In 1917 the profession of occupational therapy was founded for the following purposes: "the advancement of occupation as a therapeutic measure"; "the study of the effect of occupation on the human being"; and "the scientific dispensation of this knowledge" (National Society for the Promotion of Occupational Therapy, 1917, p.1). The philosophy of the Occupational Therapy Doctoral (OTD) degree program at the University of Toledo reflects this commitment to the use and study of occupation as a therapeutic measure.
Because of its focus on occupation, the profession of occupational therapy has a vital and unique mission in health care. "Occupation" involves doing things that are meaningful and purposeful to the individual. For example, preparing a meal, playing a game, washing a car, completing a school assignment, and finishing a task at work are all occupations of daily life. Indeed, we can think about a person's life as a stream of occupations engaged in by the individual. To a great extent, we are what we do. Further, our doing or occupation actually shapes our character: we become as we do. And we reveal who we are (our abilities, our values, and our other characteristics) through our occupations. Occupation characterizes the dignity and uniqueness of humanity.
Therapeutic occupation is based on the principle that people can actually improve their health and well-being by engaging in occupations. The patient or client in occupational therapy is an active participant, not a passive recipient of services. For example, a child with a movement disorder can acquire better motor patterns while playing a game designed by the occupational therapist. Or, for another example, a client in a community mental health program can develop skills in personal financial management and other necessary tasks of daily life with the assistance of the occupational therapist. Sometimes, therapeutic occupation involves new growth in the person, or adaptation. In other cases, therapeutic occupation involves ways around the problem, as in compensation. Whether through adaptation or compensation, occupation offers significant therapeutic benefits to many different populations in many different settings.
The Occupational Therapist
The occupational therapist is a facilitator of therapeutic occupation. The therapist's role is to collaborate with the person who is active in the pursuit of one's own enhanced health. In doing so, the occupational therapist must draw upon a wide array of knowledge, including biology, psychology, sociology, anthropology, various health professions, as well as the body of knowledge that is specific to occupational therapy. While many professions draw upon an interdisciplinary base, the uniqueness of occupational therapy is that the patient or client actually helps oneself through active occupation. No other profession is based on this principle. The profession of occupational therapy is aptly named: occupation is the method of therapy.
Clinical Assistant Professor Lynne Chapman and alumna Missy Rugh work with a gentleman following his amputation.
The UT OTD Conceptual Framework of Therapeutic Occupation
The OTD program at UT focuses on the study and application of occupation as a therapeutic method. This is the program's commitment to the public, to the profession, to our students, and to those who will receive therapeutic services from our students in the future. To fulfill this commitment, the faculty members of the OTD program advocate a distinctive perspective on the study of occupation. We call this perspective the Conceptual Framework of Therapeutic Occupation, or CFTO (Nelson, 1997). CFTO involves precise definitions of key occupational terms, such as meaning, purpose, occupational form, occupational performance, adaptation, and impact. This terminology is helpful both in the analysis of clinical problems and in the analysis of research problems in occupational therapy. Early in the curriculum OTD students at UT master CFTO terminology as a base for later explorations of the many facets of occupational therapy. The fact is that there are many different approaches, or models of practice, in the profession of occupational therapy. CFTO provides a common language and way of thinking about the various models of practice and the underlying processes of occupational therapy. Therefore, CFTO provides a firm identity for occupational therapists. CFTO is the common thread of ideas with which the UT OTD program is woven.
Doctoral Education in Occupational Therapy
The goal for the OTD program is for the student as a future therapist to have a personal commitment to the advancement of occupational therapy practice, advocacy, and research. The program's faculty view the graduate student as a future colleague. Like graduate programs of high quality in other fields, the OTD program brings faculty and students together in a joint effort to improve the field, not just to impart or absorb information. A graduate program involves the building of knowledge as well as the attainment of knowledge. Every course in the OTD program requires abstract reasoning as well as self-direction. As the OTD student acquires knowledge and skill, an important role is to teach fellow students. The graduate student not only learns about the past and present of the profession, but also shares in the design of the future of the profession. Upon graduation, the newly certified and licensed occupational therapist is well prepared to begin a career of excellence in practice, advocacy, and research.
Preparation for entry-level Occupational Therapy Practice
The UT OTD program also provides a solid foundation in the practical aspects of occupational therapy. The student experiences clinical practice in every semester throughout the curriculum. In the early stages of the curriculum, the student observes the occupational therapy process and learns to analyze therapeutic occupations. With increasing knowledge, skill, and self-awareness, the student gradually begins to plan occupational therapy evaluations and interventions under the supervision of faculty and occupational therapy practitioners. Over time, the student experiences first-hand the practice of occupational therapy in a wide variety of settings, traditional and non-traditional, and in accordance with many different models of practice. The OTD curriculum also recognizes that education and therapy have an essential psychosocial component. Through practical experiences, the student learns the importance of a holistic perspective, including empathy and the therapeutic use of self in the analysis of therapeutic occupations. Finally, full-time Level II fieldwork for six months and a semester of a capstone experience in an area of personal interest are integral parts of the academic program, with joint clinical and academic assignments. At the conclusion of the OTD program, the student is ready to begin practice as an entry-level occupational therapist across the broad spectrum of occupational therapy treatment settings.
The OTD program is firmly rooted in certain core values. Derived from occupational therapy philosophy and graduate educational philosophy, these values commit the OTD student to the following:
· An unshakable belief in the inherent dignity of the person
· A holistic conception of the occupational nature of the human being
· Expertise in occupation as an effective therapeutic method
· Application of the Conceptual Framework of Therapeutic Occupation
· Assumption of a new identity as a professional occupational therapist
· The use of advanced cognitive abilities, including abstract reasoning, in professional life
· The importance of empathy in clinical practice and in professional life
· Research and scholarly inquiry in the profession
· Advocacy for the profession and those in need of therapeutic occupations
· A willingness to learn from and teach others, including peers
· The ability to engage in mentoring relationships
· Self-directedness and ultimate responsibility for one's own learning
In conclusion, the OTD student is a collaborator in a social movement dedicated to the advancement of the profession of occupational therapy. Those in need of therapeutic occupations will be the ultimate beneficiaries of the contributions of occupational therapists educated in UT's OTD program.
National Society for the Promotion of Occupational Therapy. Certificate of Incorporation of the National Society for the Promotion of Occupational Therapy. Incorporated in the District of Columbia and notarized by James A. Rolfe in Clifton Springs, New York, March 15, 1917.
Nelson, D. L. (1997). The 1996 Eleanor Clarke Slagle Lecture. Why the profession of occupational therapy will flourish in the Twenty-first century. American Journal of Occupational Therapy 51, 11-24.
*Applicants are invited to read this article for a comprehensive overview of the Conceptual Framework of Therapeutic Occupation.