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Occupational rehab/therapy
Refers to the use of meaningful occupation to assist people who have difficulty in achieving a healthy and
balanced lifestyle; and to enable an inclusive society so that all people can participate to their potential in daily
occupations of life.[1] Occupational Therapists & Occupational Therapy work with a variety of individuals who
have difficulty accessing or performing meaningful occupations.
Most commonly, Occupational Therapists & Occupational Therapy Assistants work with people with
disabilities to enable them to maximize their skills and abilities. Occupational therapy gives people the "skills
for the job of living" necessary for living meaningful and satisfying lives.[2]
Services typically include:
• Customized intervention programs to improve one's ability to perform daily activities.
• Comprehensive home and job site evaluations with adaptation recommendations.
• Performance skills assessments and treatment.
• Adaptive equipment recommendations and usage training.
• Guidance to family members and caregivers.[2]
History of Occupational Therapy in Aotearoa/New Zealand
The early use of occupation to support, treat and rehabilitate people in Aotearoa New Zealand is evident in
services for returned soldiers after World War 1 ((Hobcroft 1949)). There are glimpses in mental health services
during the 1930's too (Skilton 1981). However the first qualified occupational therapist Margaret Buchanan
arrived in New Zealand in 1941 (Buchanan 1941). Initially employed in the then Auckland Mental Hospital she
was rapidly involved not only in the development of occupational therapy services there, but also the
development of the first training programmes and advice to government. Initially those trained had previous
health or education backgrounds (Skilton 1981). A formal two year training programme was established by
1940 (NZNJ 1940), and state registration provided for in the Occupational Therapy Act 1949 with the New
Zealand Occupational Therapy Registration Board 1950 but since replaced by the Occupational Therapy Board
of NZ through the Health Practitioners Competence Assurance Act 2003. From its early services in mental
health and returned serviceman settings occupational therapy expanded into general rehabilitation, work with
children with disabilities and services for the elderly (Wilson 2004) p88.
Educational programmes moved from the health sector to the education sector in 1971 (New Zealand
Occupational Therapy Registration Board 1970b 17th July). OT career training is now provided by the Schools
of Occupational Therapy at the Auckland University of Technology and Otago Polytechnic in Dunedin. An
advanced diploma in occupational therapy was first made available in 1989 (Packer 1991) and bachelor
programmes have been available since the 1990's. However, it was not until a review of the Education Act that
it was possible for masters degree programmes to be made available, as they now are through both schools . The
first New Zealand occupational therapist to complete a PhD in the country in a programme related to
occupational therapy was Linda Robertson who completed her PhD in 1994 (NZJOT 1996). The development
of distance education technology has enabled large numbers of therapists to participate in post-graduate distance
education.
An association for practitioners was formed in 1948 (New Zealand Registered Occupational Therapists
Association 1949) and since renamed as the New Zealand Association of Occupational Therapists (Inc) or
NZAOT. The NZAOT provides a bi-annual conference, representation at government levels, a journal and a
monthly newsletter.
History of Occupational Therapy in the United States of America
Occupational therapy began as a profession in the United States in 1917 with the founding of the Society for the
Promotion of Occupational Therapy (now, The American Occupational Therapy Association, Inc.). The
creation of the society was impelled by a belief in the curative properties of human occupation (or everyday
purposeful activity). It had previously been employed as part of the moral treatment movement in the large state
supported institutions for mental illness that were widespread in the United States. Occupational therapy has
played a prominent role in epidemics, providing treatment for patients with tuberculosis, polio, and HIV/AIDS.
In 1975, following the enactment of legislation known as the Education for All Handicapped Children Act (PL

