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THE OUTLOOK
FOR WOMEN
\

OCCUPATIONAL THERAPISTS
MEDICAL SERVICES SERIES
Bulletin No. 203—2, Revised

U. S. DEPARTMENT OF LABOR
Maurice J. Tobin, Secretary
OMEN’S BUREAU
Frieda S. Miller, Director

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UNITED STATES DEPARTMENT OF LABOR
MAURICE J. TOBIN, SECRETARY

WOMEN’S BUREAU
FRIEDA S. MILLER, DIRECTOR

The Outlook for Women
as
Occupational Therapists

Bulletin of the Women’s Bureau No. 201-1, Revised
Medical Services Series

U. S. GOVERNMENT PRINTING OFFICE
WASHINGTON : 1952

For sale by the Superintendent of Documents, U. S. Government
Printing Office, Washington 25, D. C.

Price 20 cents

This is Bulletin 203-2 in the

MEDICAL SERVICES SERIES, REVISED
No. 203-1

The Outlook for Women as Physical Therapists.

No. 203-2

The Outlook for Women as Occupational Therapists.

LETTER OF TRANSMITTAL

United States Department of Labor,
Women’s Bureau,

Washington, May 29,1952.
I have the honor of transmitting a report on the employment
outlook for women as occupational therapists. This is a field in which
women did the pioneering during World War II, and in which women
have continued to be predominant both in numbers and in leadership.
Although issued as a revision of a previous bulletin on Occupational
Therapists (Bulletin 203, Number 2) in the Women’s Medical and
Other Health Services Series, the present study is based on new and
extensive research and has been entirely rewritten. The research was
carried out and the report prepared by Agnes W. Mitchell of the
Branch of Employment Opportunities for Women in the Bureau’s
Division of Research, under the direction of Mary N. Hilton, Chief,
Division of Research.
I want to express appreciation here for the generous cooperation
rendered by the many organizations, agencies, and individuals who
contributed information and photographs for this study.
Respectfully submitted.
Frieda S. Miller, Director.
Hon. Maurice J. Tobin,
Secretary of Labor.
Sir:

hi

FOREWORD
The field of medical and other health work, employing more than
1,200,000 persons in 1952, is vital to the public welfare and offers a
variety of employment opportunities, of which occupational therapy is
one. The health services were recently reported to be second only to
teaching among the professional and semiprofessional occupations in
the number of persons employed. As about one-half of the health
workers are women, this service offers an extensive vocational field
for women.
The present report on “The Outlook for Women as Occupational
Therapists” is the second prepared by the Women’s Bureau in re­
vision of the medical and other health services series. For the most
part, it describes trends in occupations for which training at the
college level prepares women. Following the pattern of the earlier
series on medical services and other series on women employed in the
sciences and in social work, this study is concerned primarily with the
changes and developments which affect the outlook for women’s
employment.
Since 1944, when the Women’s Bureau first issued a report on the
outlook for women in this field, occupational therapy has proved its
value in the treatment of a wide range of mental and physical dis­
abilities, including casualties of war, injured and handicapped civil­
ians, crippled children, and neuropsychiatric patients.
Two Federal grant-in-aid programs—for vocational rehabilitation
and for crippled children—require occupational therapists for their
effective operation. In addition, these therapists are needed in hos­
pitals, in curative workshops and clinics, and in visiting nurse
associations.
The supply of well-qualified occupational therapists has failed to
keep pace with the rapidly expanding needs of the profession. Al­
though the number of occupational therapists employed in the country
was estimated to be 5,000, existing vacancies, including replacements
and new positions resulting from the expansion of medical services,
were thought to exceed this number.
A very real need exists, therefore, for bringing the opportunities for
a useful and rewarding career in occupational therapy to the attention
of women students now in college and high school. The present bulle­
tin is planned for the use of deans of women in colleges and universiIV

FOREWORD

V

ties, vocational counselors in higli schools, and other persons in a
position to advise girls and women as to the choice of a profession. It
covers the situation preceding the emergency defense period beginning
in mid-1950, including historical facts from the original report (Bulle­
tin 203-2), and the defense period outlook for women in an occupation
in which women compose about 98 percent of the workers.
Although more than 1,000 books, articles, and pamphlets have been
culled for information, the principal sources of material have been the
professional organizations, public and private agencies, schools of
medicine, and individuals familiar with the field. To these contribu­
tors the Bureau is indebted for the raw material which made the report
possible.
The Bureau is also grateful to the following for the illustrations
used in this bulletin:
American National Red Cross (figs. 7, 8, 9).
Curative Workshop of Milwaukee (fig. 1).
Liberty Mutual Insurance Co., Boston, Mass. (fig. 5).
U. S. Department of the Army (cover picture, figs. 2, 3, 4, (i).

CONTENTS
Page

Foreword _
_......... _ ______
Definition. _ _
_______
___
The setting
The outlook_______________________
Demand and supply in 1952______ ___________
_
Employment in hospitals___
_ ______ __
_
_
Employment in curative workshops or clinics-_
_
Home-care program ______
Other types of occupational therapy______
_ _
Geographic variations in employment_
_
__
Sources of supply__________________
Training__________________________________
__
Classroom training_____ _ _____________
Hospital practice____________
______
__
Registration
___
_
Scholarships and fellowships____
________
Service in the Armed Forces____
Earnings, working conditions, and advancement- ______
_
Earnings_____________________________
Hours and working conditions_____
_ _____
Advancement____________________________
__
___
Organizations______ ___ _____________ _____
_
Unpaid volunteers________________________________
_ _ ____
Suggestions to those interested in entering the field of occupational
therapy----- .---------------------------------------------------------------------------------Prewar and wartime distribution___
Appendix:
Minimum requirements for a beginning Federal Civil Service position
as an occupational therapist____________
__ _ _______
Minimum requirements for a beginning Federal Civil Service position
as an occupational therapist with the Veterans’ Administration___
Minimum standards for the college curriculum in an acceptable school
of occupational therapy_____
Schools of occupational therapy in the United States accredited by
the Council on Medical Education and Hospitals of the American
Medical Association, April 1952________
______________ ____
Bibliography_____ _______________________
Tables:
1. Occupational therapists, by type of institution or agency, United
States, 1951___
2. Geographic distribution of occupational therapists compared with
the schools and the general population, United States. ______
VI

IV
VIII
1
9
13
14
18
20
21
21
22
24
24
25
26
26
26
27
27
28
29
31
32
38
40

45
45
40

47
48

13
22

CONTENTS

VII

Illustrations:
Page
1. An occupational therapist holds a stop watch, timing a patient with
an amputated finger as he completes a task in a curative workshop-----------2
2. Poliomyelitis patient, 3-year-old daughter of a master sergeant, is
using hand skate to strengthen hand and arm. The occupational thera­
pist, member of the Women’s Medical Specialist Corps, is making a game
of the treatment to hold the child’s interest------------------------------------- ■
3
3. An occupational therapist, a member of the Women’s Medical Spe­
cialist Corps of the Army, aids a soldier in regaining finger dexterity in
metal work--------------------------------------- ------------------------------------------8
4. Pottery work is used to strengthen a patient’s hands under the
supervision of an occupational therapist, a member of the Women’s
Medical Specialist Corps of the Army-------------------------------- --------15
5. A patient with an injured arm weaves with the help of an occupa­
tional therapist in a curative workshop----- _ — ----- - --------------19
6. An amputee works on a leather project under the supervision of a
member of the Women’s Medical Specialist Corps of the Army--------------23
7. A chief occupational therapist shows volunteers the working of a
loom for veterans at a VA hospital. _ —--------------------------------------------30
8. A patient in a home for incurables is assisted in weaving by a Red
34
Cross volunteer worker- ----9. An outdoor art class is conducted at a VA hospital by a Red Cross
volunteer wrorker - - ___----------------------------37
Cover. An occupational therapist, a member of the Women’s Medical
Specialist Corps of the Army, assists a soldier in using the new prosthesis
replacing his hand.

Occupational Therapist (Medical Service): 0-32.04. Special Attendant,
Institution, as Defined in the Dictionary of Occupational Titles (59)

Conducts programs for patients confined in hospitals and other in­
stitutions to provide them with directed activity and to assist in their
rehabilitation: Plans and organizes work projects for patients, ac­
cording to medical prescription. Supervises workers who teach and
direct patients in assigned activities, such as basket weaving, rug
making, and sewing [Attendant, Occupational Therapy]. Teaches
patients specialized activities, such as arts and crafts, gardening, and
library work. Studies patients’ reactions while they are engaged in
work situations and writes reports describing symptoms indicative
of progress or regression. May conduct recreational programs
[ Recreational Therapist].
VIII

THE OUTLOOK FOR WOMEN AS
OCCUPATIONAL THERAPISTS
THE SETTING
More than 5,000 occupational therapists were assisting in the re­
covery of patients in hospitals, other institutions, and curative work­
shops throughout the Nation in 1952, over 98 percent of them women,
according to available estimates. Of these, 3,851 were registered with
the American Occupational Therapy Association and were permitted
to place OTR (Occupational Therapist, Registered) after their names
(1). Of the estimated 1,100 or more additional practicing occupa­
tional therapists, not registered with the Association, some were grad­
uates of approved schools but had not applied for registration with the
Association and others were college graduates with majors in fine arts
or other related subjects. A sizable group were aides who assisted
with occupational therapy and had been trained on the job in certain
aspects of the work, and others were specialists in a single art or craft
and were employed by an institution to instruct certain patients in
that field. Some had entered the profession before registration had
been initiated.
Occupational therapy is the science of employing creative, indus­
trial, educational, and recreational activities in a restorative program
for the sick, injured, and disabled. The concern of the therapist is
with the patient and the process rather than with the finished product
made by the patient. Therefore, the activities used must be sufficiently
interesting to motivate the patient’s active participation.
Rehabilitation

Occupational therapy is part of the larger program of rehabilitation,
which is the restoration of the handicapped to the fullest physical,
mental, social, and economic usefulness of which they are capable.
Physical therapy, occupational therapy, medical social service, voca­
tional training, and placement are all parts of the program of rehabil­
itation in the treatment of patients with mental disease, disabling ill­
ness, or physical injuries. Rehabilitation includes all medical, psy­
chological, and social services whereby the person recovering from
disease or injury is taught to live and, if possible, to work with what
capabilities he possesses.
l
210104°—52------ 2

2

OUTLOOK FOR WOMEN

Physical Medicine
The term “physical medicine,” used by the American Medical Asso­
ciation to mean the diagnosis and treatment of disease by various
physical agents, includes both physical and occupational therapy.
Physical therapy uses various means, such as light, heat, hydrother­
apy, electricity, massage, exercise, and mechanical devices in the treat­
ment. of disease. The action may be passive as when massage or
manipulation is used, or active as when gymnastic exercise is pre­
scribed. As the patient cannot devote more than a portion of the day

jgsSfgi

Figure 1.—An occupational therapist holds a stop watch, timing a patient with
an amputated finger as he completes a task in a curative workshop.

OCCUPATIONAL THERAPISTS

3

to the procedures of physical therapy, occupational therapy may he
prescribed to strengthen muscles, increase joint range, etc., in a setting
of useful activity. While physical or mental recovery is the primary
aim of treatment, the program never loses sight of secondary goals
such as the acquisition of skills for recreational or economic reasons.
Closely related are the recovery of self-confidence, the discovery of
interests and aptitudes, and the social readjustment of the patient.
Types of Patients
In actual practice, treatment consists of activities suited to t lie pa­
tient’s individual physical, social, or mental needs as well as his par­
ticular interests and abilities. The occupational therapist must be
prepared to treat various types of patients. Her greatest usefulness
is with old people, children, cardiac patients, and other persons in­
cluding the handicapped, neuropsychiatric, and tubercular. In the
rehabilitation of an amputee, the surgeon, limb maker, physical and
occupational therapists, vocational counselor, and training specialists
work as a team. Industrial therapy is used in neuropsychiatric hos­
pitals of the Veterans’ Administration and civilian mental hospitals

Figure 2.—Poliomyelitis patient, 3-year-old daughter of a master sergeant, is using
hand skate to strengthen hand and arm. The occupational therapist, member of
the Women’s Medical Specialist Corps, is making a game of the treatment to
hold the child’s interest.

