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Department of Occupational Therapy Faculty Papers Department of Occupational Therapy

11-1994

Bridging conflicting ideologies: the origins of American and British occupational therapy.

Ruth L. Schemm Thomas Jefferson University

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Recommended Citation Schemm, Ruth L., "Bridging conflicting ideologies: the origins of American and British occupational therapy." (1994). Department of Occupational Therapy Faculty Papers. Paper 55. https://jdc.jefferson.edu/otfp/55

This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Department of Occupational Therapy Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. LOOKING BACK his article describes the tension between the arts and crafts ideology and the emerging scientific fo­ Tcus of occupational therapy practice by using the development of American and British occupational ther­ Bridging Conflicting apy during the late 1930s as an illustration. American leaders were anxious to separate themselves from the lay Ideologies: The Origins health "occupation cure" that was widely used during the World War I era and eagerly sought status as an adjunctive of American and British aspect of medicine. Although not torally divorced from the ideology of the Arts and Crafts Movement, early occu­ Occupational Therapy pational therapists strove to make their work therapeutic and scientific. The result was an uneasy alignment of ideas that were not totally congruent. The arts and crafts Ruth Levine Schemm ideology, reflecting the compelling force of intrinsic cre­ ation, was combined with a therapeutic process (occupa­ tional therapy) that was developed to make persons with Key Words: history of occupational therapy. disabilities and idle persons productive. Early therapists human activities and occupations were socializing agents, stalwart in their medical beliefs, who compared their occupation cure to medication. At the turn of the century, British physicians used occupations extensively to rehabilitate injured World War Occupational therapy practice has bridged two con­ I soldiers. After the war, Dr. David Henderson directed a tradictory value systems for more than 100 years. This small department at Gartnavel Hospital, Glasgow, Scot­ article describes the origins ofpractice ideas in both land, but this intervention was not identified as occupa­ the United States and Britain and demonstrates that tional therapy until a British physician, Elizabeth Casson, founding members ofthe occupational therapy profes­ sion all shared a core ofhumanistic beliefs while em­ founded Dorset House Residential Clinic in Bristol, Eng­ bracing the emerging paradigm ofscientific medicine. land, in 1929. Casson worked for the social welfare move­ The result has been an intellectual tension between ment under the supervision of Octavia Hill and entered the biological and the psychosocial aspects ofpractice. medical school when she was 30 years old. Interested in For more than 75 years, occupational therapists strug­ psychological medicine, Casson traveled to America to gled to balance the art and science ofpatient care; re­ visit occupational therapy programs and, in effect, im­ cent debates on modalities. practice domains, and re­ ported the profession back to England by starting her search priorities indicate that the unifying core ofthe own clinic and education program. profession is occupation tbat considers a person's Some of the contradictions in modern practice can mind and hody. be traced to this early differentiation between the use of arts and crafts as occupations for invalids and the medical­ ly based use of activities. This differentiation explained Casson's trip to America to learn about occupational ther­ apy because ideas from the British Arts and Crafts Move­ ment were the basis of U.S. practice. Early American occupational therapy was shaped by many popular beliefs, some holistic and some mechanis­ tic. Thus, the contemporary argument - that selected modalities are reductionistic and that the use of arts and crafts is holistic-does not capture the complexity of these turn-of-the-century ideas in which the body was likened to a machine (Dunton, 1915) and arts and crafts were prescribed like a dose of medication (Barton, 1920; Haas, 1922; Tracy, 1914). The practice of skillful occupa­ tional therapy cannot be classified merely by the modality used by the therapiSt. In fact, the therapeutic interaction Ruth Levine Schemm, Eell), O1RfL, FAO'lA. is Professor and Chair­ between patient and therapist must be considered. man, Department of Occupational Therapy, Thomas Jefferson University, Room ~24 Edison, 130 South Ninth Street, Phila­ delphia, Pennsylvania 19107. The British Arts and Crafts Movement This article was acceptedfor publication December 10, 1993. On the basis of the thinking of Oxford University don

