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Occupational therapy is the use of practical activities to treat physical or mental disabilities. Doctors often prescribe this kind of treatment for people affected by an injury, illness, or emotional problem, or by aging. Occupational therapy focuses chiefly on helping patients develop skills needed to perform specific tasks. For example, patients who use a wheelchair might be taught how to get around in the kitchen and cook meals from a seated position. In this way, they gain confidence in their ability to lead a normal life. Blind people who learn to clothe, feed, and care for themselves are better prepared to live a useful life. Sometimes patients must relearn such basic skills as dressing, writing, or eating. Occupational therapy is often described as "curing by doing" because the patients themselves carry out the activities.
Activities used in occupational therapy are planned and supervised by professionals called occupational therapists. These specialists may be assisted by occupational therapy assistants. Occupational therapists work in hospitals, rehabilitation centres, mental health centres, schools, nursing homes, and day-care centres. The therapists may also treat patients at home.
Occupational therapists determine what kind of treatment will best help patients. The therapist first must become familiar with a patient's interests and background, and the cause of the patient's disability. The therapist uses this information to plan a programme of activities.
How occupational therapy helps patients
Occupational therapy has two chief goals. These goals are (1) to help physically disabled people use their bodies more effectively and (2) to help mentally disabled people overcome emotional problems.
Helping the physically disabled. People who suffer a serious injury or illness may lose strength and coordination in a part of the body. For example, a person with multiple sclerosis may lose the use of some muscles because the disease damages nerves that control muscles. The occupational therapist then provides activities that restore muscle strength and usefulness. An activity such as woodworking helps build up the patient's arm muscles. The patient can strengthen leg muscles by operating a potter's wheel, using a kicking motion on the pedal. In addition to providing activities, the occupational therapist may make a splint for the patient's hand, arm, or leg to prevent weakened muscles from stretching or shrinking.
Sometimes a disease cripples the body so severely that the patient cannot regain use of certain muscles. The occupational therapist must then teach the patient new ways to perform familiar tasks. Some patients might learn to dress and eat with one hand instead of two. Others might need to develop strong arm and shoulder muscles to operate crutches or a wheelchair.
Occupational therapy plays a vital part in helping people with permanent disabilities, such as blindness or the loss of a limb. Patients learn that they can do things in spite of their handicaps. A blind person might learn to shop or cook alone. An amputee might learn to drive a specially equipped car.
Doctors often prescribe occupational therapy for children who have cerebral palsy. This disorder damages the brain and affects muscular control. A child with cerebral palsy may have difficulty dressing. The occupational therapist might devise a game that involves doing and undoing zips and buttons. This activity helps the child practise the movements of dressing. Some children grow and develop more slowly than others. Such youngsters may receive occupational therapy as part of their school programme. The therapist then works with family members and teachers to provide the child with activities that promote normal growth and development. These activities might include ball games or skipping.
Helping the mentally disabled. Occupational therapists also work with people who have mental disabilities. Some mental disabilities result from emotional disorders, including anxiety, depression, and neurosis. Such problems can interfere with the person's ability to function normally. A person who suffers from depression may find it difficult to manage daily activities. The occupational therapist works with this person to help the person accomplish everyday tasks. For example, a schedule that helps the person plan activities for the day might be one goal of occupational therapy.
People with a chronic illness may worry that they will be unable to lead a normal life. An illness such as emphysema or heart disease can prevent people from participating in activities they enjoy. Occupational therapy helps such people redirect their energy into activities within their limits. For example, a patient recovering from a heart attack might substitute a less strenuous activity, such as walking, for tennis.
Children with learning disabilities can also be helped by occupational therapy. Some children may have difficulty recognizing shapes or colours. To help these children, a therapist provides games that requires the children to match objects of different size, shape, texture, and colour.
History
The idea behind occupational therapy goes back to A.D. 172, when the Greek physician Galen said: "Employment is nature's best medicine and essential to human happiness." During the late 1700's, doctors in several countries prescribed useful activities as treatment for mentally ill patients. These doctors included Philippe Pinel in France, Johann Christian Reil in Germany, and Benjamin Rush in the United States. As early as 1798, patients at the Pennsylvania Hospital for the Insane in Philadelphia were being taught such skills as carpentry, shoe repair, and needlework.
Modern occupational therapy developed from a nursing course called Invalid Occupations. This course was first offered to student nurses in 1906 by Susan E. Tracy, a Boston nurse. The term occupational therapy was first used by an American architect George E. Barton. He had received this form of treatment after the amputation of a foot. The need to help disabled veterans of World Wars I (1914-1918) and II (1939-1945) stimulated the growth of occupational therapy.
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