4

OUTLOOK FOR WOMEN

as well as in other agencies and institutions. The more recreational
and diversional forms are found to be effective for children and pa­
tients in mental hospitals. For the tubercular patient, occupational
therapy has a sedative effect; his recovery depends to a large extent on
simple bedside diversional and social activities and educational
therapy, all of which tend to sustain morale. When work tolerance
has been achieved by the patient, physical reconditioning treatment
can be provided 'which will aid in later vocational counseling and train­
ing. In the tuberculosis hospitals of the Veterans’ Administration,
21 percent of the patients received occupational therapy in 1948 in tex­
tile crafts, reed and cane work, woodworking, leather work, and book­
binding (21).
In addition to these fields for the occupational therapist, there are
a number of others, as for instance in work with the blind, and those in
the cerebral palsy group. The blind can be introduced to the possi­
bility of leading happy, useful lives by the occupational therapist.
The role of the occupational therapist in aiding cerebral palsy patients
to meet their vocational problems begins with training in the skills of
daily living. The majority of these are not lacking in intelligence,
for 7 out of 10 are normal or superior mentally and can be trained to
improve their condition (44).
Agencies Served

Occupational therapy is di versified not only as to kinds of patients
served but as to types of institutions and agencies requiring service.
Among hospitals and other institutions are those for the armed forces,
the United States Public Health Service, and the Veterans’ Adminis­
tration, mental hospitals, public, pri vate, and children’s hospitals, and
tuberculosis and cardiac sanatoria. Homes for the aged, penal insti­
tutions, and boarding schools for handicapped children use occupa­
tional therapists to some extent.
Newer developments are curative workshops where patients come
for longer or shorter periods during the day. These may be out­
patient clinics connected with hospitals, community workshops, treat­
ment centers supported by religious organizations, welfare agencies,
rehabilitation centers, or schools for cerebral palsy victims, the blind,
or the hard of hearing. In industrial centers occupational therapy is
used to rehabilitate injured workers and thus reduce the work time
lost. Insurance companies, finding that patients are rehabilitated in a
shorter period under treatment, use occupational therapy to decrease
the period of accident compensation.
Workshop patients usually have been dismissed from a hospital but
are still under a physician’s care. Each handicapped person who is

OCCUPATIONAL THERAPISTS

5

rehabilitated through occupational therapy finds added satisfaction
in life and also adds to the productive capacity of the community.
About 325 clinics or workshops of all types were operated by registered
occupational therapists in 1951.
Home Visitation

Another development in this field is the home visitation program
for those unable to attend a hospital or a curative workshop. Many
homebound disabled persons need new and wholesome sustaining inter­
ests to increase their resources and fortify them against the stresses and
strains of modern existence. Under the Federal-State crippled chil­
dren’s program, one visiting occupational therapist very occasionally
may have an administrative district as great as 15 to 20 counties and
visit some of her patients only at monthly or bimonthly intervals.
Meagerly populated counties may have only a few patients referred to
the therapist. In some States a visiting occupational therapist is pro­
vided by the National Society for Crippled Children and Adults,
either directly or through assignment to assist the crippled children’s
agency. The home visitation program for crippled children is small,
but is expected to expand in the future {39).
A private 77-patient hospital in the East had a home-care program
in 1951 with two full-time occupational therapists (one a supervisor),
who were members of a medical-services team—a home-care executive,
four physicians, three medical social workers, a physical therapist, a
consulting psychiatrist, and a consulting psychologist. The patients
are persons of all ages suffering from long-term illnesses and were
under active medical supervision; some were bedfast and some ambu­
latory. All were in the lower-income groups and most were unable
to make any payment for services. Average visits were from a half­
hour to one hour in length. About G to 10 patients were scheduled to
be seen weekly and 10 to 15 at 6- to 8-week intervals. Children needed
weekly periods of supervision because of their shorter span of interest
and attention and because of their reluctance to accept limitations of
physical activity. Visits were made either by private car or by public
transportation. Since only a comparatively small quantity of mate­
rial could be transported to the homes or mailed to the patients, the
problem of transportation was an important consideration in choosing
the occupations for the homebound. Channels for selling the products
of the patient were found in some instances through a volunteer
agency. For child patients, sometimes the worker taught the craft to
the mother or older sister of the child so that she could act in the
capacity of substitute until the next, visit.

6

OUTLOOK FOR WOMEN

Activities of an Occupational Therapist
The duties of the occupational therapist are so manifold that a
classification is difficult. Part nurse, social worker, psychologist,
teacher, and librarian, as well as therapist, she must have a broad
knowledge to provide activity to hasten the recovery of a patient.
The physician diagnoses the ailment and states treatment objectives.
The occupational therapist selects and carries out the appropriate
treatment.
Often, the occupational therapist must rely on her own initiative
and training for determining the type of occupational therapy
which would be most helpful to the patient—typesetting, weaving,
painting, or leatherwork, for example—for arousing and maintaining
the patient’s interest, and for devising procedures best adapted to
his needs. Therefore, she has wide scope for the exercise of her
resourcefulness and imagination as well as her full range of skills
in arts and crafts.
The therapist may supervise affiliated students or volunteers who
are specialists in certain types of activity or she may be assisted bv
instructors from schools or colleges for patients able to take up school
or college work.
An occupational therapist may be required to have a knowledge
of many different types of activities. In a mental hospital a wide
variety of activities are used, as painting, clay modeling, other artistic
endeavors; group activities provide an outlet for the patient’s deep
feelings and anxieties. He may thus be guided back to normalcy or
prevented from regressing. Play groups are frequently organized,
musical concerts planned, and dances arranged. Orthopedic treat­
ment for physical deformity cases may call for adapted equipment,
and include activities such as setting newsprint for a hospital paper,
playing checkers with weighted pieces, or sandpapering ■wooden
blocks. In a children’s hospital the child is given bright yarns,
crayons, or diverting toys. Regular play periods are conducted.
Riding a tricycle or pulling colored pegs from a pegboard may be
used to strengthen the limbs. The mild exercise and the mental
relaxation of constructive work by bedridden patients has been found
to.speed recovery beyond the rate accomplished by medical care alone.
The creative arts include printing, which has been used in occupa­
tional therapy for over 25 years, textile arts, pottery, basketry, car­
pentry, and many other arts and crafts. Bookbinding in leather is
found to be excellent because the use of the hands on this soft, flexible
material has a distinct advantage for patients with injuries of the.
upper extremities.
Other forms of occupational therapy have been developed in cer­
tain institutions. For instance, at an eastern hospital, garden therapy

OCCUPATIONAL THERAPISTS

7

was used with mental cases as well as with those recovering from
operations and injuries. Weeding and picking beans helped to re­
store injured fingers to normal use. Some patients picked beetles off
the plants, hoed corn, or merely practiced walking normally about
the garden. Others painted still-life pictures of vegetables (63).
Bibliotherapy, that is, the use of books as a remedy for disease, is
utilized for the most part for mental patients with functional psy­
choses or psychoneuroses, where prescription of suitable reading ma­
terials will help to develop emotional maturity and promote mental
health. One neuropsychiatric hospital reported having a library of
1,250 books. This therapy is distinct from the usual library service,
provided in many hospitals for diversional purposes, in which the indi­
vidual preferences of the patient are the main consideration in the
choice of reading material (W). Soap carving, building a miniature
library by patients in a mental hospital, the construction of a model
railway by men with injured hands or arms were some of the more
unusual developments in the field of craft work. A music supervisor
used piano playing for arthritis victims with crippled hands, cello
playing to loosen stiff shoulders, the trombone for forearm muscles, the
mandolin for the wrist, and the xylophone for exercising the entire
arm.
In some mental hospitals work therapy has been used as one form
of occupational therapy. When a relationship with the patient
is established, he can do various tasks about the institution to his own
advantage. In one midwestern mental hospital the peed for patient
help is channeled through the occupational therapy department.
Patients perform various tasks such as housekeeping, assisting in
dietary department, clerical work, and operating the elevator—
work which creates a feeling of responsibility and aids in establishing
normal relations with the world about them (10).
During World War II physicians in Army hospitals frequently
used activities which tended to clarify the patient’s thinking along
vocational lines. The work selection often was adapted to meet
physical reconditioning needs. An instance of this in another field
was the practice of occupational therapists in U. S. Public Health
Service hospitals, who found rope work to be more relevant than
some other modalities for seamen who had hand or finger involvement.
Under these physical reconditioning programs, patients are
encouraged to extend their education for later use when they have
fully recovered. For others, industrial shops in hospitals are used
as laboratories in evaluating aptitudes to help the patient decide on
interesting and suitable work to be used after discharge from the
institution. This industrial therapy may include many types of
activity, such as jewelry and clock repair, electric work, machine and

8

OUTLOOK FOR WOMEN

Figure 3-—An occupational therapist, a member of the Women’s Medical Specialist
Corps of the Army, aids a soldier in regaining finger dexterity in metal work.

metal work, radio repair, drafting, shoe repair, photography, clerical
work, typing, the operation of business machines, auto mechanics, and
agriculture. In a Veterans’ Administration facility in the Midwest,
of the patients desiring occupational therapy about 60 percent have
it at the bedside and 40 percent in the hospital shops (31). The social
atmosphere and the competitive attitude it encourages among patients
have been found to be advantageous in some instances.
In a report from 190 State hospitals, 140 stated that they had in­
stalled an occupational therapy program. Of these, 113 hospitals
permitted the products of the industrial shops to be sold and 27 paid
the patient for his work as the program was more realistic for the
patients if a monetary return was involved (7). Some occupational
therapists believe that industrial therapy programs should not de­

OCCUPATIONAL THERAPISTS

9

generate into actual work programs but should be kept in the physical
reconditioning field. However, the ability to earn a return on one’s
work is a powerful mental stimulant provided it does not interfere
with physical progress.
Men in Occupational Therapy

Occupational therapy is becoming increasingly attractive to men.
They are in demand especially in civilian mental hospitals and those
of the Veterans’ Administration. The American Occupational
Therapy Association reported 75 men among its members in 1952.
THE OUTLOOK
All evidence points toward a continued growth in the demand for
occupational therapists. The American Occupational Therapy
Association estimated in 1951 that some 6,000 positions were cur­
rently available for occupational therapists. This includes replace­
ments and accumulated vacancies and also new positions arising
from the expansion of public and voluntary programs of medical
service. Thedemand is not only immediate but promises to be pro­
longed as a trend toward a continued extension of service in this field
is apparent. These opportunities result from a variety of factors,
such as the expansion of veterans’ hospitals and of civilian health
programs, the increasing use of occupational therapy for mental
patients, crippled children, tubercular patients, and convalescents,
the needs of the armed forces, the increasing and aging population,
the rising income level, the growth of preventive medicine, and prog­
ress in medical science itself. The Commissioner of Labor Statistics
in the U. S. Department of Labor predicted early in 1950, before the
Korean situation became acute, that most occupational groups im­
portant to medical and health services, including occupational
therapists, would have good employment opportunities for a number
of years (60).
With only about 500 graduates entering the field each year and the
heavy depletion in the ranks because of marriage, usual in a pre­
dominantly woman’s occupation, the American Medical Association
designated the shortage in 1951 as critical, accentuated as it was by
the defense emergency measures of the period. As a result of the
endeavors to increase service in this field by the American Medical
Association and the American Occupational Therapy Association, 13
additional schools gave consideration to offering training courses in
occupational therapy. One of these has now been accredited, bringing
the total of accredited schools to 26 (listed in the appendix). The use
of accelerated or emergency courses was considered as a possibility.
2)0194