1082 November/Decemher 1994, Volume 48, Number 11 Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms John Ruskin, William Morris founded the popular Arts tally ill, impoverished, and underachieVing persons in in­ and Crafts Movement, which eschewed machine-made sane asylums and manual training programs. A well-de­ goods, valued handcrafted objects, and celebrated the signed and well-executed arts and crafts project could return to a life that integrated mind and body with soul­ prOVide an opportunity to foster discipline and effective satisfying labor that refreshed rather than taxed the per­ worker roles (Boris, 1986; Hull House Bulletin, 1902; Kap­ son (Boris, 1986; Leal's, 1981; Orage, 1907; Tames, 1990). Jan, 1987; Simkhovitch, 1906). The mind-numbing experience of factory work attracted Among early Arts and Crafts proponents, the reading British and American followers to Morris' ideas because of Ruskin, Morris, and other like-minded authors became he articulated their disdain for the materialism of indus­ popular, and followers extolled the benefits of hand­ trialized society. Although Morris was a poet, critic, and made goods that were well-deSigned, created from natu­ devoted socialist, his audience was far more taken with ral materials, and were functionally useful. George Bar­ his craftsmanship and aesthetic wisdom than with his ton, one of the founders of the American Occupational social criticism. A prodigious worker, Morris designed Therapy Association (AOTA), served as Secretary of the and made furniture, fabric, tapestries, stained-glass win­ Boston Arts and Crafts Society in 1904, embraced the dows, and hand-bound and illuminated books ("William ideals of the Arts and Crafts Movement, and worked at Morris," 1901). However, his social criticism was em­ Kelmscott Press in London, where Morris did much of his braced only by a small and scattered group of followers bookbinding and calligraphy work. Barton applied these among British leftists (Leal'S, 1981; Orage, 1907; Wiener, ideas to himself when he developed paralysis of his left 1976). This situation frustrated Morris, and, at the height siele after part of his left foot was amputated; he opened a of his popularity in 1888, he attacked the Arts and Crafts workshop, Consolation House, to demonstrate the pow­ Movement for placing self-interests ahead of social er of using goal-directed activities or occupations to cure change (Leal'S, 1981; orage , 1907; Wiener, 1976; "William persons with illness or disabilities. Morris," 1901). Morris' speeches and lectures resulted in few Occupation Therapy as a Medical Profession changes to the British social order, and his influence waned during the last years of his life, although he contin­ Americans were nor interested in Morris' socialist ideas; ued to work as a socialist organizer (Leal'S, 1981; Wiener, however, they eagerly applied the aesthetic aspects of the 1976). The influence of the Arts and Crafts Movement also Arts and Cr3fts Movement to persons in settlement declined after Morris's death in 1896 because no other houses, hospitals, and home programs from 1880 to arts and crafts leader combined Morris' artistic talents, 1920. Demand for these programs accelerated during dogged determination, and interest in improving society World War I because the number of war-injured men (Orage, 1907). Morris's criticism of the British ArtS and mounted, and programs offered in France, England, and Crafts Movement proved accurate because fellow arti­ Canada were discussed in newsl1aper and magazine arti­ sans fought for the opportunity to produce quality work cles (Federal Board for Vocational Education, 1918). Ma­ rather than participate in a movement designed to im­ jor General Rohen Jones, a prominent orthopedic sur­ prove society. geon, was the first British physician to develop an occupation treatment program. Jones was directed to in­ vestigate the types of cases that required comprehensive The American Arts and Crafts Movement care where "every therapeutic department could be re­ Many Americans were interested in the Arts and Crafts presented and each member of the staff should be allot­ Movement, which lasted from 1895 to 1920 and shaped ted the work for which he was fitted" Oones, 1918a). the values of many occupational therapy leaders. John Throughout England, Jones found evidence of war injur­ Ruskin. the Oxford University don who influenced Wil­ ies that were poorly treated, neglected, and painful. With liam Morris, was widely read by prominent American so­ the approval of his superiors, Jones opened a 250-bed cial reformers, and the Arts and Crafts Movement swept hospital in Liverpool and found that the need was so great across the continent so that every maior community es­ that accommodations were expanded to 20,000 beds all tablished an arts and crafts organization. The ideas dis­ over the United Kingdom Oones, 1918a). Jones' program cussed in these clubs struck a responsive chord in socially featured comprehensive medical care in which surgeons advantaged Americans, who appreciated the benefits of followed their aSSigned cases; occupations, therapeutic capitalism but found its excesses (materialism fed by ab­ exercise, and vocational training were included in ject poverty among the lower classes) unnerving (Leal'S, treatment. 1981) In the United St,tes, a network ofenlightened physi­ Searching for ways to improve society, members of cian leaders like Adolf Meyer, Edgar King, Joel Gold­ the American Arts and Crafts Movement developed pro­ thwait, Herbert Hall,lIld Elliot Brackett continued to pro­ grams that used art, craFts, music, and dance to socialize mote the occupation cure. The need for an experienced, less accepted members of society such as disabled, men- educated profession 11 trained specifically to teach arts

