Future of Occupational Therapy -- Past, Present Ideas

OCCUPATIONAL THERAPY -- NAVY & ORANGE  2025 into the Future

In 2025, Occupational Therapy Australia announced a new colour scheme and logo change. A new logo and colours signifies systemic changes in vocabulary used within the profession. Over time, the requirements for practice have changed to keep up with social and political changes. Therapists tend to have a more specialised role as the practice frameworks have been applied to pioneering areas that expand concepts of possibility. 

Artificial Intelligence is impacting therapy practice and education--rivaling the foundational hand-crafted historical basis of occupational therapy. The processes of problem-solving and adapting to disability persist through therapists devising solutions in customised design and fabrication of assistive technology (formerly known as 'adaptive equipment.)' New directions signal greater recognition of the role of consumers in deciding how they want to be supported.

A new definition of Occupational Therapy has been proclaimed by the World Federation of Occupational Therapists (WFOT) in 2025:

“Occupational therapy promotes health and wellbeing by supporting participation in meaningful occupations that people want, need, or are expected to do.”(WFOT, 2025).

The new definition does not prescribe how therapists will work, and challenges the individualised one-to-one notion of delivering services. There is hope for more population-based, local and international complex problem-solving across borders of discipline incorporating leadership by consumers. Cultural engagement and collaboration are at the fore.

OCCUPATIONAL THERAPY WENT PURPLE 1986 into the new millennium

The logo and colours used by Occupational Therapy Australia changed to purple and golden yellow. Change was very welcome to accompany new ways of thinking and consumers supported by advocates. De-institutionalisation occurred in 1986 when many people with a disability moved out of institutional care into homes in the community and Residential Care Officers replaced Nurses and medical-model oriented teams. 

The Social Model of Disability and Recovery Models demonstrated Wolfensburger's 'Normalisation' of care as services moved into communities following institutional closure. Community Health centres thrived with well-equipped therapy services.

In the last 15 years, National Disability Insurance Scheme (NDIS) brought a revolution to therapy practices, in how services are funded--with consumers taking the lead in setting goals and priorities for use of their own funding.

Funding dwindled to Community Health Centres as therapy services shrunk. Culturally safe and culturally relevant services were an important feature of the new millennium. Deinstitutionalisation went hand in hand with normalisation, social model of disability, and recovery-oriented practice. De-colonisation grew with social reform. Social justice approaches aligned with a more political and participatory approach to practice (Whiteford et al, 2018). The number of players grew with consumers becoming active and gaining recognition as having expertise in healthcare / disability services. This saw more engagement in collaborative partnerships with therapists and the introduction of new funding categories for Support Coordinators and Plan Managers.

The National Disability Insurance Scheme supported participants to self-manage their own funding and decision-making, as far as able. Occupational Therapists were in demand for providing Functional Capacity Assessments and Review Reports to justify allocation of NDIS funding for supports that are 'reasonable and necessary.' The number of people with a disability in receipt of NDIS services grew and grew to the point that in October, 2024, NDIS re-structured processes to contain and reduce government costs. Changes in legislation for social justice, NDIS and disability services were paramount to the political changes and re-distribution of funding. Aged Care reforms also changed the service environment. 

Hand-Crafted Occupational Therapy  1960s to early 1980s    Bottle Green and White

In 1978, Occupational Therapy used concepts of adaptation (temporal, psychological, physical, social, environmental), time-use, and meaningful occupation. We entered the UQ School of Occupational Therapy through a rain-forest path under a leafy arch canopy. Strangely, this off-set the smell of formaldehyde emanating from the adjacent anatomy laboratories. Lecture rooms were not air-conditioned and were ventilated by fans and louvres. We carried a heavy collection of five cent pieces to feed photocopiers for learning materials that were found through the library card index catalogue search, and we browsed databases in huge volumes, later microfiche research. Assignments were typed on typewriters, or handwritten.

The primary concern was for adaptation to disabilities, illnesses, injuries through engagement in occupations (work, rest, play, self-care, activities of daily living, recreation). 

Creative arts were a key modality for improving health. Therapist ingenuity through collaboration and problem-solving was at the forefront of helping. As a helping profession... We kept Problem-Oriented Written Records--that documented the Activity Analysis process which was applied in health, hospital, education, and community contexts.