■3

10

OUTLOOK FOR WOMEN

especially for military requirements and the approved' schools agreed
to cooperate if this program was initiated {49). To stimulate enroll­
ment, contacting high-school pupils was suggested so that they may
choose college courses which conform with the requirements of the
approved schools. Sending qualified speakers from the local branches
of the Association, the U. S. Public Health Service, or the Veterans’
Administration hospitals to address high-scliool students and taking
students to visit hospitals was also advised. Motion pictures are also
available.
The need for these workers exists in military and civilian hospitals,
mental institutions, tuberculosis sanatoria, and schools and homes for
crippled children, the deaf, blind, and feeble-minded. It is believed
that all general hospitals will have occupational therapy departments
in the future because the patients themselves will demand the service.
Although largely confined at present to the larger cities, this service
is also needed in smaller centers of population and in rural areas.
Recreational and educational forms of occupational therapy are ad­
visable for many children confined to institutions in long-term ill­
nesses, such as rheumatic heart disease, poliomyelitis, or tuberculosis
{36).
The curative workshop development is vigorous and appears to be
expanding. These workshops are frequently rehabilitation centers
offering both physical therapy and occupational therapy. A New
England rehabilitation workshop, which opened in 1948 with two
occupational therapists and 8 patients, had doubled in size 2 years
later with regard to staff, and the weekly patient load had increased
to 65 with a waiting list (52). A school for crippled children in the
Middle Atlantic area was treating 125 children in 1949 and hoped
to double its capacity in the near future, as applications may run as
high as 500 during an epidemic of poliomyelitis {25).
Heart Patients

Occupational therapy service for those suffering from cardiovas­
cular disease is expected to expand, but it is thought that this group
can be merged with other disabled groups instead of being served
through a separate program. After all, cardiacs do not need special­
ized treatment. Many cases are similar to tuberculosis as far as occu­
pational therapy treatment is concerned, in that rest and light
recreation are needed and those with some type of paralysis resulting
from a thrombosis need the same treatment as other paralytics.
Promotional Agencies

The movement for rehabilitation will be further stimulated as time
passes not only by the many private programs in existence but also
by the expanding governmental undertakings to extend this service

OCCUPATIONAL THERAPISTS

11

to more and more of those who are handicapped or disabled, such as
the Federal-State crippled children’s and maternal-child health
programs, and the State-Federal vocational rehabilitation program.
In 1950, 245,000 children received services under the State programs
for crippled children according to the preliminary estimates of the
Children’s Bureau—an increase of about 38,000 children over 1949.
The corresponding increase for the previous year had been 32,000
children. The Office of Vocational Rehabilitation reported 58,000
rehabilitants in 1949, 59,600 in 1950, and 66,000 in 1951 under the
Federal-State program. The treatment of many of these persons
involved the services of occupational therapists.
The study of the problems of chronic disease and disability has been
undertaken by the Commission on Chronic Illness, a private national
agency established in 1949. The national organizations which con­
tributed to its financial support in 1951 included the American Cancer
Society, American Dental Association, American Heart Association,
American Hospital Association, American Medical Association,
Arthritis and Rheumatism Foundation, National Foundation for
Infantile Paralysis, National Multiple Sclerosis Society, National
Society for Crippled Children and Adults, Inc., and National Tuber­
culosis Association; the U. S. Public Health Service also cooperated in
the study. A survey of 1,600 hospitals by the Commission in 1951
indicated that 65 of them operate organized rehabilitation services.
As a total of only 49 occupational therapists were employed in these
hospitals, some rehabilitation units evidently lacked this medical
service. The organization, with its campaign for the installation
of rehabilitation wards in all general hospitals, tends to increase the
demand for occupational therapists (1$) ■
Rehabilitation

The possibilities in the field of rehabilitation have scarcely been
scratched. Current estimates indicate that among civilians about 2
million disabled persons of working age are in need of vocational
rehabilitation. An estimated 250,000 persons, disabled by accidents,
chronic disease, or congenital defects become in need of vocational
rehabilitation each year (6%).
Under the State crippled children’s programs, 214,405 children
received physicians’ services during 1950, primarily for orthopedic
and plastic conditions; this was only about a third of the number
listed on State registers of crippled children, which vary in their
coverage. If all persons under 21 who have or have had rheumatic
heart disease, cerebral palsy, and epilepsy were included, the total
would probably run well over a million. It has been estimated that
there are 6 persons with cerebral palsy per 100,000 persons.

12

OUTLOOK FOR WOMEN

Aid to the Handicapped

Some cities and States are pioneering in providing service for the
severely disabled. A notable municipal experiment is that in the
Department of Rehabilitation and Physical Medicine at Bellevue
Hospital in New York City, which began in 1947 with 80 beds and
planned to expand ultimately to 600 beds. It operates as a service
department to the other departments of the hospital and in addition
to physical medicine and physical rehabilitation service has com­
prehensive facilities for a program of physical and occupational
therapy, social service, corrective speech, psychologic services, voca­
tional guidance, education, and planned recreation (4?’). In 1951,
the American Occupational Therapy Association reported the employ­
ment of 21 of its members in this hospital. One of these was the
director of the occupational therapy department, and another was
director of the children’s receiving section of the department.
An instance of State activities is a rehabilitation center in the South
where 400 persons can be accommodated in 52 buildings (64).
An outstanding program in the treatment in rehabilitation of the
handicapped is the Institute for the Crippled and the Disabled, affil­
iated with the Columbia Presbyterian Medical Center in New York
City. It began during World War I and has continued to operate
with great success.
Professional Growth

Some of the specialists in this work place the onus of expansion in
the profession on practicing occupational therapists themselves to a
certain extent. Occupational therapists are urged to contribute more
liberally toward the development of this promising field by research
and technical writing. They are urged to publish information re­
garding their activities so that the medical profession may be aware
of their programs and contributions. It is also urged that admin­
istrators release their therapists for advanced study for short periods
to stimulate increased efficiency and growth in professional stature.
Opportunities

I he future offers a variety of prospective choices to women who
gain experience in the field of occupational therapy. These include
work directly with the disabled individual; supervision of assistants,
volunteers, and students; administrative positions in occupational
therapy programs; teaching the subject in its many ramifications in
schools of occupational therapy; and research activities to add to exist­
ing knowledge. An occupational therapist may assist in the defense
effort by serving with the armed forces. As a member of a medical
ser\ ice team with a physician, nurse, medical social worker, physical

13

OCCUPATIONAL THERAPISTS

therapist, and dietitian, she may deal with patients having many
different ills and handicaps, all seeking treatment leading toward
rehabilitation in order to take their places in productive work.
Occupational therapy offers a rewarding career to the young woman
who wishes to be of service to others and who has a real interest in
medicine, combined with manual skill and creative ability.
DEMAND AND SUPPLY IN 1952
The total number of occupational t lierapists employed in the country
is estimated to be at least 5,000. Some are graduates of approved
schools of occupational therapy; some are registered with the Oc­
cupational Therapy Association; and others qualify on the basis of
experience rather than on educational preparation. In one eastern
State, the Department of Institutions and Agencies made a survey
of hospital and health resources and reported 1 '2'2 full-time and 9
part-time occupational therapists employed in all the hospitals within
the State in 1947 (34)- However, in 1951, the yearbook of the Associa­
tion reported only 40 registered occupational therapists employed in
the hospitals of this State, which is about one-third of the total
number reported employed in 1947. From this example, it would
seem that at least 50 and possibly 100 percent more are working in
the field than are registered as employed by the Association. Between
3,000 and 4,000 occupational therapists were reported to be employed
in hospitals in 1950 (30). The 1951 yearbook of the Association indi­
cated that about 80 percent of registered occupational therapists were
employed in hospitals, with the remainder in workshops, corrective
and penal institutions, or homebound programs. On the basis of
these figures, an estimate of at least 5,000 employed in 1951 would
seem to be conservative.
Table 1.—Occupational Therapists, by Type of Institution or Agency, United
States, 1951
Type of institution or agency

Registered
women
therapists
reporting 1

Total

Total thera­
pists inU. S.
(estimated)

Percent
distribution

Workshops_____________ . .

__________ ____

5,000

100.0

1.480
General .. __________ _______ _____ _________
Mental_________________ _____ _____________________
Tuberculosis
Other hospitals and clinics________________ ___________

1,822

4,000

81. 2

535
470
151
324

1,470
1.290
415
885

29.4
25.8
8.3
17.7

325

895

17.9

Crippled children and adults.....................................................
Rehabilitation
Cerebral palsy.. ___
________ _______________ ____
Other schools and workshops...................................................

83
82
79
81

225
225
215
230

4.5
4.5
4.3
4.6

Miscellaneous_______________________________________ ____

17

45

.9

1 American Occupational Therapy Association, the yearbook, 1951.

14

OUTLOOK FOR WOMEN

Employment in Hospitals

The greatest demand for occupational therapists is in hospitals.
The American Hospital Association stated that of 5,803 hospitals re­
porting to the Association in 1950, 1,340 or one in four had occupa­
tional therapy departments. Of these departments, 222 were in Fed­
eral hospitals, 197 in tuberculosis sanatoria, 365 in mental hospitals,
and the remaining 562 in general medical and surgical hospitals (64).
A disproportionately small number of occupational therapists in
mental or tuberculosis hospitals was apparent in a study made in 1948
of graduates and students from an approved eastern school (12),
and the same condition is noted at present.
The employer of the largest number of occupational therapists in
the hospital field is the Federal Government. Including occupational
therapy aides, affiliated students, and manual arts therapists to­
gether with the. occupational therapists themselves, almost 2,000 per­
sons were working in Federal hospitals.
Of the 1,822 registered occupational therapists studied in 1951,
1,480 women, or four-fifths, worked in hospitals. The majority of
these (1,091) were in government hospitals (Federal, State, county,
or municipal). The largest number worked for the Federal Govern­
ment (526 women, or 28.9 percent of the total). State hospitals
employed 367 women or 20.1 percent of the total. While tuberculosis
sanatoria constituted 10.8 percent of the institutions reported, only
151 women, or 8.3 percent, were employed in the tuberculosis field.
Veterans' Administration.—The Veterans’ Administration alone
absorbed about one-sixtli of the occupational therapists in the country.
The 154 hospitals of the agency, including 100 general medical and
surgical, 20 tuberculosis, and 34 neuropsychiatric hospitals, had from
1 to 29 occupational therapists in each hospital in 1952. They were
part of the rehabilitation team under the direction of a chief of physi­
cal medicine and rehabilitation. In addition to 577 physical thera­
pists, the agency employed 500 occupational therapists, and 360 occu­
pational therapy aides.
All of the occupational therapists in the Veterans’ Administration
hospitals are graduates of schools approved by the American Medical
Association. Registration with the American Occupational Therapy
Association is not obligatory for employment by this agency although
all workers have the same qualifications as registered therapists.
Probably about 90 percent were registered with the Association. The
15 men occupational therapists comprise about 3 percent of the group
and the number is increasing. The proportion of men tended to be
higher in this Government agency because under the “GI Bill of
Rights,” veterans took the required training and obtained positions
with the Veterans’ Administration. Several had been engaged in

15

OCCUPATIONAL THEKAPISTS

§l®g|

Figure 4.—Pottery work is used to strengthen a patient’s hands under the super­
vision of an occupational therapist, a member of the Women’s Medical Specialist
Corps of the Army.

this type of work in military hospitals while they were in service.
In addition to the qualified occupational therapists, the agency
employed about 360 occupational therapy aides who were full-time
paid workers. Many were college graduates—some having earned
the master’s degree, but not in occupational therapy. They work
under the direction of a qualified therapist but are not responsible for
the treatment program.
Department of Defeme.—Another large employer in the Federal
Government is the Department of Defense. The Department of the
Army in 1952 had 140 occupational therapists including 22 students
who completed their clinical affiliations at Army hospitals in July
1952 and 8 civilians, in the service since the last war. No civilians
were being hired in 1952. By law, male occupational therapists are
not eligible for a commission but they may serve as enlisted occupa­
tional therapy technicians. The occupational therapist in the Army
is one of a team including physician, nurse, dietitian, psychologist,
social worker, and physical therapist under the guidance of expert

