Liz: Here is the information on the NYU Anne Cronin Mosey Lectureship:

The Anne Cronin Mosey Lectureship addresses timely and controversial issues facing the occupational therapy profession. It is sponsored annually by the Department of Occupational Therapy and the Occupational Therapy Alumni Board, bringing together current students, alumni, OT professionals, and others from the NYU and occupational therapy community. The lectureship honors Dr. Anne Cronin Mosey, former professor and chair of the Department, for her many achievements and contributions to NYU and the occupational therapy profession.

1st in April 2004: Anne Cronin Mosey on “It’s more than a matter of words: How language has affected the occupational therapy profession and what this holds for the future”

2nd on March 6, 2005: Mary Foto, OT, CCM, FAOTA on “The Crisis in Reimbursement” – Foto is former president of AOTA, owns and manages two companies, co-chair of the AMA’s Health Care Practitioner’s Advisory Committee

3rd on April 6, 2006: Marie-Louise Blount, A.M, OT, FAOTA on “How Do Issues of Social Justice in Health Care Relate to Occupational Therapy?”

4th on “Volunteering Oversees: The Pearls and Pitfalls” – panel of featured occupational therapy professionals with significant experience working in less developed countries – hoped the lecture would be a springboard to action for those considering volunteering outside the U.S.

5th on March 30, 2008: Helene J. Polatajko, Ph.D., FACOT on “The Science of Practice: Can Data Trump Lived Experience - Lessons from SI”

6th on February 19, 2009: Gary Kielhofner, DrPH, OTR/L, FAOTA on “Scholarship in Support of Evidence-Based Practice: Bridging the Gap between Theory, Research and Practice in Occupational Therapy” – Dr. Keilhofner was Professor and Wade/Meyer Chair and Professor of Public Health at University of Illinois at Chicago. Wrote 17 books, published 130 articles, worked on theoretical development, research and application of the Model of Human Occupation

Liz: I found this book at Mugar. It provided great information about Anne Mosey, as well as a summary of her most important work:

Perspectives on Theory for the Practice of Occupational Therapy by Miller and Walker
Chapter 3: Anne Cronin Mosey
Biographical Information:
- Born in 1938
- Raised in Minneapolis, Minnesota
- 3rd in a family of seven children
- As a child, she loved reading, cooking for her family, and long talks with her father about the world
- Graduated from high school, then attended the University of Minnesota, where she pursued a double major in sociology and psychology
- During the summer of her junior year, she volunteered at the Veteran’s Hospital in Minneapolis – worked in the OT department in the psychiatric unit at the suggestion of the coordinator of volunteer services – then changed her major to OT
- Volunteered because her Irish family background did not permit young ladies to work
- After graduation, she worked for several months at Glenwood Hills Hospital (in Minneapolis), then moved to NYC to work with and learn from Gail Fidler
- Joined the OT department at New York State Psychiatric Institute (stayed for 5 years)
- Fidler encouraged Mosey to think, read, and broaden her horizons about clinical practice and to focus on patient needs
- MA at NYU
- Human Relations and Community Studies at NYU for her doctorate
- 1966-1968 – faculty at Columbia University as an instructor in OT
- During this period she developed the idea and structure of the frame of reference and wrote “Three Frames of Reference for Mental Health” (1970)
- Joined faculty at NYU, later served as department chairperson (1972-1980), and in 1977 was the acting head of the Division of Health
- 1985 – awarded the AOTA’s Eleanor Clarke Slagle Lectureship – the title of her lecture was “A Monistic or a Pluralistic Approach to Professional Identity?”
- Has one son
- Is interested in history and anthropology, enjoys the theatre, concerts, being with friends, reading
Theoretical Concepts
- Concerned with laying the groundwork for the OT evaluation and intervention process
- 3 main themes can be seen in her work:
- The articulation of frames of reference for occupational therapy in mental health
- The process of structuring and translating theories of psychosocial dysfunction into frames of reference to apply to practice
- The development of a taxonomy that identifies the various elements of the profession and their relationship to each other
Frames of Reference for Mental health
- Theoretical base is derived from a variety of personality and developmental theories (Sullivan, Piaget, Bruner, Freud), as well as from her theoretical work with Fidler
- Mosey’s frame of reference is specifically concerned with the development of basic adaptive skills that build on each other and must be learned in proper sequence, beginning with the most elementary components and moving on to the more complex
- The individual is a being who seeks equilibrium
- Disequilibrium results from changing psychological and physical needs and new environmental demands – motivates one to learn adaptive skills needed to reestablish a state of equilibrium
- 7 adaptive skills, in the sequential order in which they are learned:
- Perceptual-motor skills; cognitive skills; drive object skills; dyadic interaction skills; primary group interaction skills; self-identity skills; sexual identity interaction skills
- When all of the component subskills of a given skill have been integrated, the person has achieved full maturity in that skill
- A state of function is characterized by integrated learning of those adaptive skill components needed for successful participation in the social roles expected of the individual in her or her usual setting. Minimal and maximal limits are usually set by one’s cultural group. Adaptive skill performance enables one to obtain gratification to meet environmental demands.
- To evaluate a patient, one must observe him or her in roles and activities that will elicit adaptive skills and then identify whether particular skill components are present or absent
- The OT must help the patient grow from where normal development ceased by providing experiences that take the person through the developmental stages of skill acquisition and facilitate learning of the needed skills
- Symbolic activities may be used, but reality and the here and now are stressed.
- Long-term goal of this approach is to help the person participate fully in his or her expected social roles and environment; short-term goal is to learn the skill component
Three Frames of Reference
- Analytical: based on Freud, Maslow, Erikson, Jung, and Anna Freud
- Developmental: based on Freud’s stages of psychosexual development and Erikson’s eight stages
- Acquisitional: based on learning theories of Bandura and Sullivan and others
- Mosey regards these 3 frames of reference as the major current frames of reference in occupational therapy in psychosocial dysfunction
Theory and Frame of Reference (translating theory into frames of reference for use in practice)
- A theoretical frame of reference is prescriptive and provides principles for action
- It applies to daily situations and can guide the decisions of the practitioner
- Function-dysfunction continuum: includes operational definitions of verbal and nonverbal behaviors that are indicative of function or dysfunction. These are derived from the theoretical base’s assumptions concerning health and dysfunction and will vary according to the frame of reference selected. The behaviors are what the therapist will assess in the evaluation process.
Taxonomy of the Profession:
Biopsychosocial model
- Alternative to the medical or health models in OT
- Created in 1974 by Mosey
- Prior, OTs only had health models (too vague) and medical models (OTs are not concerned with diagnosis or elimination of pathology)
- This model focuses on the body, mind, and environment – views client as a person with thoughts, emotions, needs, and values
- Therapist effects change in the individual by identifying learning needs and guiding the teaching-learning process
- The therapist, as the teacher, begins where the learner is and moves at a rate that is comfortable for the learner. The therapist provides opportunities for trial and error, imitation, repetition, and practice in different situations so that the learner can observe and experience the consequences of action
- This method provides a method to systematize OT knowledge; provides a holistic statement of OT goals and theories of change; is oriented to the development of skills needed by the client for fuller participation in the community setting; helps clarify the role of OT in relation to medicine and health-related fields; is well suited to community-based programs and the meeting of health needs
- This model was later refined to encompass a holistic approach
Professional Model:
- Defined and described the structure, function, and characteristics of a model for professions in general and one specific to OT
- A model for a profession describes the way in which a profession perceives itself, its relationship to other professions, and its relationship to society, as well as the profession’s responsibility to society, methods, and rationale
- These models are dynamic and constantly changing
Mosey’s 7 basic beliefs about the individual (the philosophical assumptions of her model for OT)
  1. Each individual has the right to a meaningful existence; to an existence that allows one to be productive; to experience pleasure and joy; to love and be loved; and to live in surroundings that are safe, supportive, and comfortable.
  2. Each individual is influenced by stage-specific maturation of the species, the social nature of the species, and the cognitive structure of the species
  3. Each individual has inherent needs for work, play, and rest that must be satisfied in a relatively equal balance.
  4. Each individual has the right to seek his or her potential through personal choice within the context of some social constraints
  5. Each individual is only able to reach his or her potential through purposeful interaction with the human and nonhuman environment
  6. Each individual is only able to be understood within the context of his or her environment of family, community, and cultural group
  7. Occupational therapy is concerned with promoting functional independence through intervention directed toward facilitating participation in major social roles (occupational performances) and the development of the physical, cognitive, psychological, and social skills (performance components) that are fundamental to these roles. The extent to which intervention is focused on occupational performances or performance components is dependent on the needs of a particular client at any point in time.

