Traditional OT

September 6, 2007 at 7:24 pm 34 comments

What do you think about when you hear the phrase, “traditional occupational therapy?”  To me, the phrase refers to OT’s doing just crafts, be it woodworking, painting, or whatever.  I would picture this traditional OT being given to a psychiatric patient or an injured soldier from World War II.

Interestingly enough, I recently had an elderly patient (in her 80’s!) who told me that she was a retired occupational therapist!  And she told me that back when she was working as an OT, she worked mainly with psychiatric patients doing crafts.

It is hard enough finding patients who even know what occupational therapy is in the first place.  But to get someone who actually was an OT is exciting.

Just thought I’d share 🙂


Entry filed under: acute care, occupational therapy, OT.

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34 Comments Add your own

  • 1. Patti  |  September 7, 2007 at 1:54 am

    Yesterday was my first day of OT school and my prof was telling us that when she was in school, over 25 years ago, she had a class just for weaving.

    It’s incredible how OT has changed… now instead of weaving we’re doing neuroscience, sensory, hand, etc etc etc.

  • 2. Sarah  |  September 17, 2007 at 5:12 pm

    I wonder though if by moving away from “traditional OT” as you describe it we risk loosing the essence of our professional. OT is about using occupational for health and wellbeing, for some ADL may be important, for others crafts or leisure activities are.

    If we embrace the medical model too willingly, I think we loose credibility. OT has its own philosophy, theories and emerging evidence base. I believe we should communicate in our own language of occupational form, function and performance so that others learn to understand and respect where we are coming from.

    Thanks for making me think and I’ve enjoyed reading the blog. If you have a moment, you might like to look at ours (I am an OT educator in the UK –

  • 3. aishel  |  September 17, 2007 at 6:12 pm

    Sarah, I agree with you, but one thing you have to remember is that I work in an acute care setting, where the predominant model across the board amongst all hospitals is the medical/biomechanical model. Not that it is so cut and dry, but we honestly need to have this medical model in an acute care setting. I think it would be more practical in a rehab setting, where patients are getting ~3 hours of therapy a day, to incorporate those “meaningful occupations.”

    I will definitely check out your blog! It looks great at first glance, but I will look at it more thoroughly a bit later.

  • 4. Sarah  |  September 18, 2007 at 1:05 pm

    Thanks for adding us to your blogroll – I’ll do the same.

    To get back on topic though, and to be controversial, if we can’t practice “traditional” OT in an acute setting (we have the exact same problem in the UK) is what we do really OT????? Not that what is being provided by OT’s isn’t valuable, but it may not be occupational therapy per say. It probably isn’t client centred, and may or may not be meaningful and purposeful to the individuals?

    I should stress that this isn’t about you specifically Aishel, more about the future of our profession. well, I’ll retreat now… Look forward to comments

  • 5. aishel  |  September 18, 2007 at 7:44 pm

    I still think that we’re able to use meaningful activities as part of our OT treatment. Especially in the morning, most patients truly want to get their teeth brushed, their mouth washed, and their hair combed. By getting patients out of bed and getting to the bathroom to stand by the sink and do so involved standing balance, ambulation, fine motor skills, coordination, and so much more. Just because crafts are what were used originally, that doesn’t mean that is the only thing that is meaningful. So I think that it absolutely is client centered.

    If I’m treating an orthopedic patient with a knee replacement or something similar, they obviously want to stay in bed; it hurts to get out of bed! But they also know that if they want to get better, they have to get out of bed, and by incorporating ADLs, we’re making it meaningful and client centered.

  • 6. Sarah  |  September 19, 2007 at 1:24 pm

    Your blog entry promoted much discussion between my colleagues and I today. A few students joined in too, and we had a really interesting debate, so thankyou for that.
    Our debate really considered the challenge of idealistic thinking, or aspirational practice against the pragmatics of working in constraining environments , especially if the OT knows that their contribution is effective even if it does not adress all components of OT as it is taught in academia.
    Some students felt they should be taught only about reality, others that they appreciated having an ideal to strive for. It might not surprise you to learn that I am firmly holding out for idealsim – perhaps my challenge is to identify a practice area that supports my philosophical stance. I think I came close to it in palliative care, but will let you know if I find the holy grail!!!