The American journal uf Occupational Therapy 1083

Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms and crafts was articulatcu by Arthur Crane (1921/1972), who made the diagnosis, performcd or assisted at an Herbert Hall (1923), and William Rush Dunton (1928) operation if needed, and. most imrorrant, rook charge of These leaders were familiar with the comprehensive sub.'>equenr treatment. "Treatment usually consisted of treatment organized by Robert Jones ami combined massagc, Iwdrotherapy, elecrrotherapv, exercises, and Jones' ideas with their own treatment experiences. In work in some curative vOGltion such as fishnet making, 1918, under the direction of Surgeon General William basket work, wood turning, jigsaw work, cabinet making, Crawford Gorgas, comprehensive services were devel­ carrentry, forestry, or farming" (Ireland, 1927, p. '553) ored for war-injured U.S. veterans (Federal Board for Through the collabora rive sharing of ideas on how to Vocational Education, 1918; Gritzer & Arluke, 1985; properly train orthopedic surgeons, provide adequate McDaniel, 1968). The occupation cure was offered before postsurgical care, and offer bedside, ward, and workshop vocational education. For every "1 million soldiers sent to programs for the injured soldier, the American and Brit­ the front, 100,000 would return, and 20,000 would re­ ish reconstruction efforts were closely allied. In the Unit­ quire vocational reeducation" (Federal Board for Voca­ ed States, physical reconstruction was defined as "com­ tional Education, 1918, p. 69); thus, occupation workers plete medical and surgical treatment, carried to the point were in great demand. where m(L'(imum functional restoration, mental and phys­ ical has been securecl" (Crane, 1921/1972, p. 1). The medical use of occupation diverted the injured, mentally ill, or sick person from suffering and offered an alternative Occupation Cure and Curative Occupations to self-centered thoughts. "In a short period of time, un­ From 1890 to 1920, two ideas formed the foundation of der rush conditions, in a new field, the Surgeon General the occupation cure: (a) the creation of a well-designed succeeded in establishing 50 hosrital schools with 2,500 product (arrs and crafts ideology) and (b) the graded, instructors and eqUipment for providing instruction in therapeutic process (the medical influence) of parricirat­ 150 occuparions to 100,000 men" (Crane, 1921/1972, ing in an activity that promoted healing, required action, p. 43) and prommed feelings of competence. From 1918 (() 1921, in rhe rraining programs for U.S Occupation workers who embraced the arrs and veterans, rhere were no standardized rules guiding thera­ crafts ideology believed that quality supplies, good de­ pists to focus on product or process. Ans and crafts teach­ sign, and concern for craftsmanship were curative, so ers joined in the medicalization of a popular Jay health there was minimal need to match patient interests with a movement, and physicians interested in arrs and crafts srecial project. Craftsmanship alone was considered a used ideas abour occupation in rheir treatments. In ideal significant motivator. Arts and crafts programs focused on circumstances, a series of projects was iniriated at the producing a well-made, hand-constructed product that bedside or on the ward after a recuperating soldier was was rleasing ro the eye and satisfying to the soul of the interviewed hya psychologist. Reconstruction aides, who crcaror. The medically influenced occuration workers were experienced reachers, offered diversionaJ activities were more interested in process rather than the final by using their rast education, personal charm, tact, en­ product (Barron, 1919; Brackett, 1918; Crane, 1921/1972; rhusiasm, and curiositj' to engage the soldier's interest in Myers, 1948). Goals were rrescriptive, such as reducing a chain of increasingly complex activities that were finally pain or increasing range of motion to the point of fa­ ried to vocational interests (Crane, 1921/1972). Bedside tigue, and therapy was an adjunct to effective medical occupation work was complex and required skillful inter­ treatment. vention. As the soldiers recovered, rhey were transferred The intermingling of process and product was evi­ to vocational teachers for job rraining (Bracken, 1918: dent in development of the occupation cure in the phys­ Crane, 1921/1972). Vocational teachers were usually ical reconstruction or rehabilitation of war-wounded sol­ craftspersons. diers. As men returned from the front lines of battle, There were two problems dominating occupation "more than 50% of those with serious batrle casualties treatment. The first was the pressure of having so many were left with chronic conditions that required compre­ patients, so few supplies, and an average of only 30 days hensive restoration" (Ireland, 1927, p. 552). In a letter, of convalescence in the rehabilitation programs for the Jones described the disorganized medical, restorative, or U.S. veterans. The demand for therapist anention lec! to rehabilitation care offered at the beginning of the war that the development of a scorecard that described essential, left the discharged men "totally un fitted either for military highly desirable, and relatively desirable traits of treat­ or civilian life. These men promised to become foci of ment. /:':ssenlial traits of treatment were those activities seething discontent, and at that time a menace to success­ that promoted rhe patient's recovery and "lead the man's ful recruiting" (Jones, 1918b). thoughts out from the wards to the shop, to the school Jones went on to describe the comprehensive mecli­ room and ro future activities" (Crane, 1921/1972, r. 54). cal and rehabilitative care he helped to organize in Eng­ High(y desirahle traits of treatment were those activities land. This care began with a trained orthopedic surgeon that required Iinle time from the instructor and propor­

