From the wretched laundry to a lovely solarium: the history of the therapeutic use of occupation in Ireland, 1863-1970

Historical research can foster critical understandings of occupational therapy. It can facilitate greater appreciation of the context within which contemporary practice and assumptions developed, and can contribute to present day debates on the role of occupation within occupational therapy. This thesis aims to construct a chronology of the therapeutic use of occupation from the Moral Treatment era through to the mid-20th century establishment of the profession of occupational therapy in Ireland. It aims to use the emergence of Irish occupational therapy education as a means of understanding the professionalisation of the discipline. Finally, it takes an interpretative analytical perspective to situate the history of the profession in Ireland in broader social, political, and healthcare contexts. The thesis comprises four papers, each of which contributes to achieving the aforementioned aims. Paper I, a methodology paper, critically reviews literature on the use of historical documentary research methods in occupational therapy. It describes a practical strategy for selecting and appraising documentary evidence, and presents several theoretical and critical paradigms that can be used to interpret the meaning of historical documents. Furthermore, it establishes the value of interpretivism, which is the epistemological perspective taken throughout this thesis. Paper II reviews existing literature on the history of the therapeutic use of occupation in Ireland from 1863-1963 prior to the establishment of the first occupational therapy programme at St. Joseph’s College of Occupational Therapy, Dún Laoghaire, Co. Dublin. It describes three significant transitions: from moral treatment to the medical patronage of occupational therapy, from medical patronage to the era of pre-professional occupational therapy workers, and from pre-professional workers to the era of professionally qualified occupational therapists. Paper III uses historical documentary research methods, supplemented by oral history methods, to construct an instrumental case study of the development of occupational therapy at St. Patrick’s Hospital, Dublin. It explores the contributions of significant individuals, identifies the links between occupational therapy and psychiatry, and situates the development of occupational therapy at St. Patrick’s Hospital in broader social and cultural contexts. Paper IV is an oral history study that explores the experiences and perceptions of occupational therapy students of St. Joseph’s College of Occupational Therapy from 1963-1970. The oral histories portray multiple professionalisation strategies that were used to establish occupational therapy in Ireland, including educational credentialism and efforts made by the participants to distinguish themselves from pre-professional occupational therapy workers. The thesis establishes a chronological timeline of the development of occupational therapy in Ireland for the first time. Furthermore, it considers professionalisation and analyses its impact on occupational therapy practice and philosophy. It illustrates the relationship between occupational therapy and psychiatry, the role of occupational therapy in institutions, and the history of the therapeutic use of occupation in an Irish context.