The history of occupational therapy, and how it differs from occupational health
Occupational therapy - what is it and where did it come from? And how is it different from occupational health?
When introducing themselves to non-medical individuals, many occupational therapists will receive these questions.
Near to 95% of our clients have little to no idea at initial assessment what an occupational therapist does, or how occupational therapy can help them. And often, occupational therapy gets confused for occupational health.
So, what is the difference?
OH vs OT at a glance
The role of occupational health (OH) is to help employers across various industries maintain a healthy workforce and adhere to health and safety regulations.
An employer will hire an OH company to:
- Manage work-related health issues
- Support employee fitness-for-work
- Provide assessments and interventions to reduce health risks in the workplace
Occupational health is often led by Occupational Medicine Physicians or Occupational Health Nurses with advanced training in workplace health.
However, the role of occupational therapy (OT) is to help individuals overcome physcial, cognitive, or psychological barriers that limit their functional independence.
It focuses on enabling people to engage in meaningful activities - occupations - whether at home, in the community, or at work.
OT serves individuals with specific needs and is led by a clinician with a specialised degree.
Neurological occupational therapy supports those living with a neurological or neurodivergent condition.
This service includes:
- Assessments and interventions promoting functional performance and participation with daily living skills
- Cognitive rehabilitation
- Assistive technology provision
- Mental health support
- Adaptions in the home or workplace
Occupational therapists use activities to improve health and wellbeing. Individuals are referred to OT companies via their employer, insurer, or a self-referral.
This means that occupational health companies will request the specialised services of an occupational therapy company, often for vocational rehabilitation. At that point, occupational therapists will collaborate with occupational health practitioners in multidisciplinary teams.
Our profession is truly holistic; the client-centred nature of the role is guided by the aspirations and goals of the clients we serve. 
Krysalis Founder and CEO, Jo Throp
The history of occupational therapy
The earliest use of activities in healthcare - and therefore the earliest use of occupational therapy - goes as far back as Ancient Greek times.
Asclepiades of Bithynia (124-40 BCE) was the first physician in Rome to treat mental illness patients humanely, using a variety of activities, including therapeutic baths, massages, exercise, and music.
Beyond that, the 18th century saw a shift in mental health treatment from poor management and asylums to the 'Moral Occupational Treatment Movement' which recognised the link between mental wellbeing and activity.
In the 19th century, social reformer Octavia Hill's 'Settlement House Movement' in London focused on self-care and poverty alleviation through recreational activities, highlighting the importance of independent living skills.
By 1917, the UK's first occupational therapy school was set up in Bristol by a woman named Elizabeth Casson.
After working as a Social Housing Officer (and subsequently training as a doctor working within mental asylums), Elizabeth realised that occupation was fundamental to an individual's health.
She pioneered occupational therapy into what it is today.
It is neither wealth nor splendour, but tranquility and occupation which gives you happiness.
Thomas Jefferson
The history of occupational health
Occupational health was estabilished in 1802 when the first UK law - the Factory Act - was put in place to protect workers' welfare, focusing on child labour in textile mills.
31 years later, the Factory Act was extended to other industries, with government-appointed inspectors enforcing regulations.
Over the next 140 years significant advancements in occupational health and safety were made, including:
- Laws prohibiting women and children from underground labour
- Safety regulations for all trades
- Acts that provided detailed codes for safety, welfare, and health
1974 introduced a new system of goal-based regulations, establishing the Health and Safety Executive (HSE), highlighting the importance of safe working environments.
And while numerous pieces of legislation have been established over 200 years, each one continuning to consolidate previous Acts, the aim of occupational health has never changed - to ensure workers, across all industries, can remain safe and healthy at work.
Human occupation is defined as doing the work, play, or activities of daily living within temporal, physical, and sociocultural context that characterises much of human life.
Gary Kielhofne
An intertwined history
Both occupational health and occupational therapy hold deep roots in history, and both have their own unique story.
But these histories merge when occupational healthcare was needed the most.
During World War I and II, occupational therapists worked alongside other healthcare professionals, including occupational health. This optimised soldiers' physical and physcological wellbeing and benefitted countless individuals with their rehabilitation.
Since then, the interactions between OH and OT have become more interwoven.
This became more prominent after the introduction of the Equality Act in 2010, a law established to ensure safe working environments are accessible for all - a key concern for both occupational health and occupational therapy.
The Act means employers must make 'reasonable adjustments' to the physical work environment, provision, or practice for employees and job applicants with disabilities.
Interested in this Act? Discover more information.
It is about understanding life after illness or injury with all its light and shade. We are here to help our clients recognise who they really are; what they could be and should be.
Krysalis Founder and CEO, Jo Throp
Together and apart
Understanding the differences between occupational health and occupational therapy is crucial for making informed decisions about workplace health and personal rehabilitation needs.
Together the two cross in history - and in vocational rehabilitation - working towards better work environments and individuals' health and wellbeing.
Apart, they stand as two integral and beneficial parts of healthcare for occupational needs.
Interested in OT? Find out more about the history of occupational therapy.
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