16

OUTLOOK FOR WOMEN

military physicians in modern, well-equipped hospitals. The Army
also had occupational therapy technicians in their hospitals, both men
and women. They are given 3 months of training before beingassigned to duty in military installations where they assist the occu­
pational therapists. Unpaid volunteers from the Arts and Skills
Service or the Uray Ladies of the American National Red Cross also
assist the staff in Army hospitals.
The Department of the Navy had 22 occupational therapists in
1952. These officers were originally registered nurses who were sent
by the Navy to approved schools of occupational therapy and given
training in the profession. In addition, the Navy had 9 WAVE’s (6
regular and ;> reserve) who assisted the occupational therapists and
thus helped to spread the service. These assistants began as hospital
apprentices, first class, and were given basic training for 6 months
at the National Naval Medical Center. After interviews to deter­
mine personal preference, part of the class became assistant physical
therapists and part occupational therapists in Navy hospitals. They
were known as technicians or hospital corpsmen and were obligated
to 18 months of service, including their training period. The highest
rank among them was warrant officer. Members of the Arts and
Skills Corps of the American National Red Cross also assisted in the
Navy hospitals as unpaid volunteers.
The Department of the xVir Force had nine occupational therapists,
each operating a hospital occupational therapy department in 1951,
but fifty more could have been used in setting up more departments,
if they had been available. All were women. A class of five students
was in the process of training but they would probably be unable
to establish a new program in an Air Force hospital without more
experience. Enlisted technicians assisted the therapists, and the
Gray Ladies of the Red Cross worked as volunteers in some of the
hospitals.
1 A'. Public Health Service.—Another employer in the Federal
Government is the United States Public Health Service with head­
quarters in Washington, 1). C. In 1951 it employed 22 occupational
therapists, both commissioned and noncommissioned. Commissions
can be held in either the Regular or the Reserve Corps on an active duty
basis. Completion of a prescribed course in an approved school of
occupational therapy, a degree or certificate in occupational therapy,
and a bachelor's degree are required for admission to the Commis­
sioned Corps. Only functional activities comprise the professional
occupational therapy program. Diversional activities are carried on
by the Red Cross or other volunteer organizations. Affiliation pro­
grams with approved schools of occupational therapy provide facilities
for clinical training. The Public Health Service hospitals have as
■

OCCUPATIONAL. THERAPISTS

17

beneficiaries American seamen, officers and enlisted men of the Coast
Guard, officers and crew members of the Coast and Geodetic Survey,
Federal employees injured at work, and the Commissioned Officers of
the Public Health Service. The Service operates 18 general, 2 tubercu­
losis, and 2 neuropsychiatric hospitals and the hospital for patients
with Hansen’s Disease (leprosy) at Carville, La., as well as 18 out­
patient clinics. To date, no occupational therapy programs are in
operation in the outpatient clinics, but plans are being made to open
departments in the larger clinics.
Bureau of Indian Affairs.—Another Federal agency, the Bureau
of Indian Affairs in the Department of the Interior, employed eight
occupational therapists and one aide in 1951 in its hospitals. No
volunteers worked in these Indian hospitals as they were in isolated
places where no Red Cross or other service was available and no stu­
dents were in training. A diversional program of arts and crafts as
distinct from functional therapy is in existence in some of the hos­
pitals. All positions were filled in 1951 but a tuberculosis hospital of
400 beds was to be opened at Anchorage, Alaska, in 1952, for which
occupational therapists would be needed.
Washington, D. C., hospitals.—The employees of four hospitals in
the Washington, D. C., area are employed under the requirements of
the Federal Civil Service Commission. These hospitals are Saint
Elizabeths and Freedmen’s hospitals, both under the jurisdiction of
the Federal Security Agency, and Gallinger Municipal Hospital and
Glenn Dale Sanatorium under the jurisdiction of the District of Co­
lumbia municipal government. A total of 29 occupational therapists
were reported as employed in these hospitals in 1951, of whom 22 were
registered therapists. Two of these hospitals each had 4 students on
its staff. One hospital had unpaid volunteers assisting in the occu­
pational therapy department, and one hoped to make arrangements
to include some volunteers in the near future. One institution does
not use volunteers because the patients are tubercular cases. Four
vacancies were reported, scattered among three of the hospitals. One
vacancy was that of assistant to the director of the department. As
the position called for a person with several years of experience, pref­
erably with a home economics education, difficulty in filling the va­
cancy was being experienced.
Other governmental hospitals.—The number of occupational ther­
apists employed by State governments is unknown. A survey made
in 1950 of 190 State hospitals, 94 percent of which were hospitals for
the mentally ill, indicated that 165 of them had either a director of
occupational therapy or a department in operation (7). Many
States have a supervisory occupational therapist on their staffs in
the State department of education or the State department of welfare
210194“—52-------4

18

OUTLOOK FOR WOMEN

to advise on the child welfare program. The American Occupational
Therapy Association yearbook for 1951 reported 367 members em­
ployed in State hospitals. In addition, 99 members were working in
county hospitals and 87 in municipal hospitals. As many hospitals
did not indicate governmental affiliations in their titles, probably
others were employed in this field. Many State employees may also
be found among the 151 members reported by the Association em­
ployed in tuberculosis sanatoria, and the 470 in mental hospitals.
As State hospitals were pioneers in introducing the use of occu­
pational therapists in the treatment of patients, the proportion of
them having such medical service is likely to exceed that of private
hospitals. That many private hospitals had the service in 1951 was
indicated in the yearbook of the Association, which reported that
371 members were employed in this type of work.
Employment in Curative Workshops or Clinics

The development of curative workshops, sometimes called clinics,
rehabilitation centers, schools, or institutes is recent. Patients usually
come for a period during the day for occupational and physical ther­
apy treatments and return to their homes at night. For the most
part these workshops function in the larger centers of population.
The yearbook of the Association for 1951 reported 325 members of
the Association on the staffs of 213 workshops. Of these, 83 were
employed in 55 workshops for the crippled, both adults and children;
79 worked in 59 cerebral palsy schools or institutes; 82 in 38 reha­
bilitation centers; and 81 in 61 schools and workshops of other types.
In the New England States the majority of workshops are sup­
ported in whole or in part through funds provided by the National
Society for Crippled Children and Adults. This society has 2,000
local crippled children’s societies established throughout the country,
and is financed mainly by Easter Seal campaigns. State and local
units are directed by boards of trustees. In 1950, 150 occupational
therapists were employed throughout the country by this organization
{28).

The local crippled children’s clinic at Washington, D. C., operated
by the Bureau of Maternal and Child Welfare of the District of
Columbia Health Department, had a staff of three occupational
therapists in 1951. A class consisting of one student each from Co­
lumbia University, the University of Pennsylvania, and the School
of Occupational Therapy at Richmond, Ya., participated in the clinic
as part of their field training.
A workshop with a long record of service is the Curative Workshop
of Milwaukee, established in 1917. In 1952 it had a staff consisting
of 3 administrators, 2 of whom were occupational therapists, 12 pliys-

OCCUPATIONAL. THERAPISTS

19

ical therapists (of whom G were registered nurses), 7 occupational
therapists, 2 speech therapists, 3 attendants, 5 clerical employees, and
3 maintenance workers. During the previous year it had treated 2,228
patients, who had been referred by 541 physicians. In addition, a
home visitation department with 3 occupational therapists wras in
operation.
An interesting example of one of the smaller specializations was that
of a project in the Southwest where polio cases were treated in a special
school operated as part, of the public school system. The school plant

Figure 5.—A patient with an injured arm weaves with the help of an occupational
therapist in a curative workshop.

20

OUTLOOK FOR WOMEN

included an occupational therapy room, classroom, library, recreation
room, and broadcasting room for these children. The staff in 1949
consisted of 2 classroom teachers who provided academic instruction,
a music and dramatics teacher, and an occupational therapist. The
children studied arts and crafts such as leather work, silk-screen print­
ing, block printing, and weaving. The acquisition of skills was
found to contribute toward keeping the students mentally healthy—
particularly important for children barred from normal activity out­
lets. 1 he chief goal of the school, aside from the educational aspect,
was to help the physically handicapped pupils to develop good per­
sonalities, self-confidence, and self-discipline (41).
An unusual type of rehabilitation center is that operated by the
Liberty Mutual Insurance Company, with one center in Boston and
one in Chicago. Six registered occupational therapists were employed
in 1951 in the two workshops and the need for more is anticipated.
Students from schools of occupational therapy come to the centers
for periods of 6 to 8 weeks for training. The aim of the treatment is
to speed the recovery of victims of industrial accidents by prompt
treatment at the center on referral by the physician in the case. Expe­
rience has demonstrated that the more prompt the beginning of the
therapeutic treatment after discharge from the hospital, the quicker
is the recovery and the more satisfactory the results. This reduces the
loss of production time to industry and lowers the compensation rate
of insurance as well as returning wage earners to their jobs and re­
storing their earning power for themselves and their families after
the shortest possible interval.
Home-Care Program

To provide services for the disabled who need occupational therapy
but are unable to attend workshops, occupational therapists visit reg­
ularly in homes, bringing materials and giving instruction. Some
hospitals, curative workshops, rehabilitation centers, crippled chil­
dren’s programs, and visiting nurses’ associations offer this type of
service in addition to that given on their premises; in some instances,
on the other hand, the entire program is built around the care of
homebound patients. The Visiting Nurse Association reported a few
registered occupational therapists engaged in this type of work in
1951. Much of the work of the Federal-State crippled children’s
program is concerned with home care. The National Society for
Crippled Children and Adults is expanding its homebound program.
Four other home-care programs, two with two occupational therapists
each, were reported to be in operation.

OCCUPATIONAL THERAPISTS

21

Other Types of Occupational Therapy

As occupational therapy is one of the smaller professions, those
engaged in classroom teaching in this subject are necessarily few in
comparison with the number in larger professions. In an eastern
college in 1951, the division of science had a staff of 12 men, all physi­
cians, and. 8 women, who instructed in physical and occupational
therapy. Two were registered occupational therapists who were
special instructors in their subject.
Another eastern school reported 5 instructors who were regis­
tered occupational therapists and 5 others who were special lecturers.
A survey of 6 other approved schools in 1949 indicated a total of 16
additional instructors (H)- On the basis of 23 instructors for these
8 schools, an average of 3 per school may be computed, resulting in
an estimate of about 80 teachers for the 26 schools of occupational
therapy in the country. Occasionally an occupational therapist is
employed as a part-time worker. In a survey of some 9,000 women
part-time workers in 10 cities, made by the Women’s Bureau in 1950,
only one part-time occupational therapist was reported. This woman
worked 2 days a week, 7y2 hours a day, in a midwestern hospital (61).
Geographic Variations in Employment

Country-wide information on the location of positions of occupa­
tional therapists in hospitals, clinics, and rehabilitation centers is
not available, but the geographic distribution of 1,822 women mem­
bers of the American Occupational Therapy Association whose place
of employment was known in 1951 may give an indication for the
entire profession. This group included about one-third of the esti­
mated occupational therapists in the country at that time. A study
of these registered occupational therapists implied a concentration
for the profession in excess of the concentration of population in
both the Northeastern States and the West.1 (See table 2.) This
may be explained by the tendency for this occupation to locate in
large centers of population. The North Central States apparently
were adequately supplied but the South, with an agricultural economy
and only two schools of occupational therapy, had little more than
1 Regions as designated in U. S. Census reports are used throughout:
Northeastern States.—Connecticut, Maine, Massachusetts, New Hampshire, New Jersey,
New York, Pennsylvania, Rhode Island, Vermont;
North Central States.—Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri,
Nebraska, North Dakota, Ohio, South Dakota, Wisconsin ;
v
South.—Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky,
Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee,
Texas, Virginia, West Virginia ;
West.—Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon,
Utah, Washington, Wyoming (57).

22

OUTLOOK FOli WOMEN

one-half of the ratio of workers which its population would suggest.
However, the number of schools seems to be no index of the number
of workers; the North Central States have more than one-half of the
approved schools of occupational therapy in the country, yet less
than one-third of the workers were employed there in 1951. This
emphasizes the need for expansion in the rural areas.
In relation to population, New Hampshire, Connecticut, New York,
Kansas, Maryland, the District of Columbia, Colorado, and California
were best supplied with registered occupational therapists, each hav­
ing at least 2 per 100,000 population in 1950. Idaho, Montana, Okla­
homa, Louisiana, Mississippi, Alabama, Georgia, South Carolina, and
West Virginia were poorest in this respect.
Table 2.—Geographic Distribution of Occupational Therapists Compared With the
Schools and the General Population, United States
Number of
women
members,
1951 i

Region

United States

__________

Northeastern.- ..
North Central___________
South_________
West____ __________

.