  • 7. Yeliz Greenhill  |  October 8, 2007 at 10:21 am

    We have discussed your blog at the university with a group of OT students. We feel these views reflect historical OT activities and intervention. In today’s Occupational Therapy we use both standardised and non-standardised assessments, models and sophisticated approaches to identify client’s areas of needs. As OT’s we value client centredness and the use of meaningful activity and do so using evidence base.

    However it is important to be able to justify and discuss occupational therapy philosophy and its relevants with patients and their families/carers in order to change steriotypical views to promote occupational therapy positively, as through the years OT as a profession has developed and evolved.

    Thank you very much for your thought provoking article.

  • 8. Amanda Ramsbottom  |  October 8, 2007 at 10:39 am

    And what is traditional occupational therapy?

    Occupational therapy has become more diverse since its early days. Through our training we see the need to look beyond a diagnosis and in doing so develop the profession.

    We wondered that if, in American occupational therapy schools, whether the focus is in physical or psychiatric settings or do you have the opportunity to experience placements in both as we do?

    Surely traditional occupational therapy is about the belief that meaningul occupation can be used to promote health and well being, irrespective of what activity is used, be it crafts, IT, washing and dressing practice, anxiety management or finding pathways back into employment.

    Thanks very much – your blog has provoked much thought and discussion amongst our 3rd year student cohort and we look forward to continuing debate.

  • 9. Merrolee  |  October 9, 2007 at 5:01 am

    Hi Ahsel
    I did wonder where your blog had gone – I’m just about to link it into my new OT blog pages!
    I too came from the era when we had whole courses on weaving, woodwork, leatherwork etc. In those days (which is really not that long ago – early 80’s) these activities were used particularly in mental health, but also in rehab. They were still activities that people did in their everyday lives (although less and less – I guess we were on the cusp of change). So in today’s language, we would should consider activities that are relevant for today’s world . My point is that the reasoning hasn’t change – we are still consider the person, the environment and the occupation and determining what it is that we adjust or mainipulate. In the area you work Aishel, you do much to manipulate the person, and adjust the environment to ensure safe independence, in a community setting we might achieve the goals of the individual through the occupations – not try to increase their range of movement or alleviate anxiety, and in school based practice, we might alter the environment, which may be trying to assist the teacher to address their beliefs about having a child with a disability in the classroom. I think we can make the mistake of focusing on the tool… when in fact it is the process and the outcome that is important to discuss! And wonderful that you met an elderly OT.. I have always pictured myself as an elderly person in a rest home and having this lovely bouncy OT approach me for newspaper reading group… and me saying – no thanks – I ran enough of those as an OT.. I’ve very happy in my memories.. so bug off!! But I’m sure I would be far more polite!


  • 10. aishel  |  October 9, 2007 at 6:48 am

    Thanks everyone for all your comments.

    Amanda and Yeliz, its neat to know that this blog is affecting discussions in the UK! Amanda, in the US, there is just as much focus on the mental health aspect as there is in the physical dysfunction aspect. However, if I recall correctly, I believe I read a statistic somewhere saying that only 10% of all practicing OT’s are working in the mental health field.

  • 11. Amanda Ramsbottom  |  October 9, 2007 at 2:26 pm

    Hi Aishel

    Thanks for your response to my question. As a novice to blogging (your site has prompted me to make my first ever comment to a blog!) I think its fantastic that we can discuss issues affecting our profession with fellow students and experienced occupational therapists in a global fourm.

    I am surprised at the statistic of only 10% of OTs working in mental health though. I feel some research coming on….