Practical workshops involved learning processes of analysis, problem-solving, creative design, fabrication of assistive devices in woodwork, leatherwork, and making splints/prostheses. Learning was through case studies and group laboratories--brain-storming solutions, making prototypes of adaptive equipment, trials, measurement, sharing ideas and receiving feedback.

Art / craft laboratories involved working in groups to adapt arts/crafts for people's disabilities and health conditions. Creative Arts, Psychodrama and play therapies were used in paediatrics and mental health classes. 

Play was experiences through riding prone on scooter boards down the University hallways--with first-hand experience of toys and designing innovative toys for projects.

We traversed the campus in wheelchairs to learn about overcoming obstacles and barriers to access and mobility.

Time was spent in physical interaction face-to-face with people, and/or telephone communication and chatting with colleagues. Typewriters clicked away with secretaries typing from handwritten reports or making stencils for educational handouts.

Every Occupational Therapy school had a Creative Arts Laboratory and Woodwork room and cabinet with assessments and adaptive equipment. Leather, polyethylene and thermoplastic materials were used to fabricate postural supports, splints, adapted equipment. Therapists sewed adapted clothes, and made long-handled equipment from coat hangers, and sock gutters from discarded Xrays. Attendance at lectures / tutorials was always face-to-face throughout the day or night on the University campus.

Many people with a disability lived in Mental Institutions or Residential Aged Care Facilities. Therapists worked in Activity Therapy Centres that supported vocational activity programs for people with a disability--a mix of work, socialisation, and recreation. Hospitals funded therapy through Hospital Boards and later through Queensland Government. The Federal Government employed therapists in Vocational Rehabilitation Centre. Therapy was free to clients.

Therapists dressed in bottle green culottes which they usually sewed themselves, with white shirts, and white leather lace-up shoes (following the British therapist dress code). We made green checked bloomers and a draw-string bikini top as the required attire for surface anatomy tutorials. Both Physiotherapists and Occupational Therapist trained together for many courses. Physiotherapists wore navy blue culottes. Occupational Therapy and Physiotherapy were one profession up until late 1950s-1960s, with therapists qualified in both disciplines at this time. Speech Therapists were nearby on campus--usually part of multi-disciplinary teamwork.

Fieldwork placements covered the required 1,000 hours of supervised therapy experience in the areas of: physical rehabilitation, paediatrics, mental health with therapists gaining broad skills in various settings.

FRAMEWORKS

Given the insidious rise and fall of creative arts which paralleled computerisation and networking, both new and old ways of creative thinking are needed. 

Therapists require:

* ability to problem-solve and adapt to disability including environmental barriers / and restrictions imposed through social attitudes; 

* ability to devise creative solutions growing from consultation and participation of people with a disability; inclusion and shared leadership of projects;

* access to state-of-the-art materials and methods for design and construction of adaptations; learning new and applying technologies

* re-purposing materials and methods to bring change in ways of working;

* using and managing time to enhance the therapeutic process 

* retaining the beauty of the natural world through using natural environments and hand-made materials;

* transmission of skills and knowledge to the next generation of how to modify environments and design / construct and create to meet the people's needs.

* maintaining flexibility to take on board new ideas and new ways of working--learning from others.

The Philosophy of Occupational Therapy developed by Adolph Meyer and other pioneers continues to guide thinking and practice. New cultural awareness and participation of people with a disability is essential. Also retaining creativity, problem-solving and adaptative flexibility is key to our success. Learning new ways of using technology is continuing, with artificial intelligence impacting practice.

References

Gunarathne, P.C. (2025) Redefining occupational therapy: A human rights and social justice perspective. https://www.linkedin.com/pulse/redefining-occupational-therapy-human-rights-social-gunarathne-kgmkc/

Whiteford, G., Jones, K., Rahal, C., & Suleman, A. (2018). The Participatory Occupational Justice Framework as a tool for change: Three contrasting case narratives. Journal of Occupational Science, 25(4), 497–508. https://doi.org/10.1080/14427591.2018.1504607

World Federation of Occupational Therapists Definition of Occupational Therapy https://wfot.org/about/about-occupational-therapy