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History of OT in Denmark

The History of Occupational Therapy in Denmark

Occupational Therapy Services

Occupational therapy started in the 1930s in Denmark . The first occupational therapists worked particularly with the occupation of psychiatric patients. The aim was to distract, divert and encourage. The work involved elementary needlework technique and the use of tools for the occupation of the handicapped. Since the beginning of the 1940s, patient reports became widespread, and more emphasis was placed on observations and the formulation of observations.

After the Second World War, there was a tendency towards function training, inspired among other things by the training of war invalids abroad. The allocation of employed therapists' occupation areas reflected the beginning of specialization: they worked in hospitals, recreation and care homes, institutions for the mentally handicapped, TB sanatoria, prisons, and some went on advanced training in the USA . Many were unemployed. In 1945, there were a total of 93 trained therapists. There was a tendency towards more specific treatment of the mentally ill, neurological and orthopaedic patients.

The occupational therapy profession is focusing to a greater extent on the consequences of somatic injuries and diseases, and new treatment methods are being developed to help patients to recover their capabilities and thereby cope on their own. The expansion of psychopharmaceutical drugs within the psychiatric field made occupational therapists work more with rehabilitation and work training, since the patients to a greater extent could be discharged from institutions and hospitals or function in another way in the institutions. This placed new requirements on the occupational therapists' qualifications and the occupational therapeutic treatment methods.

From 1953 to 1960, the number of positions at the somatic hospitals and institutions doubled so that this work area became larger than the psychiatric one. Focus was on rehabilitation in terms of legislation and specialization. The government supported the retraining of people who had been expelled from the labour market. In 1968, the 'Law on Therapy Assistants' was passed, which regulated occupational therapists' work.

At the beginning of the 1970s, the focus was on preventive work and a new Work Environment Act came into force with requirements on the establishment of an employees' health service, where many occupational therapists were employed.

In 1970, the employment areas were divided into 44 % somatic, 28 % social, 23 % psychiatric and 5 % students. More occupational therapists were entering into the work environment area. The social and elderly policy concept - for as long as possible in your own home - created a need for more advice on assistive technology devices, home adaptations and ADL training.

In 1975, it was decided by law that patients at the time of discharge from hospital should be provided with assistive devices. Many counties and local authorities established local centres for assistive technology devices. The product development of assistive technology was started by public and private businesses with substantial participation by occupational therapists. Some of the rehabilitation given to patients at the hospitals so far was to a greater extent moved out to local authority training and rehabilitation centres.

This was a period of closer links to medical science disciplines and the requirement on medical and scientific qualifications was embraced by the occupational therapists' association in the form of post-qualifying courses.

This scientific track existed in parallel with the early humanistic basis. The period from the end of the 1970s to the end of the 1980s was characterised by an incipient debate on the theoretical basis of occupational therapy. In connection with this track, there was now also a link to social medical criticism and criticism of society. These different theories and methods lay alongside the different context in which occupational therapists worked.

The 1980s saw a development in society where welfare services were decentralised, and in some cases also privatised. Among other things, the care of handicapped people was passed out to the counties, and the residents moved out to smaller institutions and residences in local societies. Focus turned to daily activities, which occupied the central focus of all occupational therapy work areas and specialisations.

Greater requirements were placed on occupational therapists' theoretical and practical knowledge, and the profession began to specialise. Among others, the fields of children's health, acquired brain damage, and psychiatry experienced a knowledge boost.

The 1990s saw the arrival of quality assurance and quality development on the agenda. There was a need to clarify and to document the effects of occupational therapy, and the development of models of theory and methods was inspired by Canadian theories, among others. An interest in more research-based knowledge became apparent, and more occupational therapists were given further academic training.

In the 21st century, the occupational therapists still find themselves in a borderland between the medical research area and the social / humanistic area. Primarily the occupational therapy work focuses on the possibilities of the individual person in connection with the daily activities and participation in social life. The occupational therapist has methods and knowledge to solve activity problems. The main purpose of the occupational therapy intervention is to strengthen the resources of the citizen on the basis of an overall evaluation and in accordance with the citizen's own opinion.

