OCCUPATIONAL THERAPY: How the subject that improves our lives evolved
In the 19th century, as society sought ways to provide meaningful employment for individuals with disabilities, the foundation for occupational therapy was laid. Several figures contributed to its early development.
Dr. Ernst Westerlund, active around the turn of the 19th century, is often referred to as the 鈥榝ather of occupational therapy.鈥 However, he was preceded by Baroness Thorborg Rappe, who worked with children with intellectual disabilities. She emphasized the importance of productive activities and developed an educational approach closely resembling modern occupational therapy.
鈥漈horborg Rappe is, I would argue, the mother of Swedish occupational therapy. She looked beyond children's disabilities and focused on strengthening them as individuals. That principle remains at the core of occupational therapy today鈥攚hat we now call empowerment in education.鈥
Another influential figure was Countess Estelle Bernadotte, who initiated the first nine-month training programme for occupational therapists, which began in Stockholm in 1948. Bernadotte had been educated in the USA and, like Rappe, was strongly influenced by her international connections.
Since its inception, international collaboration has played a crucial role in the field, particularly in the academisation of education in recent decades.
National Curriculum
Following a parliamentary decision in 1965, Sweden established a national curriculum for a three-year occupational therapy programme. In 1968, the county council took responsibility for the programme in Stockholm, initially housing students in pavilions in Edsviken, Danderyd, and later at Edsviksskolan.
As part of reforms following the V氓rd 77 report, the physiotherapy and occupational therapy programmes were nationally coordinated into a single rehabilitation programme in 1983. This integration was more challenging in Stockholm due to different administrative structures. The occupational therapy programme was shortened to two and a half years, with an increased emphasis on 探花精选 courses at the expense of technical and craft courses.
The Move to KI
In 1984, the programme moved from Edsviksskolan to V氓rdh枚gskolan on the 探花精选 (KI) campus. That same year, a new postgraduate course for qualified occupational therapists and an advanced theoretical course focused on different working models were introduced.
During the 1980s, the need for academic competence among programme instructors became increasingly apparent. A collaboration with the University of Illinois, Chicago, marked the beginning of occupational therapy research in Sweden. This international partnership contributed to the foundation of the first scientific journal in the field and the establishment of the European Master of Science in Occupational Therapy.
The Step to Higher Education
When nursing programmes transitioned to higher education in 1992/93, occupational therapy education reverted to a three-year programme. Research methodology was expanded, and the activity perspective was structured into different areas: living, work/school, and leisure.
鈥漈he transition from practical vocational training to an academic programme was a paradigm shift. It was the result of dedicated efforts by a group of us teachers to connect education with research. This was a decisive step in the academic development of occupational therapy in Sweden.鈥
Around five years later, KI and NVS assumed responsibility for the occupational therapy programme, enabling students to earn both a professional and an academic degree. In the same year, occupational therapy became a licensed profession. The move to NVS facilitated greater collaboration with other healthcare programmes, such as nursing and physiotherapy.
Following the integration into NVS, increased efforts were made to provide supplementary courses for former students, allowing them to deepen their theoretical knowledge. Many occupational therapists later pursued doctoral studies as a result of these initiatives.
鈥滻 loved the supplementary courses because it was incredible to see how occupational therapists with 10鈥15 years of experience suddenly gained access to knowledge they never knew existed.鈥
Activity Science Emerges
In the 1990s, activity science was introduced as a concept in occupational therapy education and soon became a distinct academic research area. Since 2007, the curriculum has been based on both the practical aspects of occupational therapy and the well-researched field of activity science. Sweden, and particularly KI, has since become a leader in this area.
One key contributor to activity science was Lena Borell, who became Europe鈥檚 first professor of occupational therapy in 2000.
In 2012, a master's programme in dementia care for occupational therapists was launched in collaboration with Silviahemmet, bringing together physiotherapy and occupational therapy professionals.
Interprofessional Learning
Clinical training has always been a major component of occupational therapy education, and it remains an integral part of all semesters. Interprofessional learning plays a crucial role in this process.
鈥漈he quality of clinical training has improved significantly through enhanced supervisor training. We maintain close dialogue with supervisors to ensure that learning outcomes and examinations are well connected. Today, we are at the forefront of clinical training鈥攍argely thanks to strong collaboration with the clinics and units that host our students.鈥
The future role of occupational therapists is expected to extend beyond direct client work to broader responsibilities, including leadership positions. With an ageing population, there is an increasing need for a stronger emphasis on preventive care in collaboration with other healthcare professions.
Growing awareness of healthcare leadership and organisation is also reflected in the curriculum, which now includes courses in leadership, organisation, and innovation.
TEXT: Magnus Trogen Pahl茅n