1084 Novemhe,-/December /994. Volume 48. Number I J Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms tionately greater time from the patient so thal the project fered by occupational therapists. permilted short periods of instruction and long periods of unsupervised activity. Relativelv desirable traits of treatment involved the appeal of the craft and the materi­ Defining Curative Occupations als to the patient. The curative use of occupation was a developing concept. The second problem involved craftspersons such as Johnson attempted to clarify various definitions of the weavers, potters, and carpenters employed in workshops concept and stated that "terms in common use which such as those owned by physicians Herbert Hall and Ed­ relate to occupation therapy are very generally applied gar King. As artisans working in workshops and clinics with a loose interpretation" (1919, p. 221). Occupation in where a quality product was sold for operating funds, the military hospitals began at bedSide, moved to ward activi­ craft teachers had to make sure that the final product was ties, and included academic subjects, shops and trades, worthy of sale. The pressure to stay solvent forced crafts­ commercial courses, agriculture, and recreational activi­ persons-rehabilitation workers to do much of the work ties. The most popular activities were work with textiles in certain clinics. Hall (1922) explained that staff mem­ (weaving); reed, cane, and fiber work; and woodworking. bers "think for the patient and complete for him all the The number of injured men enrolled in all services that parts of the work he would not he likely to accomplish as used reconstruction aids, vocational workers, and teach­ well as [sic] himself" (p 244). ers from January to June 1919 totaled 249,474 (Crane, U.S. occupational therapy founders could not re­ 1921/1972). solve whether the focus of therapy should be on process Dunton (1918a, 1918b) identified three types of oc­ or product. Some examples of this dilemma are Barton's curation: (a) occupations for invalids that diverted the claim that an occupation could produce a similar effect to patient from pain and were performed at bedside, (b) that of every drug in materia medica (Barton, 1920). Con­ occupational therapy that restored mental and physical versely, Haas (1922), the director of the Occupation De­ function, and (c) vocational therapy that restored func­ partment at Bloomingdale Hospital, New York, believed tion to persons with disabilities. Johnson (1919) con­ that occupations had to he "interesting, controlled curred and discussed a continuum of care that beaan at and the patient perform at least four-fifths of all the work bedside where the occupation worker had knowledge'" of involved" (p. 446). Earlier, Dunton had claimed that occu­ medical conditions (occupations for invalids), progressed pational therapy justified itself as a "medical agent" (Dun­ to formal occupations where education and moral issues ton, 1918a, p. 91), although Tracy (1912) 4uoted