Academic journal article British Journal of Occupational Therapy

The Way We Were: Thinking Rationally

Academic journal article British Journal of Occupational Therapy

The Way We Were: Thinking Rationally

Article excerpt

This is the second of three articles arising from a study that employed a history of ideas approach to explore how occupational therapists working in the United Kingdom before 1962 thought about their practice. The perspective taken was that people think about things in ways that are consistent with Western society's philosophical roots in Romanticism and rationalism. The data were drawn from books and journals published between 1938 and 1962. The purpose of the study was to learn about the profession as it was being established, in order to increase understanding of current practice issues and concerns.

The focus of this article is occupational therapists' rationalism, which is evident in their careful accrual of technical expertise and attempts to account for their practice. Over time, occupational therapists' proclivity to organise and expand their knowledge base supported developments in vocational rehabilitation and activities of daily living programmes. These efforts were encouraged by other health professions and while they helped to secure occupational therapists' place in rehabilitation settings, they also contributed to the decline in craftwork, an emphasis on independence in activities of daily living, and circumscribed therapeutic goals.

Key words: Occupational therapy, history of the profession, rationalism, technical expertise, knowledge base, philosophy, history of ideas methodology.


This article builds on an earlier discussion of occupational therapy's development in the United Kingdom, in the 25 years between 1938 and 1962, which revealed the profession's philosophical roots in Romanticism and the Arts and Crafts Movement. The first article in this series of three presented an analysis of published literature, focusing on the craft equipment and supplies that occupational therapists used and the crafted objects that they taught patients to make. The discussion revealed that occupational therapists' work and their accounts of therapeutic success were rooted in the Romantic assumption that, by making things, patients could be transformed. They would rise above their circumstances, whether caused by physical or mental illness, confinement to an institution or the depravities of industrial work, to release unsuspected creativity, dignity and soulfulness (Hocking 2008).

In this article, which discusses the same period, attention turns to occupational therapists' equally prominent proclivity to be rational. Their rationality is revealed in the things that they designed, manufactured, adapted, adopted into practice, debated, accounted for, used, prescribed and supplied, as well as those that they directed instructors and patients to make and use. The discussion will reveal that therapists' rationality centred on the needs of the profession at that time: to develop its knowledge base, improve patients' mental and physical health, and be accepted as part of the health service and, later, rehabilitation teams. To those ends, therapists organised what they knew, applied mechanical principles, made careful observations, catalogued which activity to use with which diagnosis, and both developed and applied theoretical explanations of the efficacy of their treatments. To make evident the rationality underlying these actions, it is necessary to outline briefly both the history and meaning of rationalism and its impact on Western people's worldview, way of thinking, values and actions.

An introduction to rationalism

The terms rationalism and Romanticism refer to the way in which people

think, reason and argue and, accordingly, the things that they value, what they do, and their expectations and assumptions. In essence, rationalism means having a rational justification for all one's beliefs and actions, developed through rigorous inquiry and deliberation (Nathanson 1994). That idea emanates from Socrates' and Plato's rationalist ideals of aspiring to the truth, impartiality, objectivity and autonomy of judgement. …

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