Percent distribution of—
Women
members

Approved
schools,
1952

General
population,
1950 24

1,822

100.0

100.0

100.0

651
519
333
319

35. 7
28.5
18.4
17.4

20.0
52.0
8.0
20.0

26. 2
29.5
31.3
13.0

1 American Occupational Therapy Association, the yearbook, 1951. The study included 1,822 women
and 34 men.
2 TJ. S. Department of Commerce, Bureau of the Census (58).

Sources of Supply

It was reported in 1950 that enrollment of 2,400 students was pos­
sible in the accredited schools but that only 1,800 were enrolled in the
schools and taking the courses (32). This was the reverse of the
situation in 1946, when the schools had many more applicants than
they could accommodate. The lack of students in 1950 may be
attributed to some extent to discontinuance of the governmental sub­
sidies to students instituted during World War II. Yet, employment
agencies reported that they could not meet the demand for these work­
ers in 1951. The Association, which also maintains a placement serv­
ice, and the approved schools report that they always have more job
orders than they can fill. With the small ratio of new therapists each
year and an attrition rate of 10 percent a year because of family re­
sponsibilities, characteristic of a predominantly woman’s profession,
the shortage is expected to continue for years to come.
Many vacancies existed in the Federal Government for occupational
therapists, both civilian and military, in 1952. The Veterans’ Ad­
ministration with 500 therapists had vacancies for 114 workers in
addition. In spite of the 187 students beginning training in 1952,

OCCUPATIONAL THERAPISTS

23

Figure 6.—An amputee works on a leather project under the supervision of a
member of the Women’s Medical Specialist Corps of the Army.

the agency will not be able to meet the demand for trained workers
because many more VA hospitals are being built. The ratio of one
occupational therapist to each 100 patients in general hospitals and
one to 150 patients in tuberculosis hospitals was considered a low
working minimum by the Veterans’ Administration. The Army
also was opening many new hospitals as a result of the situation in
the Far East in 1951 and planned to recruit 180 occupational ther­
apists. Without counting service personnel wounded in battle, ac­
cidents and sicknesses occur in the Army as in the civilian population,
so that hospital personnel of all types are needed.
The Air Force announced a procurement program for 50 additional
occupational therapists to begin in July 1952, and the Navy a similar
program for 10 occupational therapists.

24

OUTLOOK FOR WOMEN

The experience of one approved school is typical. Over a 10-year
period from 1942 to 1951, admission ranged from 24 to 60; only 49
students were admitted in 1951. The number of graduates averaged
about 23 per year, varying from 15 in 1945 to 31 in 1948, but only
16 were graduated in 1951. The active professional life of the average
graduate of this college was about 5 years, and was terminated
most frequently by marriage. However, some returned to work
temporarily after marriage and others continued with their careers
regardless of marital status. This college constantly receives requests
for applicants for interesting openings which it is unable to fill.
The college has the policy of not recommending frequent change in
employment for an occupational therapist, as this increases instability
of the field.
The occupational therapy department of a midwestern college
offered three special scholarships in 1951; in addition, the college
had a number of general scholarships and grants-in-aid which could
be used in any department of the school, including the occupational
therapy department. An extension of funds for scholarships by
schools and organizations would probably increase the number of
graduates. In addition, the development of new schools for training
personnel in universities, colleges, and hospitals which can provide
adequate facilities and teaching staffs would increase the number of
qualified persons in this profession.
TRAINING
Classroom Training

The usual training period for qualified occupational therapists is
5 years beyond high school, in schools acceptable to the Council on
Medical Education and Hospitals of the American Medical Associa­
tion. The schools are listed in the appendix. The college course of
5 years leads to the Bachelor of Science degree and certification in
occupational therapy (55). A trend has arisen to condense the train­
ing into 4 years in the future. A student with one or more years
of college education or equivalent professional experience in related
fields such as art, nursing, or personnel may sometimes complete the
required training in a 3-year diploma course. The college graduate
with a bachelor’s degree other than occupational therapy may be
required to take 18 months of professional training for certification.
To qualify as a registered occupational therapist the graduate must
also pass the national registration examination given by the
American Occupational Therapy Association (20). Minimum
standards for the college curriculum as established by the AMA
Council are given in the appendix.

OCCUPATIONAL THERAPISTS

25

Suggested high-school subjects include science courses such as
chemistry and biology, psychology, sociology, arts and crafts, and
typing. Extracurricular activities may also be helpful, especially
leadership in Girl Scout, Campfire Girl, or Junior Red Cross
activities, and camp and playground experience.
A suggested pre-occupational therapy curriculum for the first 2
years in college, leading to the more specialized professional train­
ing, might include: (first year)—English, biological sciences, modern
languages, speech, arts and crafts; (second year)—English,
sociology, psychology (either general, child, or educational), modern
languages, chemistry or physics, arts and crafts. A number of junior
colleges give pre-occupational therapy courses. After 1 or 2 years
in junior college the student may transfer to a diploma course in an
accredited school (56).
For the more specialized part of the occupational therapist’s train­
ing, suggested subjects include those on the physical aspects of
disability, those on mental and social aspects, and those concerned
with economic aspects, such as the various skills (19). As this is a
medical services occupation, the medical phase of the preparation
is important. It is also a teaching occupation, as the patient is
continually taught the methods and skill needed for his improvement
and recovery. In order to understand the close relationship between
the patient and the occupational therapist, the study of social work
and of the psychology of normal and abnormal minds is also helpful
in understanding the frustrations and aspirations of the ill and the
psychology of the handicapped. For the occupational therapist who
desires to specialize in home visitation work, additional courses in
psychology, sociology, and a knowledge of languages would be useful.
Hospital Practice

In addition to the academic training of the occupational therapist,
a minimum of 9 months of hospital practice is required in approved
courses. Clinical affiliations are arranged by the schools to include
experience in children’s, orthopedic, general, mental, and tuberculosis
hospitals. The Veterans’ Administration operated 16 training
hospitals in 1952 in which they had a total of 187 students. As the
Veterans’ Administration can offer no training in pediatrics, the
student must take that part of her training elsewhere. Some institu­
tions offer special types of training for students, such as the treat­
ment of children suffering from rheumatic fever or cerebral palsy or
of blind patients. In New York City, students served 1 month of
their training period with a New York City Home for Dependents
which had approximately 1,800 elderly “guests,” both men and
women. The guests worked 4 hours a day in group craft work, using

26

OUTLOOK FOR WOMEN

mostly discarded materials to make toys and other salable articles.
Each one received two-thirds of the selling price of the article he
had made, after the costs of any additional materials purchased were
deducted (IS).
Registration

A registration examination is given by the AOTA twice each year.
The examination covers complete and representative material in this
field. Passing the examination permits occupational therapists to
add OTR after their names. Many positions are open only to
registered therapists.
Scholarships and Fellowships

Scholarships and fellowships were comparatively few in 1952. Most
colleges have scholarships in general which may be used to train occu­
pational therapists. Some scholarships are available for registered
therapists for specialization in such fields as cerebral palsy or polio­
myelitis, granted by the National Society for Crippled Children and
Adults and its affiliated State and local chapters and by the National
Foundation for Infantile Paralysis. The Elks National Foundation
also makes funds available for graduate occupational therapists for
specialization in cerebral palsy. The Alpha Gamma Delta Inter­
national Women’s Fraternity in cooperation with the National Society
for Crippled Children and Adults in 1950 offered several scholarships
for special training in cerebral palsy at the New York University (53),
and a similar project was sponsored in 1948 by Alpha Chi Omega, a
national women’s sorority interested in the movement to treat cerebral
palsied children and young adults (Ifi).
Service in the Armed Forces

A college graduate whose course included 2 years of study in a
recognized school of occupational therapy may apply to the Army
and complete the remainder of her training while receiving an officer’s
salary. The Air Force commissions students to accomplish only the
clinical period of training either in military installations or civilian
institutions. The applicant for an Army commission must be unmar­
ried with no dependents under 18 years of age and must be at least
21 and under 28 years of age at the time of her appointment. If the
candidate is accepted, she is commissioned at the beginning of her
training as a second lieutenant in the Women’s Medical Specialist
Corps Reserves and is entitled to the pay, privileges, and benefits of an
Army officer. She volunteers for a 3-year period of duty, including an
18-montli training period. In addition she receives Government quar­
ters and full medical and dental care. Following training of 34 weeks
in the classroom, the clinical training, lasting 36 weeks, consists of the

OCCUPATIONAL THERAPISTS

27

application of occupational therapy in the treatment of patients with
physical disabilities in military hospitals. As the training con­
forms with the standards of the Council of Medical Education and
Hospitals of the American Medical Association, a woman may become
a registered occupational therapist through this channel. The mili­
tary occupational therapy departments claim many advantages for the
trainee aside from the financial benefit while training: The diversity
of clinical material, the availability of the best of equipment and
supplies, the direction by skilled physicians, and the opportunity to
utilize the student’s medical knowledge and her training in applied
arts to the fullest advantage.
Qualified therapists with no experience may enter the armed forces
with the rank of ensign or second lieutenant, provided they are not
yet 30 years of age. Those with experience may obtain an initial
appointment in grades commensurate with their experience. In such
cases the age limit is higher. In addition, single women from 18 to
34 who are high-school graduates may enlist for a 3-year period or
more and request training as occupational therapy assistants, or
hospital technicians, as they are called in the armed forces.
Graduate occupational therapists in military service may apply to
pursue their education further and, if the application is accepted,
they may leave the service for specializations of various kinds, such
as neuropsychiatric or cardiac work or tuberculosis treatment. An
officer who is given educational leave in order to obtain her master’s
degree receives salary, tuition, and other expenses but she, in turn,
must agree to serve in the armed forces for 4 years. If therapists
marry, they are permitted to remain in the service, but if they become
pregnant they are separated from the service.
EARNINGS, WORKING CONDITIONS, AND
ADVANCEMENT
Earnings

The salaries of occupational therapists compare favorably with
those of nurses and of other medical technicians. The earnings are
influenced by the locality and size of the institution, the size of the
therapy department, and the therapist’s experience, degree of special­
ization, and extent of responsibility.
Private hospitals.—Private hospitals are reluctant to release infor­
mation on salaries, but in general it is believed that they pay less than
State or Federal hospitals, both for beginners and for experienced
workers. A report of $2,800 for beginners in private institutions was
made in 1951.
State and local institutions.—As for public employees, a large south­
ern city employed an occupational therapist at an annual salary of

28

OUTLOOK FOR WOMEN

$3,000 in 1951. Information available tlie same year for beginners
employed in State institutions in seven States in the northern and
western parts of the country indicated the lowest rate for beginners
to be $2,700. An eastern State paid experienced occupational thera­
pists $3,086 to $3,776.
Federal agencies.—Beginning occupational therapists who had com­
pleted 1 year of graduate work in the subject were hired by the Federal
Government or the District of Columbia, under United States Civil
Service Commission regulations, at the GS 5 rate of $3,410 per year in
1952.
In the military forces the remuneration for commissioned officers
was slightly higher than for civilians in the Federal Government and
in accordance with the custom of the armed forces it was broken down
into its components. Beginners received $213.75 per month in 1952
as a basic salary as second lieutenants or ensigns and in addition a
monthly subsistence allowance of $42 was paid. Allowance for quar­
ters is also given if Government quarters are not available.
The U. S. Public Health Service has both commissioned officers and
civilians serving as occupational therapists in its hospitals and clinics.
A commissioned junior assistant occupational therapist receives the
same salary as a second lieutenant in the Army or Air Force or an en­
sign in the Navy, which in 1952 was a total of $3,789 without depend­
ents or $3,969 with dependents. This includes both the base rate
fend allowances for rental and subsistence. The noncommissioned
MU
.
.
.
‘ occupational therapists begin at the GS-5 level with an annual salary
of $3,410. Promotion is made on the basis of performance.
Hours and Working Conditions
Hours.- -The working conditions for occupational therapists are at­
tractive on the whole. The regular 40-hour week with an 8-hour day
is usual in this type of work. However, in some institutions and agen­
cies the 44- or 45-hour week is in force. In mental or neuropsyhciatric hospitals where a 7-day week is necessary, those who work dur­
ing the week end are given compensatory time the following week.
Because of the shortage of qualified workers, depleted staffs sometimes
find it necessary to do some overtime work on their own time if some­
thing needs to be completed.
Vacation provisions.—Liberal vacation periods are usual in this pro­
fession, ranging from 2 to 4 weeks annually. In the Federal Govern­
ment and the District of Columbia, the amount of leave in 1952 varied
depending upon length of service. As the work is physically exacting,
a generous vacation is deemed good policy both for the institution and
the individual.