Liz: Here is a rough outline of the information from the book Three Frames of Reference. I did NOT change the wording too much yet, but will once we start turning the information into slides. I just wanted to show you what information we have so far.

Three Frames of Reference for Mental Health – Anne Cronin Mosey
Copyright: 1970 by Charles B. Slack, Inc. in Thorofare, NJ
- A trained therapist must be able to form an intimate relationship with the client, to integrate theoretical material into the approach, to interpret varying degrees of behavior, and to act on the basis of therapeutic principles
- Definition of “meeting mental health needs”: response to one’s commonality and uniqueness must be available for an individual to maintain his sense of identity with humanity

Chapter 1: Theoretical Frames of Reference
- “A theoretical frame of reference is a set of interrelated internally consistent concepts, definitions, postulates and principles that provide a systematic description of and prescription for a practitioner’s interaction within his domain of concern” (p. 5)
- Frames of reference for therapy must be stated in an organized and logical way, be comprehensive, and internally consistent
- Involves recognition, selection, and application of a theoretical frame of reference
- Remark on the importance of using a frame of reference: “It is that which differentiates any helping relationship from a systematically planned treatment process”
- When a therapeutic relationship is not based on a frame of reference, one cannot assess the specific factors that will lead to positive results, nor assist others in applying these factors to other situations

Frames of reference in therapy deal with:
1. A statement of the theoretical base
- outlines the assumptions, concepts and hypotheses necessary to adequately describe the relationship between the environment, normal development and the developmental deviation
- draw on theories from neurology, sociology, and psychology to serve as the base of the frame of reference
- the chosen theoretical base identifies the parameters of the frame of reference and serves as the basis from which all other parts of the frame of reference are deduced
2. Delineation of function-dysfunction continuums
- identifies the nature of the dysfunction to be treated by application of the frame of reference – describes what the therapist assesses in evaluation
- may be several continuums (dysfunction area), all are mutually exclusive
- list behavior indicative of function and dysfunction in these areas
- identify and define areas of concern
3. Evaluation
- identify whether or not an individual is in a state of dysfunction or function in the various areas of concern
- the theoretical frame of reference describes the tool s and techniques the therapist uses to observe behavior indicative of function and dysfunction
- Rules for interpreting evaluative data
- Procedural information
- Reliability and validity report
4. Postulates regarding change
- Deduced from the theoretical base
- Statements regarding the alteration of dysfunction
- Identification and description of techniques
- step-by-step sequence of treatment process
- guidelines for selecting techniques
About the Frame of Reference:
- these criteria are an ideal situation – never actually occurs, just an attempt to move in this direction
- the 3 frames of reference are not complete
- created the three frames of reference to stimulate thinking about what therapy evaluations should and should not include; to identify a goal for our work in this area; to give an orientation for classification of the frames of reference currently available