Dewev were added to therapeutic goals, moved on to outpatient and stated that occupation was not "busy work" (p. 13) workshops where medical supervision was still available, and had to be used to create a "non-sick place" for the and finally culminated in a curative workshop where a patient (p. 4) so that interest could be "aroused and specialist in one or more academic, industrial, or com­ fanned into real enthusiasm" (r 6). Tn 1914. Tracy main­ mercial subjects would be combined \-vith knowledge of tained that occu pations - like other remedial tre~tments vocational education. "Poor results" were a consequence such as exercise, massage, hydrotherapy, and lightrays of "the lack of logical methods of teaching" rather than a - possess "true therapeutic value" and share the same lack of knowledge of subject matter Oohnson, 1919, properties as medication that can be classified into like p. 222) "categories. " Mere engagement in a well-designed occupation was not necessarily therapeutic; rather, the choice of activity Ju>t 3' the physician runs through the list of stilllulants and read, - strychnIne, caffeine. adrenalin- so he mal' read down required knowledge of medical conditions, time to con­ the: list of stimulating occupalion.,-\Vatel· colol' p;iming, doll sider activity options, the ability to plan and set up the dressing, designing of CUSlU111 es, paper folding. Making his patient for a successful experience, and attention to safe­ selection from these. he lUrns to the nur.w to order its administra­ tion (Traq'. 1914, p. 386) ty, fatigue, and patient abilities (Hall 1923· Johnson 1919; Tracy, 1912). Apparently, the e;rly nO~lon that ~ craft would be therapeutic in and of itself did nm prove to Ultimately, the grou p of occu pation workers who shared be accurate. an interest in linking their ideas to medicine formed a professional aSSOCiation, the National Societ\' for the Pro­ I~ter [r "'ill alwa,,<; bc a problem to keep a definite middle path between motion of Occupational Therapy, which became the nursing and the teaching ~spe([;, of rhi;, work. Thnapeutics AOTA. The first presidem of the aSSOCiation, George Bar­ have rI)o often been an excu.;,e for poor craftsmanship and tl'i"ia[ ton, summarized the group's beliefs by stating that "re­ results. On the other hand, inStl'uclOrs "'hose 'iole training has been that of the craftsm8n or h8;, been in educmional and "oca­ education ,-ests on the making uf a man not an obJect" tional fi<.:lds outside of 1he hospital would naturally ane! quite (Barton, 1919, p. 61). The American founders of the pro­ unconsclousl" put toO strong an cmphasis upon the educarion81 fession worked to estahlish boundaries between the and economic sides. lt is thi, abililv to keep a fine balance be­ tween thcse two things which. after a[!. will pro"e the r"al uncler­ more global and common use of arts and crafts as a mind standing and <.:fficicncv of the direClors of OCCUpillion therapv. diversion and the more medically directed therap\' of­ (Johnson, 1919. p. 223) .