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94-142), thousands of occupational therapists were employed by public schools to provide therapeutic services
(known as related services) to enable children with disabilities to participate in regular school settings.
Originally, therapists from approved training programs were certified, or registered by the American
Occupational Therapy Association. A baccalaureate degree was required for certification beginning in the
1940s. Fifty years later, accredited programs were required to be at the Master's degree level. The 1990s saw the
evolution of doctoral programs in occupational therapy. Educational programs in occupational therapy are now
accredited by the Accreditation Council for Occupational Therapy Education, and national certification is
granted under the auspices of the National Board for Certification in Occupational Therapy. More recently, a
new discipline within occupational therapy has opened up known as occupational science. Many students in 5-
year masters program now receive their undergraduate degree in this discipline and go on to receive a Masters
degree in occupational therapy during their 5th year.
Occupational Therapy Educational Requirements
Occupational therapy practitioners are skilled professionals whose education includes the study of human
growth and development with specific emphasis on the physical, emotional, psychological, sociocultural,
cognitive and environmental components of illness and injury.
Occupational Therapy Education in the USA
Most registered occupational therapists (OTR) practicing in the field today possess a Bachelor of Science
degree in occupational therapy. However, by 2007, all OTRs will enter the field with a Masters (M.S. or MOT)
or Doctoral degree (OTD). A certified occupational therapy assistant (COTA) generally earns an associate
degree.
To become eligible for the national examination for certification, students must complete a minimum of two
(three maximum) supervised clinical internships in physical disabilities, pediatrics or mental health. Many
college programs encourage students to pursue a third internship in an area of OT of their choosing. Upon
successful completion of at least two internships, graduates must pass a national examination (NBCOT or
National Board for Certification in Occupational Therapy). Most U.S. states also regulate occupational therapy
practice (OTs must possess a license within their state).
The Philosophy of Occupational Therapy
The philosophy of occupational therapy has evolved over the history of the profession. The philosophy
articulated by the founders owed much to the ideals of romanticism [3] , pragmatism [4] and humanism which are
collectively considered the fundamental ideologies of the past century [5] [6] [7].
William Rush Dunton, the creator of the National Society for the Promotion of Occupational Therapy, now the
American Occupational Therapy Association, sought to promote the ideas that occupation is a basic human
need, and that occupation was therapeutic. From his statements, came some of the basic assumptions of
occupational therapy, which include:
• Occupation has an effect on health and well being.
• Occupation creates structure and organizes time.
• Occupation brings meaning to life, culturally and personally.
• Occupations are individual. People value different occupations [1].
These have been elaborated over time to form the values which underpin the Codes of Ethics issued by each
national association. However, the relevance of occupation to health and well-being remains the central theme.
Influenced by criticism from medicine and the multitude of physical disabilities resulting from World War Two,
occupational therapy adopted a more reductionistic philosophy for a time. While this approach lead to
developments in technical knowledge about occupational performance, clinicians became increasingly
disillusioned and re-considered these beliefs [8] [9]. As a result, client centeredness and occupation are re-
emerging as dominant themes in the profession, perhaps indicating growing maturity and self confidence [10] [11]
[12]
. Over the past century, the underlying philosophy of occupational therapy has evolved from being a
diversion from illness, to treatment, to enablement through meaningful occupation [1].
The two most commonly mentioned values are that occupation is essential for health and the concept of holism.
However, there have been some dissenting voices. Mocellin in particular advocated abandoning the notion of

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health through occupation as obsolete in the modern world and questioned the appropriateness of advocating
holism when practice rarely supports it [13] [14] [15]. The values formulated by the American Association of
Occupational Therapists have also been critiqued as being therapist centred and not reflecting the modern
reality of multicultural practice [16] [17].
Potential Uses of Occupational Therapy
A wide variety of people may benefit from occupational therapy, these may include people with:
• work-related injuries including lower back problems or repetitive strain injuries
• physical, cognitive or psychological limitations following a stroke, brain injury or heart attack
• rheumatoid and age-related conditions such as arthritis
• neurodegenerative movement disorders such as multiple sclerosis, amyotrophic lateral sclerosis, or
Parkinson's disease
• birth injuries, learning difficulties, or developmental disabilities
• mental health difficulties Alzheimer's, schizophrenia, ADHD and post-traumatic stress
• substance abuse problems or eating disorders
• Fetal alcohol syndrome due to central nervous system damage from prenatal alcohol exposure
• obsessive compulsions, or diagnosed obsessive compulsive disorder (OCD)
• burns, spinal cord injuries, or amputations
• fractures or other injuries from falls, sports injuries, or accidents
• visual, perceptual or cognitive impairments
• developmental disabilities such as autism or cerebral palsy
• domestic abuse issues
• homelessness
• refugees and asylum seekers
• sensory processing disorders
Areas of Occupational Therapy
Occupational therapists work in a vast array of settings, these include:
Physical
• Orthopedics (outpatient clinics), Pediatrics, Long-Term Care, Hand therapy, Cardiac rehabilitation, Burn
Centers, Rehabilitation centers (TBI, Stroke (CVA), spinal cord injuries, etc.), Hospitals (ranging from
inpatient, subacute rehab, to outpatient clinics), Forensic units, Homeless Shelters, Educational Settings,
Refugee Camps, Community Settings, Industrial therapy (work hardening, work conditioning, job
demand analysis)
Community
Community based practice means moving away from hospitals and rehabilitation clinics and working with
atypical populations such as the homeless or at risk populations.
Examples of community-based practice settings:
• Health promotion and lifestyle change, Intermediate care, Day centers, Schools, Child development
centers, People's own homes, carrying out therapy and providing equipment and adaptations,
Implementing gradual return to work programmes which include workplace and work station
assessments, Home Care
Cognitive
• Stroke rehabilitation, Traumatic brain injury, Multiple sclerosis, Parkinsons disease
Mental Health
• Child and adolescent mental health services (CAMHS), Forensic psychiatry, Prisons/sections, Mental
health clinics, Psychiatric rehabilitation programs, CSP's, Club houses, Early Intervention for Psychosis
services

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Occupational Health
Occupational health problems occur at work or because of the kind of work you do. These problems can include
• Cuts, broken bones, sprains and strains, or amputations
• Repetitive motion disorders
• Hearing problems caused by exposure to noise
• Vision problems or even blindness
• Illness caused by breathing, touching or ingesting unsafe substances
• Illness caused by exposure to radiation
• Exposure to germs in healthcare settings
Good job safety and prevention practices can reduce your risk of these problems. Try to stay fit, reduce stress,
set up your work area properly, and use the right equipment and gear.