What does an Occupational Therapist do?
OTs use activities to improve health and wellbeing. They work with all age groups and understand the concept of human occupation and behaviour; they understand activities, human function and the impact of the environment on individual abilities. They are interested in a person’s ability to participate and perform activities and they use activities as therapeutic tools to promote health and wellbeing.
OTs hold a BSc (Hons) degree in occupational therapy or a Diploma of the College of Occupational Therapists (Dip COT) and after a period of clinical practice they usually specialise in a chosen clinical speciality, including, among others, neurogical OT.
The history of the use of activities in healthcare
Occupational therapy and, specifically, the use of activities in healthcare has established roots in history. The earliest use of activities in healthcare goes as far back as Ancient Greek times. Asclepiades of Bithynia (124-40 BCE) was the first physician in Rome who treated patients with a mental illness humanely using a variety of activities, including therapeutic baths, massage, exercise and music.
Having a knowledge of how medical care has evolved throughout the centuries helps us to understand how and why the occupational therapy profession evolved and was established, and the principles that guide the way we work today.
In the 18th Century, management of individuals' mental health needs was poor. Formal descriptions of diagnosis were rare and little was understood about mental health. Care in the asylums was often harsh and people were treated poorly. Examples of poor management included:
People being chained up in cells
Records of treatment for insanity, which included wrapping patients in wet sheets, obscuring vision and laying them out in neat rows, or restraining people in adult size restraint beds known as cribs
Towards the end of the 18th Century, things started to change with the introduction of the ‘Moral Occupational Treatment Movement’. It was felt that treating people in the examples given, unsurprisingly to us today, does little to help people improve. The Moral Occupational Treatment Movement recognised the connection between mental wellbeing and activity; their views pushed forward change within the mental health services at that time and cemented the professions foundations within the mental health arena.
In the 19th Century a lady called Octavia Hill worked as a social reformer, her life's work focused on trying to address the causes of poverty. Octavia believed in the principle, ‘give a man a fish and he will eat for a day, teach a man to fish and he will eat for a lifetime.’
In the late 19th century she established the ‘Settlement House Movement’ to help people living within the London slums, the focus of which was on self-care and helping people to look after themselves. The settlements were created to move people out of poverty, and would offer care of ‘the whole person’ by supporting general wellbeing, assisting individuals to develop independent living skills, such as managing their lives and affairs and encourage development of new skills by the introduction of recreational activities. The movement, started by Octavia Hill, highlights the importance of independent living skills within the community setting and offers insights into the value that is placed on these skills within the occupational therapy profession today.