7be American Journal of Occupalional Therapl' 1085

Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms The Emergence of British Occupational Therapy and by enlisting the assistance and support of fellow phy­ sicians Newman Neild and Carey Coombs of the General The use of occupations ro treat injured patients contin­ Hospital of Bristol. Acceptance by the British medical ued in a few programs in Great Britain during the 1930s, establishment was slow. For example, the Southmead but most occupation programs were confined to mental Health Committee took more than 5years to accept Cas­ hospitals. Furthermore, the personnel conducting these son's offer to provide occupational therapy services With­ programs lacked professional status and had no formal out compensation, even though the medical superinten­ relationship to medical rehabilitation and vocational dent of Southmead Hospital, Dr. Phillips, supported the training. idea. In 1937,920 patients received occupational therapy The development of the profession of occupational services under Casson's supervision, and her efforts be­ therapy in Great Britain is therefore rightfully credited to gan to take effect (Casson, 1938, p. 266). The Allendale Elizabeth Casson (1932), an energetic physician who en­ Curative Workshop (Clifton, Bristol) opened in 1939 and tered medical school after working as a social worker. offered treatment for orthopedic injuries, including frac­ FollOWing American ideas and knowledge of the arts and tures, with graded craft activities (Casson, 1941). By 1939, crafts ideology, Casson championed the initiation of oc­ World War II had begun, and "the Organizers of the Emer­ cupational therapy. In 1926, during a 2-week vacation in gency Medical Service of the Ministry of Health decided to America, Casson toured occupational therapy programs entrust the training of occupational therapists to imple­ and visited Bloomingdale Hospital and the BostOn School ment wartime rehabilitation to Dorset House" (Casson, of Occupational Therapy (Casson, 1939). She returned to 1947, p. 304). The pressure to produce needed therapists England to search Out existing occu pation or craft pro­ in a short time was complicated by the bombing of Bris­ grams and initiated occupational therapy at Virginia Wa­ tol, so the program was moved to Barnsley Hall E.M.S. ter, a psychiatric facility, by using the talents of two crafts­ Hospital at Bromsgrove. Members of this emerging pro­ women. Casson left the hospital to found a residential fession struggled for a place in the medical society hierar­ clinic at Dorset House on Clifton Down, Bristol, England. chy as rehabilitation emerged as a specialty field. Casson was committed to full-time patient care, and from The tension between the "scientific" aspects ofoccu­ this idea the Dorset House School of Occupational Ther­ pational therapy and crafts was noted by E. M. MacDon­ apy grew (Casson, undated, p. 4). Medical control of oc­ ald, an occupational therapist, who believed that "trade cupational therapy, standardized education programs, prejudice" complicated the growth of the profession be­ and habit training for patients were concepts that Casson cause of the therapists' choice of limiting treatment mo­ imported from America and used in the development of dalities to crafts. "This was frustrating to those who had to British occupational therapy. She also adapted the combi­ carry out the prescriptions, and gave quite a wrong em­ nation of arts and crafts ideology and therapy based on phasis to the occupational aspect of the treatment" (Mac­ medical prescription to British occupational therapy. Donald, 1976, p. 9). Casson believed that the products made by patients were important. "There should be an aim at producing beautiful finished work, for only by doing her best work will the patient recover her right attitude to life" (1941, p. British and American Occupational 41). On the other hand, Casson's commitment to thera­ Therapy - Emerging Issues and Problems peutic gains was evident when she addressed the prob­ Casson (1940) based the British occupational therapy lems of an orthopedic patient. "Massage and remedial profession on American ideas: the importance ofspecific exercise can be extraordinarily dull to a patient with a stiff training for occupational therapists, the need for medical knee while a bicycle saw and intricate jig-saw puzzle to cut supervision and prescription, the treatment of more will produce a quicker result" (Casson, 1938, p. 268). acutely ill patients, and the need for research to explain Casson's views were consistent with those of American the success of occupational therapy. Although Casson occupational therapy leaders such as Dunton, Barton, and American leaders remained dedicated to arts ~lnd and Hall. She described the difference between a pro­ crafts ideology, they began to rely more heavily on patho­ gram directed by a trained occupational therapist and one kinesiology and scientific reasoning to justify treatment. directed by an arts and crafts teacher: The need to emphasize the scientific aspects of occupa­ Unfortunately, even in some of the best English mental hospitals. tional therapy was clear to many therapists, as shown by an idea is prevalent that anyone who is pleasant an<.J good-tem­ rered and who is capable of leaching hasket and rugmaking may the reference to the "scientific" therapy groups men­ be regarded as being able to start an occupational therapy depart­ tioned in the annual report of a chief therapist (Letter to ment but although occupation i.s thus provided, therapy i, usually Elise Spuehler from S. Metz Miller, Norristown State Hos­ absent. (Casson, 1932. p. 39) pital Superintendent, 1929; Draft ofsubmission for Annu­ Casson fought for acceptance of the occupational al Report, Elise Spuehler, Norristown State Hospital, year therapy profession through the encouragement of a gov­ ending June 1, 1931 [R.L Schemm, private collectionj). ernment regulatory agency called the Board of Control Occupational therapists have bridged two contradic-