OCCUPATIONAL THERAPISTS

29

Other benefits.—All institutions supported by public funds, such
as Federal, State, county, and municipal agencies, have retirement
provisions and sick leave, as do many private institutions. In the
armed forces, retirement is possible after 20 years of service but be­
cause of the present shortage of personnel, the policy is followed of
prolonging the period of service if the health of the person permits.
Sick leave and hospital care are provided for those in military service
without cost. In the Federal Government and the District of Co­
lumbia, liberal retirement practices prevail and the 13 days of sick
leave permitted annually may be accumulated indefinitely. Most
voluntary institutions have adequate sick-leave arrangements, usually
1 day per month, cumulative according to a definite plan or schedule,
and give emergency care on the job. Many institutions participate
in health and insurance plans also. Old-age benefits under the revi­
sion of the Social Security Act became possible for occupational
therapists in private institutions beginning with 1951.
Advancement
Administrative and supervisory positions.—Advancement within
an occupational therapy department depends in part upon its size.
Where departments are well staffed or several institutions are united
under one administration, the possibility of advancement may be
fairly good. High turn-over trends are the rule because this is almost
entirely a woman’s profession with high incidence of marriage. Half
of the beginners in this field marry by the fifth year after graduation
(l 6). As a result, advancement is likely to be realized if a person has
2
interests and ability beyond the practical phases of the work. One
may rise from the assistant or staff level to that of chief therapist with
20 or more subordinates. A movement exists from governmental to
nongovernmental institutions or the reverse as therapists move from
lower levels in one institution to more attractive positions in another.
In some of the Federal agencies the practice is followed of advanc­
ing the beginner to the GS-7 level with a beginning salary of $4,205
after a year or two of satisfactory service, provided an opening is
available. Possibly in another 2 or 3 years, if the worker indicates
ability, she is advanced to the GS-9 level at $5,()f>0. However, before
reaching the GS-9 grade she is usually expected to show that she
possesses the quality of leadership by having supervised or assisted
in supervising for at least fi months. Persons in the position of ad­
ministrator in occupational therapy with the Federal Government
can reach a top salary of $8,140. Any maintenance provided is usually
deducted from the total salary. For instance, in some hospitals where
total maintenance is given, which includes room and meals, $500
yearly is deducted.

30

OUTLOOK FOR WOMEN

Figure 7.—A chief occupational therapist shows volunteers the working of a loom
for veterans at a VA hospital.

Advancement is from second to first lieutenant, captain, and major
in the Army, Air Force, and U. S. Public Health Service; and from
ensign to lieutenant junior grade, then lieutenant, lieutenant com­
mander, commander, and captain in the Navy.
Work as director of a curative workshop is a possibility for a person
with some experience and is well paid.
Training school instructors.—Many positions are available in the
educational field and occupational therapists may become instructors
or directors in training schools. Such work is well paid and satisfy­
ing to those who enjoy the campus atmosphere.
Clinical specialists.—Some women become specialists in certain
fields, such as work with cardiacs, paraplegics, the blind, and the aged.
The number of cardiacs and blind tends to increase with the advanc­
ing age of the population in the country and the number of para­
plegics is augmented throughout the country, not only as a result of
battle injuries, but also because of the growing toll of accidents among
civilians.
Geriatric -field.—The newest specialty for occupational therapists,
that of geriatrics, is receiving considerable attention at present. For
instance, a movement has arisen in the Veterans’ Administration to

OCCUPATIONAL THERAPISTS

31

make disabled veterans of World War I self-supporting and have
them enjoy normal life in their communities wherever possible, rather
than relegate them to hospitals or homes for the aged. A rehabilita­
tion program in a county hospital, begun in 1946, employed three
registered occupational therapists in 1951. During the first 4 years
of operation, 308 patients were chosen for rehabilitation, many of
them bedridden and 63 percent of them ranging from 50 to more
than 70 years of age. As a result of physical and occupational therapy
programs, 13 percent were discharged to go to work, 15 percent
were able to return to their families, 52 percent recovered to the
point of being ambulant in the hospital, and only 20 percent were
unimproved {13).
ORGANIZATIONS
The principal organization in the field of occupational therapy is
the American Occupational Therapy Association. In 1952, 3,851
registered occupational therapists were members (1). About 500
former members of the Association were inactive, having left the
profession because of family responsibilities or retirement. Many
registered therapists, in addition to belonging to the national organ­
ization, also were members of one of the 34 State and regional organ­
izations of the Association.
Membership is divided into six classes as follows: (1) active regis­
tered therapists who are or have been engaged in the profession;
(2) fellows who by virtue of their professional or community status
can relate the profession to the public need; (3) students in accredited
schools; (4) associates interested in promoting the profession but
not eligible for active membership; (5) sustaining members who are
eligible for active or associate membership but whose interest
prompts them to give larger contributions for the support of the
organization; and (6) honorary life members who have performed
distinguished service and upon whom life membership has been
conferred.
To be eligible for active membership in the American Occupa­
tional Therapy Association, the occupational therapist must be a
graduate of an accredited school of occupational therapy. In addi­
tion the applicant for membership must be listed on the register of
the Association. The Association holds examinations twice a year
for graduates of approved schools for registration purposes (45)
and those who successfully pass these examinations are eligible for
registration with the Association.
Annual dues for active members are $10 per year, for student mem­
bers $5, and for other types of members the amount varies from $4

32

OUTLOOK FOR WOMEN

to $12. All members receive the publications and the other literature
given out by the Association.
The technical journal of the organization is a bimonthly. From
1922 to 1925 it was called Archives of Occupational Therapy, was
then renamed Occupational Therapy and Rehabilitation, and is now
the Journal of Physical Medicine. In February 1947, the Association
began the publication of a monthly, The American Journal of Occu­
pational Therapy (8). It also issues the Occupational Therapy Year­
book. a monthly newsletter, reprints from various articles, craft books,
photostatic reproductions of interpretive material, lists and require­
ments of approved schools, and a list of films (45).
The Association works to promote the profession, to improve the
standard of education and practice in this field, and to encourage
research. It carries on a recruitment program and operates a place­
ment service for the benefit of its members.
Besides belonging to this Association, some occupational therapists
are associate members of related organizations, such as the American
Physical Therapy Association, the American Congress of Physical
Medicine, and the Association of Military Surgeons.
UNPAID VOLUNTEERS
An important segment of occupational therapy services throughout
the country is the work of unpaid volunteers.
State Occupational Therapy Volunteer Aides

In a number of States, the State occupational therapy organization
sponsors the training of volunteer aides to serve in the “O. T.” de­
partments of hospitals and agencies, assisting the therapists in their
work with patients. The State organization appoints a State occu­
pational therapy volunteer committee which recruits volunteers
through local groups, such as the Red Cross or women's clubs, ar­
ranges for the training course, places volunteers in hospitals after
completion of training, and keeps records of the hours and accom­
plishments of each volunteer. The training courses are given prefer­
ably under the direction of an accredited school of occupational
therapy, the State association, or qualified therapists and usually
consist of 7 hours of lectures and 152 hours of craft training. The
minimum service pledged by each volunteer is (> hours a week or 150
hours a year.
An instance of such a State activity is the New York State program,
undertaken in New York City, sponsored jointly by the New York
State Occupational therapy Association and the Junior League of
New Y ork City, beginning in 1942. Groups of women volunteers were

OCCUPATIONAL THERAPISTS

33

given a 10-week training course, meeting in 3-hour sessions 3 after­
noons a week. Lectures were given on the theory of occupational
therapy by instructors at Columbia University; the director of the
Museum of Modern Arts had charge of a design course; skilled ar­
tisans gave 48 hours of craft training; and 18 hours of hospital work
completed the course. Finally examinations were given. Graduates
were expected to pledge a minimum of 150 hours of service yearly,
that is, at least 3 hours a week, in one of 33 voluntary, municipal, or
veterans’ hospitals in the city. The program reported that 619
women had been trained under its auspices between 1942 and 1952.
Classes averaging 30 volunteers were trained twice a year. The
hours of service of this group totaled 19,793 in 1950 and 18,179 in
1951. The Junior League had an occupational therapy committee
which conducted social meetings periodically for these volunteer
members of occupational therapy staffs. The League also arranged
for the sale of the articles made by patients in the New York hospitals.
Sometimes these sales extended over a 4-day period. The proceeds
were returned to the hospitals for the purchase of materials necessary
for handicraft work.
The American National Red Cross

Many volunteers are Red Cross workers. The number of these
workers began to expand in 1943 when they were needed to provide
sick and disabled men in military hospitals with creative and con­
structive work. At first artists were recruited for volunteer work
under the supervision of the hospital staff. For instance, in Philadel­
phia, a sculptor volunteered to teach patients in a military hospital.
In a short time it was found impossible to meet the demand by using
only professional artists. As a result, classes of volunteers with
various skills were trained and served not only in hospitals of the
armed forces but were also requested for the hospitals of the Veterans'
Administration and civilian institutions, many of them children’s
homes and hospitals. The installation of art, dramatics, puppet shows,
and various creative activities in children’s hospitals helped to enter­
tain the small patients and created values in the child’s learning
program. When World War II came to an end, the need for uncom­
pensated volunteers became proportionately less in military hospitals,
but it tended to expand in the hospitals of the Veterans’ Administra­
tion and civilian institutions.
The qualified occupational therapists are responsible for the reme­
dial phase of the work; the volunteers in these hospitals assist them.
For instance, volunteers may be directed by occupational therapists
to interest and keep a patient occupied in a specific activity. The

34

OUTLOOK FOR WOMEN

V :

1
■' m

Figure 8.—A patient in a home for incurables is assisted in weaving by a Red Cross
volunteer worker.

field of children’s work is always attractive to volunteers. In an
eastern State in a diagnostic center for delinquent children, a group
of 60 women from the Red Cross taught arts, crafts, recreation, and
library work to children, under the supervision of the head psychiatric
social worker in 1950 (J^).
The membership of the Arts and Skills Service of the Red Cross
consists for the most part of professionally trained people or those
with an interest in a skill. Local Red Cross chapters having this
service have an Arts and Skills Committee made up of professional
volunteers, such as people from a museum, art department, or uni­
versity, who evaluate applicants before they are permitted to under­
take training to become an active member of the service. However,
it is not always possible to obtain people connected with an art or
profession to serve on the committee so that outstanding interested
citizens serve instead. Approved representatives from civilian hospi-

OCCUPATIONAL THERAPISTS

35

tills, Red Cross representatives, and the chief occupational therapist
often serve as advisory members of this committee.
Applicants for this service must be acceptable both to the Red Cross
chapter and to the hospital occupational therapy department. They
are expected to have one or more skills when they apply although
some, lacking skills and/or experience, are admitted occasionally as
assistants or apprentices. They must be the type of person who is
adaptable to hospital work and who has the ability to teach. They
also must have the intent to serve regularly and be willing to accept
assignment and supervision cheerfully.
Training includes orientation both to the Red Cross and to the
program of the hospital. The volunteers are given lectures by Red
Cross instructors on the history and the objectives of the organization
and on the service which they expect to enter. Then a hospital in­
doctrination course follows. In some institutions this consists of lec­
tures by the chief nurse, the occupational therapist, the hospital
librarian, psychiatrists, and members of the medical staff of the hos­
pital on such topics as hospital ethics, the organization and admin­
istration of the occupational therapy department, and the types of
patients in the hospital. This indoctrination course is arranged by
the hospital or agency, and will vary according to the type of institu­
tion, its needs, and practices. After orientation, a probational period
of 10 hours on the job is recommended to help the supervisor to de­
cide whether placement has been made where the volunteer best fits
into the staff and where the best use will be made of the volunteer’s
talents and capabilities.
Members are pledged to give the minimum number of hours of
service established by the local chapter. This means, for example,
that they are scheduled to work at least a lialf-day a week, usually a
3-hour period in the morning or afternoon. They aid children with
cerebral palsy to perform simple manual operations and teach many
skills, from crafts and typing to violin making. Some business
women devote an evening to this work each week but the evening
periods are likely to have less occupational therapy and more of the
diversional type of activity. Men volunteers are interested in archi­
tectural or industrial design, fly-tying, and various types of shop
work. Members of the service wear uniforms whose design is ap­
proved by the American Red Cross. Many are master craftsmen in
their line, while the occupational therapist who supervises all craft
activity programs must have some knowledge of many crafts and
ability to think along therapeutic lines.
Some Red Cross volunteers, with only a general interest in craft
work and no particular skill, may be assistants to the skilled volunteers
or apprentices and help them in the work. Sometimes college students

