The Slagle Lecture: New Insight into OT's Ongoing Struggle for Recognition
I have been studying the history and concept of occupational therapy for the past 21 years, mentored mostly by people like the late Helen Hopkins, the late Gail Fidler, ADVANCE columnist Jane Sorensen, and Texas educator Kitty Reed. The founders' names, the places, are inscribed on my brain. Their philosophies are by this time in my blood.
Yet I never understood the way it really was for the founders of the profession - the fact that they had to fight almost from the beginning the same way we do today - against colleagues in medicine and science who didn't take them seriously. This sleeve-tugging issue we have didn't begin in the 1970s; it started in the 1920s.
In her 2009 Slagle Lecture, historian Kathleen Barker Schwartz, EdD, OTR, FAOTA, brought the day and age of OT's birth and "childhood" a little closer, so we could look at it more clearly. Her goal was to show how the original mission of William Rush Dunton, George E. Barton, Eleanor Clarke Slagle, Adolf Meyer, Herbert Hall, Thomas Kidner, Susan Tracy and others meshes with our Centennial Vision today.
All of these people were unusual in some way. They determined what they believed and lived by it, despite the opinions of friends and sometimes even family. It was a time of war, steady immigration, industrialization, poor schools and inadequate medical care. "The founders believed that society's problems could be solved with progressive reform," Schwartz said. Their work was founded on social science, their treatment principles guided by compassion, and their tools enmeshed with the arts and crafts movement led by Englishman William Morris.
I will mention two men here whose particular philosophies demonstrate the thread between yesterday and today in OT. Barton, an architect, was introduced to OT when he suffered from TB; later, in 1912, he lost a foot to gangrene. Inspired by his pastor to help others, he bought a home in Clifton Springs, NY, with a barn and a lot of ground and turned it into "a place to rest, get well, gain enjoyment and learn a new profession." Consolation House was probably the first true "rehab center" of its time. Here Barton created opportunities for carpentry and gardening. As an architect, he was interested in methods of measurement and preciseness.
Dunton, on the other hand, was a physician who strongly believed in the value of therapeutic occupation. He believed that mind/body medicine was coming back. He explained occupational therapy in terms of medical diagnoses (and it was taught that way well into the 1960s). Dunton was a lifelong believer in crafts, but he had a hard time convincing his 20th Century colleagues, who were leaning toward science rather than art, that occupational therapy was really medicine. He wrote and published voraciously throughout his life, and tirelessly advocated for research. "He understood that it was necessary to conduct research, and that research needed to be published," Schwartz said. "It was necessary to articulate the occupational process in a way that could be scientifically understood."
Today, in the World Health Organization (WHO), the medical branch of the United Nations, occupation is a strong principle in its international classification of functioning, disability and health(ICF) for countries around the world. (I believe that occupation is much better understood as medicine outside the United States than it is here. Even in the early 20th Century, physicians began to lump OT with physical therapy, seeing occupational treatment as an end-stage of recovery rather than a means to it.)
In the 21st Century, occupational therapy will concentrate heavily on prevention of chronic illness through lifestyle modification. The Occupational Therapy Framework best articulates the methodology and scope of the profession.
"The Vision links the profession to the global community," Schwartz explained. She added that to do that, occupational therapists must retain their founders' vision, blending science and humanism, and become risk-takers and pioneers. "It takes courage, optimism and imagination to implement a vision," she said.