  • 12. aishel  |  October 9, 2007 at 5:05 pm

    Amanda, I did some quick googleing, and according to this Word document:

    Occupational therapy has a firm foundation in mental health, yet in a recent survey, only two percent of all OT’s were employed in a purely mental health field (Brown, 2003). Another survey, The AOTA 2000 Member Compensation Survey conducted by the AOTA, found that five percent of OT’s work in mental health (cited in Cooksey and Fisher, 2002a). The numbers have been decreasing rapidly. Price (1993) cited a member data survey from the AOTA with the following decline in OT mental health practitioners: in 1973, 36% of OTs practiced in mental health; in 1982, 27%; and in 1990, 16.6%. The American Journal of Occupational Therapy documents this decline and responses to it, back to the 1970’s and the AOTA is still forming committees to research this phenomenon (Bonder, 1987; Smith, 2003).

  • 13. Yeliz  |  October 10, 2007 at 5:43 am

    Dear Aishel,

    In UK as far as I am aware OTs are employed in variety of settings be it physical, mental, vocational. I personally chosen OT because of its holistic qualities and the skills that can be applicable in countless health care and work settings. Here as well as NHS, government employing OTs for vocational rehab in order to help people who are off work with mental and physical disabilities to get back on employment or more productive lives. Housing Associations employing OTs to take part in their services to their tenants. OTs are working in schools with teachers and many charities all over UK, because of their holistic and client centred approach to issues whatever these issues made of.

    We look at the service users as a whole, not necessarily as a mental health patient or a patient with RA. We take in their needs and goals into consideration and enable them to have more independent lives through use of meaningful occupation. Therefore I feel, however intriguing, the research in what areas OTs mainly employed is quite irrelevant in this sense. After all, we are holistic therapists and we should abide by our code of conducts rather then who pays our salary.

  • 14. V.L.  |  October 11, 2007 at 2:41 pm

    I’m a COTA who works at an in-patient psychiatric facility. For some of our population we still provide what you all are callling traditional OT.
    For our higher level patients (those who will be returning to the community) our focus is on IADLS. However, for our chronic long term patients (many who’ve been here for 20 years or more) we focus on purposeful and meaningful activity, which usually involves crafts. Use of crafts can be so very beneficial to some of these patients. And a wide variety of issues/problems/abilities can be addressed by using craft modalities.
    I ,for one, would hate to see “traditional OT” cease to exist.

  • 15. Great discussion « Occupational Therapy - A Blog about OT  |  October 11, 2007 at 10:08 pm

    […] been really busy.  I did want to point out that there is a great discussion going on in my post, Traditional OT, and that you should definitely check it out if you haven’t […]

  • 16. maikatka  |  October 12, 2007 at 3:45 pm

    I am an Finnish OT although not practicing OT anymore. For me “traditional OT” with time, creativity, crafts, meningful activities and fun was the point of being an OT. I was working with chronical mental health illnessess and it was like V.L mentioned often really well justified to do these things. Fun,motor skills, interaction, social skills, group behaviour, cognitive tasks in a nice package. Traditional OT as you call it is exactly the reason why I still sometimes miss my job as an OT. Now I am really grateful of my OT backgroud in intercultural field. I am inegrating some of the ideas that I think are traditional OT: client-centeredness, meaningful activities, learning by doing, creativity and fun, facing every person with a respect regardless of the background or looks. Holistic and positive attitude of OT is what I think is the traditional OT.

  • 17. Merrolee  |  October 12, 2007 at 10:37 pm

    Hi Aishel
    The US does seem to be loosing its foothold in mental health whereas in many other countries there are many of the profession working with clients with mental health issues – this is certainly the case in New Zealand with many therapists preferring to work in mental health areas!

  • 18. Karen  |  November 7, 2007 at 12:51 am

    Suzanne Peloquin’s Slagle lecture on Embracing our Ethos, seemed to me to be an entreaty to get back to our roots – in other words, in my opinion, traditional OT. I guess it’s all about semantics. To some, traditional OT means the basic view of OT – arts and crafts style. To others, like me, traditional OT is Ora Ruggles style – being creative and AMAZING and really helping people find meaning in their lives and regain function. I like the medical model, but I think we can use the medical model and STILL be somewhat Ora Ruggles-y!!

  • 19. Karen  |  November 7, 2007 at 12:52 am

    PS: EVERY OT IN THE WORLD SHOULD GO READ THE HEALING HEART BY JOHN CARLOVA, ON ORA RUGGLES, OT PIONEER! You can find it on Amazon used for under 20 dollars usually! It’s the best book in the entire world! Ok, getting off my obsessive soapbox now.