36

OUTLOOK FOR WOMEN

and Junior lied Cross members work as apprentices. The lied Cross
makes no attempt to train a volunteer in a skill, but it frequently
happens that the original skill which the volunteer had to offer when
beginning work with the lied Cross does not remain the only skill
which he possesses. In some hospitals, Junior Red Cross members
participate in the program by preparing materials, such as rolling
clay for the use of patients. However, the policy of the Red Cross is
to prevent these children from coming into actual contact with the
patients.
In the Army, the Navy, and the U. S. Public Health Service hos­
pitals only volunteers who are certified by the Red Cross are per­
mitted to work in occupational therapy departments. In the hos­
pitals in many of the smaller communities, the Arts and Skills Service
is lacking, and qualified Gray Ladies serve.
Veterans’ Administration

In the Veterans' Administration, Red Cross volunteers are but one
of many groups who assist the occupational therapists in the hospitals.
In
the Veterans' Administration organized its Voluntary Service,
a community plan for participation in the VA program for hospital­
ized veterans. This service affords skilled training to volunteer
workers, gives them a definite place in hospital work, and unites the
efforts of all participating groups in a smoothly operating Volunteer
Service in each VA hospital.
The VA Assistant Administrator of Special Services and his staff
in Washington, I). C., and the Veterans’ Administration Voluntary
Service National Advisory Committee, which meets twice a year, en­
courage the organization of a VAVS Hospital Advisory Committee,
with the Chief of Special Services as chairman, in each VA hospital in
the country. This hospital committee is made up of representatives
selected by interested local organizations in the community. Country­
wide, an estimated 350 local and national organizations provide rep­
resentatives for volunteer service, not all, of course, serving in any
one hospital. In actual practice an average of from 10 to 50 such
volunteer organizations in each community having a VA hospital
send representatives to the Hospital Advisory Committee. These
organizations are responsible for recruiting volunteers from their
memberships.
The typical VA hospital team is composed of VA staff and un­
compensated volunteers who work for the return of the veteran to
normal and productive life in the community. The volunteers serve
usually from a minimum of 3 hours a week to one or more days weekly
and assist nurses, therapists of all types, social service workers, librar­
ians. recreation workers, and others in the hospital. During the sum-

37

OCCUPATIONAL THERAPISTS

■'

in ■

WWM

Figure 9.—An outdoor art class is conducted at a VA hospital by a Red Cross
volunteer worker.

mer of 1951 in VA hospitals throughout the country 1,747 occupational
therapist volunteers served an average of 18,418 hours a month. This
amounts to an average of 10^ hours a month for each volunteer.
In one Veterans’ Administration hospital in the East, 26 volunteers
from the Red Cross Arts and Skills Service contributed a total of
500 hours per month on the average, assisting patients in weaving,
leather and metal work, painting, applied design, and other skills {23).
These volunteers sometimes travel long distances to reach the hospital.
Some organizations provide their members with uniforms while other
volunteers wear arm bands or badges. Certificates for service are
awarded by the Veterans’ Administration.
Other Types of Volunteer Service

While volunteers are useful in hospitals and institutions where they
can be carefully supervised, many occupational therapists engaged in
home visitation work believe that volunteers can rarely be used for
the homebound, because of the amount of training and supervision
necessary to have them function adequately. In a few instances, Red
Cross Arts and Skills Service has been extended into homes of invalids.
For such service, a direct request from the patient or his family
should have the approval of the attending physician.
Sometimes volunteer work is used indirectly through volunteer
organizations, as for instance, a federation for the handicapped which
sold items made by homebound patients in its store and a charitable

38

OUTLOOK FOR WOMEN

organization which provided radios for patients unable to supply
themselves. In addition, a welfare council in an eastern city included
a demonstration of weaving by one of the homebound patients in a
hobby show.
It is the consensus that occupational therapy departments, in view
of the shortage in professional personnel, could not function without
the assistance of these socially minded volunteers who relieve the
occupational therapists of much of the routine and recreational phases
of the work and permit them to concentrate on the therapeutic aspects
of the program. Married qualified therapists, inactive in the pro­
fession because of family responsibilities, frequently serve as volun­
teers. This keeps them informed of the rapid changes in the
occupation and helps them to make a vital contribution to community
welfare. Devoted volunteers are highly valued bv the hospitals in
filling a need which could not otherwise be met.
SUGGESTIONS TO THOSE INTERESTED IN ENTERING
THE FIELD OF OCCUPATIONAL THERAPY
Education

The young woman who wants to become an occupational therapist
should prepare herself by completing training in a school approved
by the Council on Medical Education and Hospitals of the American
Medical Association. For those interested in the field but unable to
finance their training, scholarships may be possible. For information
on scholarships or fellowships, write to the American Occupational
Therapy Association, 33 West 42d Street, New York 36, New York,
or the accredited school of your choice.
Personality Traits

Personality as well as education is important. A professional atti­
tude includes respect for others, the maintenance of an objective
attitude, an interest in the affairs of others without prying, infinite
tact, the giving of criticism only when it will be helpful, dignity and
friendliness without familiarity, and a sincere appreciation of the
efforts of others (JjO). The occupational therapist needs a cheerful
outlook, ability to instruct, good craftsmanship, and the ability to
interpret and apply the doctor’s analysis (8). She must be inspired
with a warm liking for people. The outstanding characteristics of the
most successful therapists are invariably a desire to serve others and
the health, poise, and patience to achieve that purpose. The therapist
must inspire child patients to cooperate in their treatment and to
have “the will to do.” In work with children she needs enthusiasm,
sound judgment, tolerance, kindness, and mental and physical good

OCCUPATIONAL THERAPISTS

39

health. The occupational therapist besides having manual dexterity
and various skills needs the same qualifications as the social worker.
Advantages

The primary rewards for this work are the personal satisfactions
that come from helping to restore individuals to health and usefulness.
There is a recurrent thrill in seeing the resulting improvement, both
mental and physical, as the patient responds to treatment, which more
than compensates for the time and effort expended. As a career, occu­
pational theraphy offers varied outlets for creative ability and
imagination.
The occupational therapist carries on her work in cooperation with
a team of highly specialized professional persons, headed by the
physician or surgeon and including (lie nurse, the social workers, and
the physical therapist. But she alone has the responsibility for apply­
ing vocational knowledge and skills to medical and psychological uses.
The synthesis of two or more fields of knowledge is a peculiarly fas­
cinating and satisfying undertaking to persons who have versatility in
both creative and practical fields.
This field offers tremendous expansion (37). Because of the short­
age of workers, advancement into administrative positions is an excel­
lent possibility. This work combines well with marriage and family
responsibilities because of its foundation in psychology and medicine
and the interesting and practical hobbies it encourages. Women may
continue on in their positions after marriage as long as family respon­
sibilities permit, with the possibility of part-time work if they so
desire.
Professional Interest

To keep abreast of progress in (his rapidly changing occupation,
occupational therapists should take an active part in the growth of
their profession, attend professional meetings and conferences, engage
in research, and undertake advanced study whenever this is possible.
In this way they will increase their efficiency and grow in professional
stature.
Placement Information

In obtaining employment in this field, most workers find positions
through inquiries received by the school from which they graduate
or through the American Occupational Therapy Association, which
maintains a placement service for its members. The largest employers
of occupational therapists are the armed forces and the Veterans’
Administration. For work with these organizations and other Fed­
eral or State government agencies concerned with the rehabilitation

40

OUTLOOK FOR WOMEN

of the disabled, direct application can be made to the agency or to civil
service commissions where these function. Personal applications
may also be made to private hospitals and sanatoria, neuropsychiatric
institutions, schools for the deaf or blind, and curative and community
workshops, clinics, or rehabilitation centers.
Occupational therapy lias developed into a recognized profession
which makes possible a real sense of accomplishment and satisfaction
for the worker. It has become a democratic sharing process in
which the occupational therapist is one of a team, including the physi­
cian, the physical therapist, the nurse, and the dietitian, who work
for the rehabilitation of the disabled. In developing her ability to
aid those who are mentally or physically ill, the woman with social
consciousness finds possibilities for her own growth and gratification
in her contribution to relieving the ills of mankind.
PREWAR AND WARTIME DISTRIBUTION
World War I

During World War I the Army trained a group of women, mostly
teachers, artists, physical therapists, and handicraft specialists, to serve
as “reconstruction aides” in base hospitals. General Pershing called
for 500 occupational therapists at the front {38). Under the super­
vision of a physician, they helped orthopedic, neurological, tubercular,
and blind patients to recover physically and mentally from disease
and injury by exercising their muscles and occupying their minds with
a variety of activities, primarily handicrafts. Some of those inter­
ested in this field formed an organization in 1917 which later became
the American Occupational Therapy Association. The field has
expanded steadily since that time, even through the depression years
{30). In the early I930's the Association established national regis­
tration with 318 occupational therapists registered. The American
Medical Association also set up standards for accredited schools in
1935 with five schools qualifying {38). However, a 1938 study re­
vealed that only 792 (13 percent) of the 6,189 hospitals approved by
the American Medical Association employed occupational therapists
(67).
World War II

The Army program in the decade of the 1930’s was permitted to
lapse for lack of funds. In December 1941, when World War II
began, only 12 civilian occupational therapy aides were in Army
hospitals {10), and approved schools were graduating about 150
students each year. At that time almost 1,000 occupational therapists
were registered with the American Occupational Therapy Associa­

OCCUPATIONAL THERAPISTS

41

tion. Possibly 500 to 1,000 more were practicing but not registered,
many of them hospital attendants, trained on the job, and some spe­
cialists in a single art or craft. The American Medical Association
indicated that approximately 1,880 full-time and 350 part-time
occupational therapy technicians were employed in hospitals in 1941
(17).
The war gave a tremendous impetus to the needs of the armed forces.
The Army stated that 300 occupational therapists would be needed
by mid-1944 and 750 in 1945. In May 1944, the Veterans’ Administra­
tion had 238 staff aides and junior aides, of whom 08 were registered
occupational therapists, and 74 attendants in 51 veterans’ hospitals.
In the Army and Navy hospitals, occupational therapy was used for
the most part for neuropsychiatric and orthopedic patients while
veterans’ hospitals, in addition to these two types, provided it also for
tubercular patients.
The subject matter of occupational therapy underwent a change as it
was administered in military and veterans’ hospitals. The diversional
programs and hand work such as basketry and chair caning were
supplemented with physical reconditioning activity to a great extent.
As soon as patients were able, they were assigned such activities as
radio repair, mechanics, printing, and photography. In some hospi­
tals, industrial programs were in operation: Manufacturers of screws,
nuts, bolts, and small parts installed machines in hospital departments
to give work to patients on a voluntary basis. Employed on piece­
work as inspectors, assemblers of small parts, sorters, or machine work­
ers, the patients received the same wages as factory workers. Two
naval hospitals used assembly type of work for bed and ambulatory
patients, and the production of electrical parts made them feel that
they were contributing to the war effort.
A war-emergency course to train personnel in this profession for
work in military hospitals was instituted in the war period. A con­
centrated 12-month course was set up for college graduates with a
major in applied, industrial, or Hue arts, and with skill in three basic
crafts used in occupational therapy, such as sculpture, pottery, or
woodwork. The training consisted of an intensive academic course
of 4 months’ duration followed by 8 months of clinical training at the
rate of $1,440 a year for the 4 months of classroom training and at the
annual rate of $1,690 for the 8 months of experience in military hospi­
tals. By the end of 1944, 200 graduate occupational therapists were
employed in all but two general hospitals of the Army. However,
this fell far short of the need (£). Even if there had been more stu­
dents, instructors were insufficient in numbers to provide an adequate
teaching force {11). By the close of the war, at the peak of opera­