Categorization of Frames of Reference

- Describes man as striving to fulfill needs
- Involves the expression of primitive impulses or controlling inherent drives
- Environment either facilitates or inhibits striving
- Needs, impulses, or drives are often in conflict with each other, the environment, and individual judgment à creates anxiety, so individual represses the desires that relate to conflictual experience, which then manifest in dreams, fantasies, and the dysfunction
- Symptoms of the dysfunction arise from the repression of the unconscious content
- individual is not “sick” but could reach a greater degree of health or self-actualization if he were more aware of his unconscious content
- issue of concern is unconscious conflict related to love, hate, aggression, sexuality, autonomy, feelings of inadequacy, and death
- evaluation is oriented towards identifying the nature of the symptom-producing unconscious content
- psychodynamic approach
- Theoretical base focuses on various skills or abilities that the individual needs to interact adequately with the environment
- Abilities of concern are independent, quantitative, and nonstage specific (developmental stage)
- Piaget: developmental process of cognition has clear differentiated stages
- vs. Guilford: development of cognition is a quantitative increment of skills; no stages
- The theoretical base describes the manner in which skills are acquired in the normal developmental process or how they may be acquired
- The function-dysfunction continuum involves the categorization of human abilities that are essential for adaptation to the environment
- Classification varies according to frame of reference
- Different frames of reference:
- ego function - use of defense mechanisms, reality testing, control, investment, and expression of aggressive drives, differentiation, synthesis, and organization of perceptions
- intermediate capacities - various function-dysfunction continuums include a number of different ego functions – includes concept of self, concept of others, communication and control of impulses
- These two frames of reference are mutually exclusive
- Specifies the various skills or abilities needed to adequately and satisfactorily interact in the community
- The abilities of concern are independent, qualitative, and stage-specific
- Theoretical base describes how these skills are acquired and the sequential interdependence of the various stages of each skill
- Lack of learning of age-appropriate subskills is the dysfunction and the causal factor in symptom formation
- Participation in situations which simulate those interactions between individual and environment that are responsible for the sequential development of a given human ability will allow the individual to learn all of the subskills fundamental to the mature skill
- Function-dysfunction continuums are delineated through a categorical, sequential structuring of human abilities - Each continuum is one area subdivided into stages
- Inspired by Erikson and Freud
- Hard to evaluate – client may have acquired splinter skills or learned by route, which makes it appear that the individual is at the functional end of a function-dysfunction continuum

Similarities and Differences in Frames of Reference:
Acquisitional-developmental vs. analytical – in acquisitional-developmental, dysfunction is related to faulty learning, while in analytic, dysfunction is symptom-producing unconscious content
- acquisitional-developmental assume the individual has not learned these adaptive patterns, while analytical assumes the individual has a repertoire of previously learned positive habits available that will emerge with the integration of conscious and unconscious content
Acquisitional vs. developmental – difference is in the assumption regarding the developmental process of human abilities
- acquisitional views it as quantitative and non-stage specific, developmental sees it as qualitative and stage specific – developmental assumes the individual must go through these various incompleted stages before he can function in a mature manner

Keep in mind…
- No frame of reference is more effective or efficient in treating psychosocial dysfunction
- Methods for studying which is best were primitive at the time this was written
- Each therapist is special and unique and will develop his or her own style of interaction with clients over time
- “Although a therapist continues to learn, grow, and change throughout his professional life, he usually maintains a core idea of ‘this is me’ and ‘this is not me.’ With this self-understanding, the therapist is able to knowledgeably select or formulate a frame of reference which is suitable to himself.”
- A frame of reference must become part of the self if it is to be useful guide for action

The book also discussed symbolism, which was interesting. At the bottom, it discusses some forms of dysfunction and the way it is symbolized in client’s drawings. I can get more information on it if you guys think we would include it in our presentation…
- Symbol: action, object, image or word which has special complexities of meanings in addition to its conventional and obvious meaning
- Because symbols are affective in nature, response to symbols is both emotional and cognitive
- Understand symbols through representation, form, and content
- Representational: the way in which a symbol is experienced or produced
- Form: the manifest structure of symbolic representation
- Content: the referent or referents
- The content of cultural symbols is related to the values, norms, preoccupations, and concerns of a particular cultural group
- Examples of common content symbols in our culture: the value of work, the integration of minority groups, the ideal of democratic interaction

Function-Dysfunction Continuum in terms of symbols
- An individual is said to be in a state of dysfunction when one or more complexes with the ability to fulfill an individual’s needs. Some common complexes are listed below, together with behaviors and symbols that indicate the presence of the complexes:

Feelings of inferiority:
- Functions inadequately
- Many statements regarding personal inadequacy
- Light, sketchy lines (in artwork)
- One aspect of picture very small and other aspects very large (in artwork)

Differentiation from the Nonhuman Environment
- Delusions regarding parts of the self as nonhuman
- Never mentions nonhuman environment
- Productions made up primarily of nonhuman objects
- Nonhuman objects have human characteristics

Trust in One’s Fellow Man
- Express fear of others
- Has few friends
- Cool colors
- Lack of human objects in productions

This is from a website that outlined her Frames of Reference -

Mosey’s three frames of reference for mental health:
1. Analytical Perspective
- Based on work of Freud, Maslow, Erikson and Jung
- Concerned with concepts of need fulfillment, expression of primitive impulses, and control of inherent drives
2. Developmental Frame of Reference
- Freud’s stages of psychosexual development and Erikson’s 8 stages. Also has incorporated more recent theories
- Skills: interdependent, qualitative, and stage-specific; acquired in the normal developmental process in growth-facilitating environment
- Development of basic adaptive skills that build on each other and must be learned in proper sequence: elementary à complex
3. Acquisitional Frame of Reference
- Based on learning theory; also incorporates biomechanical and rehabilitation approaches
- Concerns skills and abilities that are independent of each other, quantitative, and nonstage-specific

Biographical Information taken from: “A Professional Legacy: The Eleanor Clarke Slagle Lectures in Occupational Therapy, 1955-2010.
- Earned a bachelor’s degree in OT from University of Minnesota in 1961
- Worked at Glenwood Hills Hospital in Minneapolis
- Joined New York State Psychiatric Unit for 5 years until August 1966
- Master’s degree in 1965 (NYU)
- From 1966 to 1968 – faculty of Columbia University as an OT instructor – at this time, developed and wrote Three Frames of Reference for Mental Health and completed her dissertation
- Doctorate in human relations and community studies in 1968 (NYU)
- Joined OT department at NYU as faculty member in 1969
- Served as NYU second chair/department chairperson from 1972-1980
- 1977: named the acting head of the Division of Health
- Retired in 2002 as professor of occupational therapy at NYU
- Known for being an educator, researcher, and leader in occupational therapy discipline
Other work:
- Consultant to several hospitals and state mental health systems, including Massachusetts Department of Mental Health, the Division of Rehabilitation Education at NYU, Hillside Hospital Professional Examination Services, the Family-Centered Research Project, the Institute of Pennsylvania Hospital, the Greater Trenton mental Health Center, and Christopher House
- Faculty member for the AOTA Regional Institutes from 1966-1967
- Member of Panel of Experts of the AOTA Continuing Education Programs in Mental Health from 1984-1988
- Member of the Scholars Group for the Directions for the Future Project of AOTA/American Occupational Therapy Foundation from 1988-1991
- Member of the Panel for the Review of Research Proposals of AOTF
- An AOTF research consultant
- Participated in development of AOTA self-study series on cognitive rehabilitation in 1992
- Honors: AOTA Fellow (1973), Distinguished Service Award from National Association of Activity Therapy (1975), Anne Cronin Mosey Lectureship presented annually by NYU

Jess: Here are brief outlines of the resources I was taking a look at:

Activities Theory – Book by Anne Mosey, published in 1973 by Raven Press
Preface + Ch 1 (Introduction)
  • Activities therapy as a type of treatment – “a way of helping people become more active participants in the life of their community” (p. v)
  • Developed for use with psychiatric patients – addresses psychosocial dysfunction – learning through doing, action-oriented – can be group or individual
  • Definition of treatment: “a planned, collaborative interaction between the therapist, the patient, and, at times, the nonhuman environment, directed toward the development of skills for community living.” (p. 3-4)
    • Treatment as a partnership betw. therapist & client
  • “Activities therapy is based on the idea that psychosocial dysfunction is learned maladaptive behavior.” (p. 5) –
    • also concerned w/ ideas, feelings & values that influence behavior
  • Emphasis on the present (this is a way that it differs from traditional therapies)
Ch 2 (Facets of Man)
  • The Private Self: cognitive system, needs, emotions & values (w/in individual)
  • The Public Self: ADLs, recreation & intimacy (interactions w/ others, observable)
Ch 3 (The Teaching-Learning Process)
  • Therapist puts together learning experience – concerned with her own actions, how to present the learning problem to the client, how to best structure nonhuman environment to help patient learn
  • Patient is the one that does the actual learning / brings about change in himself
Ch 4 (Group Dynamics and Process)
  • Group membership roles = what people do and how they act in groups
    • 2 categories: task roles & social-emotional roles
    • therapist must maintain awareness of patients’ abilities to take on different roles needed to form a functional, productive group
  • Group decision-making, communication, cohesiveness & norms also discussed
Ch 6 (Evaluation)
  • Evaluation = process determining what patient able/not able to do, not same as diagnosis
  • Findings used by therapist/patient for treatment planning - collaborative
  • 3 steps of evaluation procedure:
1. Observation: “noting what the patient says and what he does, or reading what he has written.” (p. 84)
2. Interpretation: “assigning meaning to what has been observed.” (p. 84)
3. Validation: “process of seeking confirmation regarding the accuracy of an interpretation” (p. 85)
  • Eval techniques typically used in activities therapy are observation, structured observation, interview & questionnaires
Ch 7 (The Treatment Process)
  • “Treatment is a planned collaborative interaction between the therapist, the patient, and the nonhuman environment directed toward the development of skills for community living” (p. 105)
  • Steps: 1.) immediate & long term goals, 2.) write plan, 3.) implement plan, 4.) periodic evaluation, 5.) alteration of goals & treatment process, 6.) discuss discontinuation treatment when appropriate
Ch 8 (Development of Basic Skills)
  • Good role models, opportunity for experimentation, feedback & reinforcement can enhance learning of group interaction skills
Ch 10 (Development of Facets of the Private Self)
  • Goal of activities therapy is to help patients acquire the skills they need for living in the wider community

The Competent Scholar – Article by Anne Mosey (AJOT, October 1998)
  • Competent Scholar = “person who engages in scholarly inquiry with the intent of creating an integrated body of abstract information that, having been evaluated and having withstood the test of time, is found to be accurate, efficacious in its use, or heuristic” (p. 760).
  • Methods of scholarly inquiry include analyzing, synthesizing, categorizing, defining, collecting data, etc.
  • Abstract info used to create theories, frames of reference, philosophical arguments, etc.
  • Scholar in OT = scientists or philosophers
  • Scientists in OT: formulate and evaluate frames of reference (reliable, valid), develop screening tools, conduct research studies, identify or develop theoretical info needed by the profession
  • Philosophers in OT: focus on refining profession’s code of ethics, philosophical assumptions & core values + focus on future direction of profession & interactions of profession with society
  • Competent OT scholar must 1.) understand profession’s current body of knowledge, 2.) have skills to engage in scientific or philosophical inquiry & 3.) communicate the results of inquiry to others
  • “Questions give direction to the process of scholarly inquiry and influence all that follows…” (p. 762).
  • Personal attributes typical of competent scholars include: love of learning, self-motivated & self-directed, skeptical & ever questioning, critical & judgmental regarding their work, disciplined thinkers, attention to detail & tenacious
  • OT needs more competent scholars – should emphasize this during recruitment, introduce the role of scholar to students, emphasize important of scholarship in literature, have post-professional ed programs dedicated to developing scholars