  • 20. Lindsay  |  November 12, 2007 at 12:37 am

    I am a pediatric OT and often wonder if the name “occupational therapist” is very confusing to consumers. I dont take the time to explain to parents that that I use a persons “occupation” as a motivating means for impacting skills. And I dont explain that “play” is a childs “occupation”. For the betterment of the field of OT, Im wondering, is it important that people realize what the name means, or just understand what we do to help function?

    Im new to this blogging thing- just started my own mostly to communicate with families I work with:

  • 21. Alyssa Karagornas  |  August 3, 2008 at 4:58 am

    I am a first year OT student and i must say that even though the theory can be a bit much, i have ‘fallen in love’ with OT. Being in first year i still dont know precisely what OT’s do, but what i have learnt, seen and participated in has been so much more than i expected. I am so excited to continue on this journey.
    I am SO desperate to read ‘The healing heart’ but i cannot find it anywhere! any advice? or connections?

  • 22. aishel  |  August 3, 2008 at 6:30 am

    I have not seen it anywhere, sorry!

  • 23. ko, hyo-eun  |  November 24, 2008 at 8:18 pm

    i’m student of studying OT in korea. do you know korea?
    i want to know about OT but it is difficult
    please, give me the infomation about OT.

  • 24. Lisa  |  December 8, 2008 at 11:01 pm

    OT is teaching skills for the job of living ie;

    bathing, dressing, toileting etc.

    Traditional OT or meaningful activities such as painting standing at a table or molding clay, small meal preparation etc, can be used to promote ub strengthening, dynamic standing tolerance, kitchen safety awareness/home management skills plus many more benefits.

    It doesn’t have to be all theraband/theraputty, dressing, bathing, toileting…sometimes you need a more meaningful act to bond with your pt and give them confidence in themselves.

  • 25. Lisa  |  December 8, 2008 at 11:05 pm

    I need ideas for increasing wrist ext in a CVA pt and a pt who had a craniotomy who is regaining function. I’ve been doing muscle re-ed e stim and prom/srom

    Also have a pt with radial nerve damage with zero wrist ext, any ideas?

  • 26. Elena  |  July 23, 2010 at 12:44 pm

    Speaking of weaving and OT… My name is Elena from Mirrix Looms. I read your blog and wanted to direct you to a social marketing campaign we’re currently running involving our looms and their use for occupational therapy.
    You can learn more here:

  • 27. Play Matters  |  October 16, 2014 at 5:09 pm

    List of therapy center in pampanga, region 3, manila and provinces

    Play Matters Therapy Center is a clinic that offers pediatric care in the line of occupational therapy, speech therapy, special education (sped) program, and reading & tutorial services. It is the first and only therapy center in Mexico, Pampanga, Region 3. It is located at Lagundi, Mexico, Pampanga. The center is a walking distance from SM and Robinsons Pampanga which makes its location highly accesible. It caters clients from neighboring towns of Mexico such as the City of San Fernando, Angeles City, Sta. Ana, Arayat, Candaba, Sto. Tomas, Apalit, Bacolor, etc. Because of its proximity to NLEX Exit (via san fernando exit which is beside SM Pampanga), Play Matters Therapy Center can also cater those coming from Bulacan and Tarlac. Clients also come from Nueva Ecija especially Cabiao because it only takes an hour by bus.
    The center caters to clients with learning difficulties, autism, ADHD, down syndrome, mental retardation, etc.

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  • 29. Gesundheitsratgeber Online  |  March 8, 2016 at 2:01 pm

    Bei Menschen mit starkem Bluthochdruck kann eine nicht-medikamentöse Therapie eine Senkung des Arzneimittelbedarfs bewirken.

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    In der heutigen Arbeitswelt, sollte an mindestens
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  • 33. Gesund Leben Ernaehrung  |  March 26, 2016 at 10:09 pm

    Evi aus Bad Belzig (20.03.2014): Ich wäre froh, wenn sich mein Blutdruck auch ohne Medikamente senken würde.

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