The Theory of Occupational Therapy
- Author:
Haworth and
i:a. ,4?n S, MacDonald. 3rd Edition. Bailli6re, lindall & Cox. 7s. 6d.
During recent years occupational therapy has become firmly established as an essential hospital practice. Although there still is a shortage of qualified therapists to carry out the work, there is a steadily increasing number of students in training, and while there is an ample literature on the teaching of crafts, there are very few books available on the theory of their application < in the treatment of the sick and disabled. Such is this book, and the fact that the demand for it has required the issue of a third edition in six years is in itself a sufficient indication that it continues to fulfil its useful purpose of providing a standard text book for the student preparing for the Diploma of the Association of Occupational Therapists.
The scope of the book goes much further than the purely theoretical aspects of occupational therapy, and it is perhaps as a practical guide that it will be found most useful. Problems of staff, equipment, materials, finance, and the general management of the department are fully dealt with, but rightly the main part of the book is concerned with the treatment of patients, who are considered in five separate categories, viz.: mental, orthopaedic, cardiac, tubercular, and industrial. The reader is warned that, ” Occupational therapy I alone does not cure, nor does it claim to do so, but it does claim to assist and hasten cure and again that, ” Occupational therapy is only one section of rehabilita- i tion “. There are some who would claim more, and it is here that one is tempted to raise the question whether the authors have not fallen into the now lamented error of the doctors, of treating disabilities rather than persons. When first introduced occupational therapy had the outstanding quality of being a treatment of the personality ; the psychological reaction to disease or injury was its primary concern, and the removal of a faulty reaction was considered to be just as remedial and individual as the re-education of a muscle.
The authors appear to have departed from that theory and to be content to regard morale as a minor factor in chronic cases in which ” only ” so-called general ] therapy is required; pride of place being given to what is called curative therapy. In a surgical hospital this means, ” To restore and improve function by (a) strength’ ening muscles, (b) increasing the range of movement in a joint, or (c) improving co-ordination To that end ingenious and most praiseworthy adaptations of looms and other apparatus are described for use by physically handicapped patients undergoing treatment in the curative workshop. The latter, however, ‘i? reserved entirely for ” special remedial treatment prescribed by the surgeon. Patients without a Pre| scription card may be given general occupations’ therapy by unqualified assistants or voluntary helpers* ‘ convenient, but otherwise ” it (general therapy) should be left and should not be carried out at the expense special remedial work
There is consistently throughout the book this emphasis of the importance of concentrating upon the correction . a particular symptom with the conscious co-operation an,d possibly pre-occupation of the patient, and whereas this may be very good and beneficial if the symptom disappears, what if it persists ?
The methods by which, under skilful direction, the Movements involved in certain crafts can be used as J^medial exercises, are admirably described in considerable detail. But although mention is made of the value ? a knowledge of psychology, the reader must be ,0rgiven if she forms the opinion that anatomy is more important. Even in the treatment of mental disorders, nich is described as a special branch, there is a bias n favour of attacking the obvious symptom in prefernce to a study of the personality background of the Patient, and a persistent implication that the recent nd curable case deserves the whole of the occupational papist’s time and attention.
‘his does not detract from the value of the book as n excellent guide to the practice of therapeutics by crafts, th m V*ew ^act * ^ ^ primarily a book on ide?ry’ anc? ^ears sornc degree of responsibility for the fufUS an<^ ‘^ea^s w*lh which the young therapist of the th Vre will embark on her profession, it is unfortunate nrff u Penological aspect of physical disabilities has . been more fully discussed.
c n an interesting appendix, there are useful notes on urseS of training and on the examinations held by the sociation of Occupational Therapists.
a he book is well and fully illustrated and contains Useful bibliography and list of suppliers. J.I.R.
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