1086 November/Decemher 1994, Volume 48, Number II

Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms tory value systems for more than 75 years. The ability to rehabilitation medicine. British journal of Physical !'vledicine, combine the biomedical aspects of patient illnesses with 3, 221-225 the humanistic values of the Arts and Crafts Movement Casson, E. (1941). Forty cases treated at Allendale Curative Workshop. Lancet, 1, 5-16. requires complex patterns of integrative treatment plan­ Casson, E. (1947). Occupational therapy in Great Britain. ning. This skill is an asset in today's health care arena journal of American Medical Woman's Association, 2, where the limitations of scientific medicine encourage 303-305. practitioners to emphasize the an of patient care. Occu­ Crane, A. G. (1972). Education for the disabled in war pational therapists who have struggled with ways to bal­ and industl]!. New York: AJvlS. (Original work published 1921 by Teachers College, Columbia University, Contributions to ance the scientific and anful aspects of practice can guide Education, No 110). other professionals to develop more integrative health Dunton, W. R (1915). Occupationaltberapy. A manual services. for nurses. Philadelphia: Saunders. Dunton, W. R (1918a). The principles of occupational ther­ apy. Public Health Nursing, 10, 316-331 Summary Dunton, W R (1918b). Rehabilitation of crippled soldiers and sailors. Mmyland Psychiatric Quarterly, 7, 85-102 This article traces the conflicting values that shaped both Dunton, W R. (1928). Prescribing occupationaL tberapy. American and British occupational therapy by comparing Springfield, II.: Charles C Thomas. the medical and humanistic origins of each. Early thera­ Federal Board for Vocational Education. (1918). Vocation­ pists did not embrace a unified value system; rather, they al rebabilitation ofdisabLed soldiers and sailors. (Senate Doc­ umenr No. 166). Washington, DC: Government Printing Office. amalgamated biomedical beliefs with the humanistic val­ Gritzer, G, & Arluke, A. (1985). The making ofrehabilita­ ues inherent in the Arts and Crafts Movement. The recent tion A political economy of medical specialization, 1890­ debate on physical agent modalities and practice domains 1980. Berkeley, CA: University of California Press. can be traced to the profession's early struggle to define Haas, L J (1922). Crafts adaptable to occupational needs: practice.• Their relative importance. Archives of Occupational Therapy, 1(6), 443-455 Hall, H. ]. (1922). Editorial: The medical workshop. Ar­ cbives of Occupational Therapy, / (3), 243-245 Acknowledgments Hall, H. J (1923). 0. T -A new profeSSiOn. Concord, !ViA: I acknowledge the suppOrt of St. Loyes School of Occupational Rumford Press Therapy, Exeter, Devon, United Kingdom, during a 1989-1990 Hull House Bulletin. (1902). Semi-Annual Report. V Chica­ research fellowship, and the support of Dr Rita Goble, Princi­ go Hull House IAvailable in the Peace Collection, Swarthmore pal, and the faculty and staff members. The following persons College Library, Swarthmore, PAl Ireland, M. W. (1927). Surgel)'. TheiV/edical Department of helped me to find important references used in the develop­ the United States Army in the World War