Theoretical bases of Mosey’s group interaction skills
Article by Mary V. Donohue (NYU), Occupational Therapy International, 1999
  • 5 levels of group interaction skills development: parallel, project, egocentric cooperative, cooperative & mature
    • Parallel: 18 mos-2 years – work/play in presence of others, minimal sharing, some mutual stimulation
      • skills: awareness of others + some verbal/nonverbal interaction
    • Project: 2-4 years – short-term tasks requiring some interaction/cooperation; task is paramount
      • Skills: centered around seeking and giving assistance
    • Egocentric-cooperative: 5-7 years – select, implement & execute relatively long-term tasks through joint interaction, mutual respect of rights & needs of members
      • Skills: ability to identify group norms and goals & some experimentation of member roles
    • Cooperative: 9-12 years – homogenous membership & mutual need satisfaction; task secondary to need fulfillment
      • Skills acquired through interaction in environment w/ compatible participants developmentally ready to engage in a cooperative group
    • Mature: 15-18 years – homogenous membership consisting of participants who are flexible enough to take on a variety of roles
      • Balance between task accomplishment & satisfaction of group members’ needs
  • Mosey – four relevant topics across each of the five levels: 1.) developmental group issues, 2.) roles & behaviors, 3.) activities & environment & 4.) the leader’s role (SEE P. 41)
  • Assumptions that movement will be in positive direction, can be applied to persons with disabilities

{Note: Donohue cites Mosey’s book Psychosocial Components of Occupational Therapy (1986) for all points referenced above}

Carmel: I researched the state of OT as a profession in the 60s as compared to today so that we can show how Mosey's work fit into the profession in a broader sense and some of the changes that could be partly attributed to her work. I listed some key information about each period below:

Occupational Therapy in the 1960s
  • OT became more specialized, starting treating in pediatric and developmental disability fields
  • Deinstitutionalization- brought greater need to help mentally ill, physically disabled, developmentally challenged ppl that were released to live independently in society
  • In 1965, under the amendments to the Social Security Acts, Medicare now covered inpatient occupational therapy services.
  • During the 1950s and into the 1960s the profession of occupational therapy adopted the reductionistic paradigmof medicine and occupational therapists increasingly found themselves working in more specialized settings
  • The trend toward specialized practice continued through the 1960s
  • Concern about professionalism of OT
  • “Many felt that the profession had lost sight of the value and meaning of occupation, the concept that had lead to the creation of the profession, and that this had lead to role confusion and loss of identity for occupational therapists.”
  • Services for mentally and physically disabled people were expanding greatly

OT Today
  • Today, occupation is the main focus of the profession.
  • Anyone with a physical, emotional, or developmental deficit can be referred by his/her physician, school, or parent for any one of the following reasons: prematurity, birth defect, spina bifida, attention deficit disorder, developmental disabilities, cerebral palsy, sensory dysfunction, autism, hyperactivity, down syndrome, amputation, stroke, arthritis, burns, head injury, dementia, diabetes, or cardiac conditions.
  • Growing movement to recognize role environment plays in health and wellness
  • Increasing influence of EBP

I also came across the Slagle lecture from 1961 by Mary Reilly, which has some really good quotes about the state of the profession. I think they would be good either as an introduction to our presentation or just somehow incorporated when we talk about the state of the profession when Anne entered it/started doing stuff. Below are some of the quotes:

"It would seem almost axiomatic that the American society in general, and medicine in particular, has need of a profession which has as its unique concern the nurturing of the spirit in man for action. In every way it knows how, America has said that this spirit must be served and served in a special kind of way when it has been blocked by physical or emotional ills. That this need will be persistent in American culture seems fairly certain. That occupational therapy will persist is not quite so certain. It is true, however, that if we fail to serve society’s need for action, we will most assuredly die out as a health profession."

"The reality of our profession depends upon an identification of the vital need of mankind that we serve. How free we are in these troubled times to reconstruct our thinking at this basic level I do not know. But I do know that the crucial nature of our service cannot
be spelled out in the loosely constructed way that it is today. I personally have little trust that
we can continue to exist as an arts and crafts group which serves muscle dysfunction or as an
activity group which serves the emotionally disabled. Society requires of us a much sharper
focus on its needs. As the next step in the development of the theme it becomes necessary to
make a critical examination of what, if any, vital need we serve."

"At no time in technological history have the behavioral scientists been producing so much knowledge directly applicable to our field as they are now."

"As far as our practice today is concerned, we have more medical science knowledge than we know how to apply and we are applying more knowledge about human productivity than we actually have on hand."