Powerful Occupational Therapists

A Community of Professionals, 1950-1980

Christine Peters

• Publisher: Taylor & Francis
• Year: 2014
• Print ISBN: 9781138108646
• eBook ISBN: 9781317980865
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Powerful Occupational Therapists examines the life and times of a small group of occupational therapy leaders and scholars in a post-1950s America, to market their profession as one of increasing importance. Participating in the 1950s rehabilitation, the 1960s equal rights, and the 1970s women's movements, these innovators, being primarily women, aimed to define themselves as having professional and scientific authority that was distinct from the male-dominated medical model. The community of therapists faced challenges such as that of retaining the appearance of being "ladylike" whilst doing "unladylike" tasks. This book describes the personal experiences of 12 differing occupational therapists and it identifies how a group of them strengthened and developed the profession in the face of diverse challenges. This volume would be of interest to those studying occupational therapy, women and medicine and the history of medicine.

This book was originally published as a special issue of Occupational Therapy in Mental Health.

SECTION VIII: OCCUPATIONAL THERAPY’S PAST INFLUENCES ITS PRESENT, AND CONCLUSION

Occupational therapy’s past and present are bridged in a common goal. That is, developing occupational therapy’s knowledge base was and is a professional priority, to better understand the outcomes of practice, and for occupational therapy’s viability (AOTA & AOTF, 2004; AOTF, 1975; Llorens & Gillette, 1985). Understanding how occupational therapy’s past influences the profession today, can be explored by asking two questions. First, what can we learn from those who created and supported occupational therapy’s science-based knowledge from the 1950s until 1980? Secondly, what significance does knowledge development have in better understanding how professions develop autonomy in a larger historical and sociological context?

By forming a community of therapists, the occupational therapy scholars and leaders involved in knowledge development, changed occupational therapy, by bridging the gap between practice and theory and making occupational therapy known to society. Their legacy was their belief in occupational therapy and knowing that professionalization meant not only developing a scientific body of knowledge, but also finding the right opportunities, people, and liaisons to better position occupational therapy in the health care and educational systems. In so doing, occupational therapy entered a system of professions, setting up a chain of events that ultimately led to occupational therapy’s professionalism, and autonomy from almost 50 years of male physician domination.

The community’s story is an account of how and why a small group of occupational therapy scholars and leaders created a community by association and their contributions that helped their profession expand and thrive. This community lacked homogeneity, and had insiders and outsiders. Community entrance came from educational pedigree, or introduction and mentorship. Primarily, this was a group of powerful women, working in clinical, academic, and administrative roles who knew each other’s strengths and weaknesses. Building occupational therapy together, community insiders gave countless volunteer hours, and their own monies when needed to expand AOTA and AOTF. Community outsiders, or occupational therapy scholars and leaders who developed theories and expanded a scientific knowledge base, held dissimilar views from the leadership mainstream. They challenged occupational therapy’s traditional views and introduced new thinking to the profession.

Riding the crest of the waves from the country’s 1960s science preoccupation and the women’s movement, these women entered surroundings previously unfamiliar to a majority of occupational therapists, like legislative lobbying, federal and state health care positions, and academic administration. Discovered in each of their stories is their connection to Wilma West, who led the profession and the community through grit, determination and financial skill. Leading a single-minded group of professionals when addressing occupational therapy’s worth, the community of therapists fought for and gained autonomy and credibility as a bona fide profession by articulating what they did, establishing rationales behind their work, and foretelling its projected outcomes to benefit society.

Finding their own voice through scholarship and leadership, occupational therapists responded to social and historical events influencing this country that strengthened their resolve to move the profession forward. Yerxa, summarizing her thinking, stated:

One of the things that has really struck me is how we are all influenced by our times, and by our context. The depression, World War II, the 60 s and post modernism have all had a great influence on me. A strong part of it is the history of the status of women. That too is imbedded in my career. I see the profession having achieved much more autonomy in my lifetime than I probably ever would have dreamed, going back to the old days of the medical prescription. I think it’s been a hard struggle, but we have been able to be set free though our own thinking from medicine. We offer important contributions to human life. (Yerxa/Peters oral history, April 21–22, 2003, lines 4,696–4,727)

Therapists negotiated occupational therapy’s place in the rehabilitation, equal rights, and feminist movement during the 1950s up until 1980. Community members known in their work environments and through publications, established occupational therapy’s place amongst other professions. Internally, the community of therapists were the leaders, decision makers, and intellectual authorities who the larger professional membership knew by name or reputation. Trusting each other, community members kept certain information private, like physical medicine’s potential takeover or sealing the Slagle meeting tapes. Did these decisions that set leaders apart from the larger membership establish an internal separateness, an occupational therapy class system or a stratification like that in any human association? These matters, although red-flagged to a student of history, may have gone unnoticed or have been of little concern to the typical occupational therapist.

