf.dk Denmark]
* [http://www.toimintaterapeuttiliitto.fi Finland]
* [http://www.ergotherapie-dve.de/ Germany]
* [http://www.aiota.org/ India]
* [http://www.irota.ir/ Iran]
* [http://www.aoti.ie Ireland]
* [http://www.isot.org.il/ Israel]
|
* [http://www.aito.it/ Italy]
* [http://www.kaot.org/ Korea]
* [http://www.ot-malaysia.org Malaysia]
* [http://www.ergotherapie.nl/ Netherlands]
* [http://www.nzaot.com New Zealand]
* [http://www.saot.org.sg Singapore]
* [http://www.otasa.org.za South Africa]
|
* [http://www.apeto.com Spanish]
* [http://www.fsa.akademikerhuset.se/ Sweden]
* [http://www.ot-roc.org.tw/ Taiwan]
* [http://www.geocities.com/otuganda/ Uganda]
* [http://www.cot.org.uk UK]
* [http://www.aota.org USA]
|}
==Other Organizations==
*[http://occupational-therapy.advanceweb.com/ ADVANCE for Occupational Therapy Practitioners]
* [http://www.wfot.org World Federation of Occupational Therapists]
* [http://www.cotfcanada.org Canadian Occupational Therapy Foundation]
* [http://www.enothe.hva.nl The European Network of Occupational Therapy in Higher Education]
* [http://www.otinfo.org Occupational therapy news and resources portal]
* [http://www.otconnect.com OT Connect: discussion board]
* [http://www.rehablicense.com/professional.php?profID=6 Occupational Therapy License Information]
{{Allied health professions}}
[[Category:Occupational therapy]]
[[Category:Special education|O]]
[[Category:Rehabilitation medicine]]
[[Category:Therapy]]
[[bn:কর্মসংক্রান্ত চিকিৎসা]]
[[ca:Teràpia ocupacional]]
[[da:Ergoterapi]]
[[de:Ergotherapie]]
[[el:Εργοθεραπεία]]
[[es:Terapia ocupacional]]
[[fr:Ergothérapie]]
[[hr:Radna terapija]]
[[it:Terapia occupazionale]]
[[he:ריפוי בעיסוק]]
[[nl:Ergotherapie]]
[[ja:作業療法]]
[[no:Ergoterapi]]
[[pl:Terapia zajęciowa]]
[[pt:Terapia ocupacional]]
[[sr:Окупациона терапија]]
[[fi:Toimintaterapia]]
[[sv:Arbetsterapi]]
[[th:กิจกรรมบำบัด]]
[[zh:職能治療]]