42

OUTLOOK FOR WOMEN

tions, the Army had 900 occupational therapists employed of whom
545 had been trained in tire Army War Emergency Course. From 30
to 75 percent of the patients in some Army hospitals were found to need
physical and occupational therapy. The Veterans’ Administration
had 445 occupational therapists employed in 1946 but needed many
more; about 40 percent of their patients needed occupational therapy.
To extend the program in military hospitals, enlisted personnel, cor­
responding to occupational therapy aides in civilian hospitals, were
trained as technicians to work under the direction of graduate thera­
pists. Some were trained in shops to teach the principles and tech­
niques of hand- and machine-work in plastics and metal to wounded
soldiers. Diversional or recreational aspects of the occupational
therapy program were provided by the Arts and Skills Service of the
American National Red Cross (65). About 500 unpaid Red Cross vol­
unteer aides were working in military and civilian hospitals in this
country in 1944.
Civilian Hospitals
Meanwhile civilian hospitals during the war period, with their sup­
ply of occupational therapists depleted by the demand of the military
forces and the expansion of veterans’ hospitals, reported the need for
approximately 250 occupational therapists to till vacancies in 1943
(66). The Association was overwhelmed with requests which it could
not fill. Only 13 percent of the hospitals approved by the American
Medical Association employed occupational therapists in 1944 (37),
and about half of the patients in these hospitals took occupational
therapy in one form or another (33). In 11 hospitals in the city of
New York, the patients who participated in occupational therapy pro­
grams held a 4-day Christmas sale in December 1944 to sell the prod­
ucts of their work, such as hooked rugs, toys, aprons, and pot holders.
The proceeds were returned to the hospitals to buy materials for their
occupational therapy departments (35).
The American Medical Association reported that, 12 schools were
accredited, and 218 occupational therapists were graduated from these
schools in 1944—almost a 50-percent increase over the number grad­
uated in 1942.
Vocational Rehabilitation Act Amendment
Additional stimulus to occupational therapy programs was given
by the passage in 1943 of Public Law 113, the Barden-LaFollette
Act amending the Vocat ional Rehabilitation Act of 1920 (30), which
provided for the “restoration of the handicapped to the fullest phys­
ical, mental, social, vocational, and economic usefulness of which they
are capable” and resulted in an expanded State-Federal system of

OCCUPATIONAL THERAPISTS

43

vocational rehabilitation agencies with the Office of Vocational Re­
habilitation of the Federal Security Agency administering the Act
(6). Since 1920, the Federal Government had been matching State
funds in a limited program to prepare disabled workers to return to
work. In the 23 years from 1920 to 1943, only 210,000 disabled had
been rehabilitated, but from 1943 to 1951, 402,000 were aided {62).
The new law authorized the granting of Federal funds on a match­
ing basis for hospitalization, surgical, medical, and psychiatric
treatment, and occupational therapy for civilians who could be made
employable (9). By 1951, over 231,000 persons annually were being
served by this program {62).
Crippled Children’s Programs

Official State crippled children’s programs are in operation through­
out the United States and the Territories under the Social Security
Act of 1935 assisted by Federal funds granted through the Children’s
Bureau. This has increased interest in preventive work and in the
treatment of convalescent children. This grant-in-aid program began
as an orthopedic and plastic surgery program, thereby becoming more
of a functional treatment program. Gradually a number of States
brought within the scope of the program other handicapping con­
ditions, including rheumatic fever, cerebral palsy, epilepsy, and
hearing and vision defects. As the use of occupational therapy of
the diversional typo is helpful in treating children confined to bed,
State agencies encourage the provision of occupational therapy for
children hospitalized under the program. In addition to FederalState programs, many privately supported children’s programs are
in existence".
Baruch Committee

The activity of the Baruch Committee on Physical Medicine and
Rehabilitation was another stimulating influence on the field of oc­
cupational therapy. Established in 1944 for the advancement of
the science of physical medicine, the Committee planned to increase
the supply of physicians who could teach and administer physical
medicine, to stimulate research, and to extend the use of physical
medicine {46). In 1945,12 projects in research and teaching had been
undertaken and 5 fellowships had been granted in various centers {4).
The Committee, believing it had finished its task by 1951, discontinued
operations. During its existence, Mr. Baruch provided more than $2
million for its operation and as a final act made a grant to the Inter­
national Congress of Physical Medicine held in London in 1952.
Fellowships for 48 physicians were provided and major centers of
physical medicine and rehabilitation in New York University, Colum­

44

OUTLOOK FOR WOMEN

bia University, and the Medical College of Virginia were established
by the Committee (3).
In the postwar period, demand continued to outstrip supply. In
1946, the 18 approved schools of occupational therapy in this country
and in Canada graduated 391 students (5). The Veterans’ Admin­
istration, with approximately 500 occupational therapists and aides
on duty, reported that 220 more occupational therapists alone were
needed. Many private institutions also were affected. The source
of the trouble at that time apparently was the accredited schools. For
instance, one school which could admit only 20 beginning students
had over 300 applications in 1946 and another with a beginning class
of 25 had 100 applications. Other schools reported the same situation.
In 1946 the Association had a total membership of 2,525, of whom 2,300
were registered (45). By 1947, rehabilitation centers and curative
workshops had been established in 22 cities. The Veterans’ Admin­
istration estimated that it could use 1,300 occupational therapists at
this time (38). Efforts were continued to stimulate recruitment as
physicians and the public came to appreciate the contribution this
professional group could make.

APPENDIX
Minimum Requirements for a Beginning Federal Civil Service Position
as an Occupational Therapist1
(As taken from the Civil Service Announcement No. 163, un­
assembled, issued March 22, 1949, closed April 19, 1949. 'This is
the last examination given in this type of employment up to May
1952.)13
2
Citizenship in the United States.
Age: Over 18 years of age and up to but not including 62 years.
Physical requirements: Capable of performing the duties of the position.
Passing of a physical examination is necessary for appointment.
Education and experience: Applicants must have one of the following or a
combination of them: A. Graduation from a school of occupational therapy
meeting the standards approved by the American Medical Association (or the
American Occupational Therapy Association prior to 1938) ; B. Four years of
successful and progressive technical experience as an occupational therapist
under medical supervision in a hospital, sanitarium, or clinic.
The positions to be filled from this examination included those in the U. S.
Public Health Service aild St. Elizabeths Hospital in Washington, D. C., the
U. S. Public Health Service hospitals throughout the country and its outpatient
clinics, and the Indian Service hospitals in the West and in Alaska. Other
depai [.mental and field positions may be filled from this examination in the
metropolitan area of Washington, D. C.

Minimum Requirements for a Beginning Federal Civil Service Position
as an Occupational Therapist With the Veterans’ Administration 1
(As taken from the Civil Service Announcement No. 233, unassem­
bled, issued July 11, 1950. No closing date.)4
Citizenship in the United States.
Age: Over 18 years of age and up to but not including 62 years of age. These
age limits do not apply to persons entitled to veteran preference.
Physical requirements: Capable of performing the duties of the position.
Passing a physical examination is necessary for appointment.
Education: Applicants for the beginning grades must be graduates of a
1 The beginning salary was $3,410 in 1932 for a GS-5 position.
2 For more complete arid later information, consult announcements of the Civil Service
Commission posted in first- and second-class post offices.
3 The beginning salary was $3,410 in 1952 for a GS-5 position.
4 For more complete and later information, consult announcements of the Civil Service
Commission posted in first- and second-class post offices.

45

OUTLOOK FOR WOMEN

46

school of occupational therapy approved by the American Medical Association.
Applicants who have graduated prior to 1938 must be graduates of schools
approved at the time of their graduation by the American Occupational Therapy
Association.
Positions to be tilled from these examinations are located in the hospitals
and regional offices of the Veterans’ Administration throughout the United
States and in Puerto Rico.

Minimum Standards for the College .Curriculum in an Acceptable School
of Occupational Therapy
(From the yearbook of the American Occupational Therapy Asso­
ciation, 1952, prepared by the Council on Medical Education and
Hospitals of llie American Medical Association.)
Distribution of time (2 years) :
1. Theoretical, not less than 39 semester hours, further subdivided as
follows :
(1) Biologic sciences totaling 18 semester hours; including: anatomy,
kinesiology, neuroanatomy, physiology, and psychology;
(2) Social sciences totaling 4 semester hours; including: sociology, in­
dividual readjustment, and social and educational agencies;
(3) Theory of occupational therapy, 8 semester hours; including: ad­
ministration, general medicine and surgery, orthopedics, pediatrics,
tuberculosis, and psychiatry;
(4) Clinical subjects totaling 7 semester hours; including: general
medical and surgical (blindness, deafness, cardiac diseases, and com­
municable diseases), neurology, orthopedics, pediatrics, psychiatry,
and tuberculosis.
2. Technical, not less than 25 semester hours with a major portion in one
of tiie following fields and survey courses in the other fields:
(1) Arts, fine and applied, as design, leather, metal, plastics, textiles,
and wood;
(2) Education, special and adult, including home ecomomics, and library
science;
(3) Recreation including music, dramatics, social activities, gardening,
and physical education.
3. Clinical training, not less than 36 weeks. No student should be assigned
to a clinical training center for less than 8 weeks. Rotation assignments for
not less than 4 weeks may be made within a given center so that the student
may have varied experience with the different patient groups within one
institution. The division of time should be as follows :
(1) Psychiatric conditions, not less than 12 weeks;
(2) Physical disabilities (surgical, neuromuscular, and orthopedic), not
less than 8 weeks;
(3) Tuberculosis, 4 to 8 weeks;
(4) Pediatrics, 4 to 8 weeks ;
(5) General medicine and surgery (other than physical disabilities), 4
to 8 weeks.

OCCUPATIONAL THERAPISTS

47

Schools of Occupational Therapy in the United States Accredited by the
Council on Medical Education and Hospitals of the American
Medical Association, April 1952 5
Boston School of Occupational Therapy,
affiliated with Tufts College
Boston, Mass.
Brooke Army Medical Center
Fort Sam Houston, Tex.
College of Puget Sound
Tacoma, Wash.’

Richmond Professional Institute, Col­
lege of William and Mary
Richmond, Ya.6
San Jose State College
San Jose, Calif.®
State University of Iowa
Iowa City, Iowa ’

College of St. Catherine
St. Paul, Minn.
Colorado A & M College
Fort Collins, Colo.’
Columbia University
New York, N. Y.“
Kalamazoo School of Occupational
Therapy, Western Michigan College
of Education
Kalamazoo, Mich.’
Michigan State Normal College
Ypsilanti, Mich.®
Mills College
Oakland, Calif.
Milwaukee-1 >o\vner College
Milwaukee, Wis.
Mount -Mary College
Milwaukee, Wis.
New York University
New York, N. Y.°
Ohio State University
Columbus, Ohio 0

Texas State College for Women
Denton, Tex.
University of Illinois, College of Medi­
cine,
Chicago, 111.®
University of Kansas
Lawrence, Kans.
University of Minnesota
Minneapolis, Minn.®
University of New Hampshire
Durham, N. H.®
University of Pennsylvania
Philadelphia, Pa.
University of Southern California
Los Angeles, Calif.®
University of Wisconsin
Madison, Wis.®
Washington University
St. Louis, Mo.®
Wayne University
Detroit, Mich.’

5 This list sub.iect to change. For more complete and later Information, write to the
American Occupational Therapy Association, 33 West 42d Street, New York 36, N. Y.
0 Accepts men students.

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OCCUPATIONAL. THERAPISTS

49

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o