The development of occupational therapy in Scotland 1900-1960
This thesis traces the therapeutic application of occupation from its role in moral treatment in psychiatry in the nineteenth century to its use in sanatoria and curative workshops in the early twentieth century. It outlines of the profession in North America and the influence of pragmatism, the arts and crafts movement, the mental hygiene movement and scientific management on the early development of occupational therapy. The main part of the thesis records the stages of professionalisation in Scotland from the appointment of the first instructress in occupational therapy in 1922 to the passing of the Professions Supplementary to Medicine Act in 1960. This record is set within its immediate medical context and highlights how occupational therapy has adapted in relation to developments in medical science. It also shows how occupational therapy has been affected by the wider social context, particularly the impact of the two world wars and the types of institutions in which therapeutic occupation developed. The thesis focuses on the male medical patrons and the all-female pioneer occupational therapists who predominantly came from upper middle class and middle class families, many with connections with prominent physicians. The humanistic philosophy of the medical patrons is explored and it is demonstrated that historically a holistic approach to patient care was not incompatible with a search for the scientific understanding of the mechanisms of treatment. Similarly, it is shown that the medical patrons were supportive of professional autonomy for occupational therapy. The changing nature of the therapeutic media used by occupational therapists is explored and the early reliance on the arts and crafts explained in relation to scientific and humanistic rationales. Finally, the findings of the thesis are summarised and discussed in relation to a synopsis of professional practice from 1960 to 2000.