Perhaps the potential separation between the community of therapists and the larger membership is a problem in itself. What did the larger membership know or care about occupational therapy frames of references or research development? To their credit, the community of therapists facilitated avenues for all occupational therapists to be involved in such lofty goals, through organizational restructuring that separated AOTA and created a new think tank in AOTF. Secondly, the Delegate Assembly reorganization and renaming to become the Representative Assembly may have permitted more grass roots involvement. Finally, setting aside annual monies from AOTA membership fees that supported the foundation’s mission meant that every occupational therapist had a vested interest in occupational therapy’s knowledge development.

This was a dynamic 30-year period in occupational therapy’s history that marked the development of a new professional culture. Gilfoyle believed that changing occupational therapy’s culture required perceptions that she described as a political maneuver when saying:

It takes changing the critical mass of a culture or 10% to 15% of the people over 30 years for things to change, in 10-year increments. For example, when I was at AOTA there were around 4,000 members, and if we could bring along 400 people we could change the profession. I think we’re right in the middle of changing some of our cultural theories in the profession, it’s evolving. (Gilfoyle/Peters oral history, February 10–11, 2003, lines 1,704–1,731)

Gilfoyle’s 30-year change analysis echoes my own view that occupational therapy gained its professional authority over three decades, in 10-year increments.

Occupational therapy’s more conservative 1950s saw therapists functioning under doctors’ prescriptions, and therapists’ names followed physicians’ names in publications. The more radical 1960s women questioned their roles, and therapists questioned physician domination and why occupational therapy worked. Theory development efforts as well as independent authorships and political activism characterized the 1970s. The 1970s marked a more formal knowledge organization, with leaders debating about scientific and philosophical differences, and learned about research in graduate education, continuing education workshops, and seminars.

Synthesizing this study, and by capturing their words, there was an overwhelming feeling that occupational therapy not only brought meaning to those it served but to the leaders and scholars who dedicated their careers to its betterment. Welles, stated simply; “I’m glad I found OT. I hope it persists” (line 4628). Yerxa identified the profession as seductive and baffling, saying:

This profession is extremely seductive, and most challenging. It’s so hard to grasp, but that’s what makes it fascinating, because I’ve always felt it isn’t finished yet. It’s still developing and we have the potential to change society. Our future can be shaped by how we can identify our science. (Yerxa/Peters oral history, April 21–22, 2003, lines 2,548–2,593; 4,886–4,888; 4,895–4,900)

If, in fact, a community of therapists were occupational therapy’s change agents 50-years ago, will a similar group continue to shape their work?

Does a current community continue the debate about scientific inquiry where this community left off, and do they borrow strategies for change, studying occupational therapy’s place in the larger system of professions? Specifically, like the community of therapists, do current leaders and scholars look to society’s changes, with an eye to historical implications in future years? As occupational therapist ranks grow, does the number of practicing therapists have an effect on how change takes place? Martha Kirkland, Executive Director AOTF, with an eye to the future stated:

I think while we do need to document our effectiveness and efficacy in the current health care environment, if we focus on just that, we’re going to be out of business in five years when the environment changes. You can’t move out if you look only at today. We are quite free to move beyond and look at different models of practice. Looking at OT’s role today, and 5 years or 10 years from now, is being able to look at trends out of the box. (Kirkland/Peters interview, March 21, 2003, lines 1,214–1,248)

Perhaps the current debate about basic and applied scientific inquiry remains too narrow when defining occupational therapy’s future path. I argue that knowledge type and focus does not make or break a profession, for at occupational therapy’s heart are the people who guarded and invested their ideas and foresight. The community of therapists discovered that knowledge alone was not enough to make occupational viable. Rather, their stories dealt with power, at a time when women professionals were not seen as dynamic change agents. They exhibited their power differently, either politically, intellectually, or through persistence, all believed in occupational therapy’s worth. Fifty years ahead of its time, this community looked beyond their daily routines to reshape the profession.

Conclusion

In conclusion, this work illustrated how a community of therapists negotiated occupational therapy’s professional power and place in the rehabilitation, equal rights, and feminist movements during the 1950s until 1980. This however remains an isolated and perhaps one-sided story if I didn’t ask what could those outside of occupational therapy learn...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Foreword
• Section I: Changing in Response to Science
• Section II: The Study
• Section III: Community of Therapists
• Section IV: Community Groupings and Portraits
• Section V: Political Movers and Sustainers
• Section VI: The Dilemma of Philosophy and Science
• Section VII: Professionalizing: Occupational Therapy and Social Movements
• Section VIII: Occupational Therapy’s Past Influences Its Present, and Conclusion
• Acknowledgements
• Index