Washington, DC: ment of this article: Kathleen Reed, PhD. OTR. MIS. FAOTA. Colleen Government Printing Office. Beatty, OTR~_. and Sharon Gutman, OTHII. Jones, (1918a). Letter written to Sir Alfred Keogh. Direc­ This article was presented to members of the Written His­ R tor General, England. Surgeon General, Record Group 112, Box tory Committee during a meeting that commemorated the 75th 431 Washington, DC: National Archives. Anniversary of AOTA, at the 72nd Annual Conference of the Jones, R (1918b). Letter written to Sir George Makins, American Occupational Therapy ASSOCiation, Houston, Texas, President Roval College of Surgeons, Liverpool, England. Sur­ March 1992 geon General, Record Group 112, Box 431 Washington, DC: National Archives. References Johnson, S C. (1919). Occupational therapy. Modem Hos­ pital, 12, 221-223. Barton, G. (1919). Teaching tbe sick Philadelphia: Kaplan, W. (1987). The art that is Ii/e· In America. Saunders. 1875-1920 Wilmington, MA: Acme Publishing, Hosron Museum Barton, G (1920). Inoculation of the bacillus ofwork Mod­ of Fine Arts. ern HospitaL, 8, 399-403. Lears, J 1'. J (1981). No place of grace New York Boris, E. (1986). Art and Labor: Ruskin, Morris. and the Pantheon craftsman ideaL in America. Philadelphia: Temple University MacDonald, E. M. (Eel). (1976). Occupational therapy in Press. rehabilitation Baltimore: Williams & Wilkins. Brackett, E. G. (May 21, 1918). Letter to Joel Goldthwait. McDaniel, M. L (1968). Occupational therapists before Surgeon General's Office, 112 Record Group, Box 431. Washing­ World War II (1917-1940). In R S. Anderson (Ed.), Armyil;/edi­ ton, DC: National Archives. cal Specialist Corps Washington, DC: Office of the Surgeon Casson, E. (undated). Tbe storv oftbe Dorset House School General ofOccupational Therapy (1930-1949). Bristol, England Dorset Myers. C. IV\. (1948). Pioneer occupational therapists in House School of Occupational Therapy. World War \. American Journal of Occupational Therapy, 2, Casson, E. (1932). Occupational therapy as a profession. 208-215 Mental Welfare, 13, 39-43 Orage, A R (1907). Politics for craftsmen. Contempormy Casson, E. (1938). Some experiences in occupational ther­ Review. 91, 787-788. apy. MedicaL Press and CircuLar, 197, 265-268 Simkhovitch, M. K. (1906). Handicrafts in the cit)': What Casson, E. (1939). The value ofoccupational therapy. Medi­ their commercial significance is under metropolitan conditions. cal Press and CircuLar, 198, 101-103. The Craftsman, XI(.» , 363-365 Casson, E. (1940). Occupational therapy as a branch of Tames, R (1990). IVilliam Morris Bucks, UK: Shire.

The Amen'can .Journal of Occupational The,-apy 1087

Downloaded From: http://ajot.aota.org/ on 01/27/2015 Terms of Use: http://AOTA.org/terms TraCl. S E. (912). Siudies in inmtid occupation. A genelal hospital ,'vlodern Hospital. rr, 386-387 manual for 1111}~,es and al/('ndants. 13osron: Whitcomh & Wiener, jvl. (976). The myth of William Morris. Albion. 8. BarrO\\·.s. 6-'-~2 Trac\'. S. E. 0':)'1-1). The place of invalid occupation in the William Morris. (1901). Craftsman. I. 1-14

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1088 NovemberlDecember 1994, Volume 48, Number 11

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