Occupational Therapy Education

Occupational therapy started in the 1930s in Denmark . The first occupational therapists worked particularly with the occupation of psychiatric patients. The aim was to distract, divert and encourage. The work involved elementary needlework technique and the use of tools for the occupation of the handicapped. Since the beginning of the 1940s, patient reports became widespread, and more emphasis was placed on observations and the formulation of observations.

After the Second World War, there was a tendency towards function training, inspired among other things by the training of war invalids abroad. The allocation of employed therapists' occupation areas reflected the beginning of specialization: they worked in hospitals, recreation and care homes, institutions for the mentally handicapped, TB sanatoria, prisons, and some went on advanced training in the USA . Many were unemployed. In 1945, there were a total of 93 trained therapists. There was a tendency towards more specific treatment of the mentally ill, neurological and orthopaedic patients.

The occupational therapy profession is focusing to a greater extent on the consequences of somatic injuries and diseases, and new treatment methods are being developed to help patients to recover their capabilities and thereby cope on their own. The expansion of psychopharmaceutical drugs within the psychiatric field made occupational therapists work more with rehabilitation and work training, since the patients to a greater extent could be discharged from institutions and hospitals or function in another way in the institutions. This placed new requirements on the occupational therapists' qualifications and the occupational therapeutic treatment methods.

From 1953 to 1960, the number of positions at the somatic hospitals and institutions doubled so that this work area became larger than the psychiatric one. Focus was on rehabilitation in terms of legislation and specialization. The government supported the retraining of people who had been expelled from the labour market. In 1968, the 'Law on Therapy Assistants' was passed, which regulated occupational therapists' work.

At the beginning of the 1970s, the focus was on preventive work and a new Work Environment Act came into force with requirements on the establishment of an employees' health service, where many occupational therapists were employed.

In 1970, the employment areas were divided into 44 % somatic, 28 % social, 23 % psychiatric and 5 % students. More occupational therapists were entering into the work environment area. The social and elderly policy concept - for as long as possible in your own home - created a need for more advice on assistive technology devices, home adaptations and ADL training.

In 1975, it was decided by law that patients at the time of discharge from hospital should be provided with assistive devices. Many counties and local authorities established local centres for assistive technology devices. The product development of assistive technology was started by public and private businesses with substantial participation by occupational therapists. Some of the rehabilitation given to patients at the hospitals so far was to a greater extent moved out to local authority training and rehabilitation centres.

This was a period of closer links to medical science disciplines and the requirement on medical and scientific qualifications was embraced by the occupational therapists' association in the form of post-qualifying courses.

This scientific track existed in parallel with the early humanistic basis. The period from the end of the 1970s to the end of the 1980s was characterised by an incipient debate on the theoretical basis of occupational therapy. In connection with this track, there was now also a link to social medical criticism and criticism of society. These different theories and methods lay alongside the different context in which occupational therapists worked.

The 1980s saw a development in society where welfare services were decentralised, and in some cases also privatised. Among other things, the care of handicapped people was passed out to the counties, and the residents moved out to smaller institutions and residences in local societies. Focus turned to daily activities, which occupied the central focus of all occupational therapy work areas and specialisations.

Greater requirements were placed on occupational therapists' theoretical and practical knowledge, and the profession began to specialise. Among others, the fields of children's health, acquired brain damage, and psychiatry experienced a knowledge boost.

The 1990s saw the arrival of quality assurance and quality development on the agenda. There was a need to clarify and to document the effects of occupational therapy, and the development of models of theory and methods was inspired by Canadian theories, among others. An interest in more research-based knowledge became apparent, and more occupational therapists were given further academic training.

In the 21st century, the occupational therapists still find themselves in a borderland between the medical research area and the social / humanistic area. Primarily the occupational therapy work focuses on the possibilities of the individual person in connection with the daily activities and participation in social life. The occupational therapist has methods and knowledge to solve activity problems. The main purpose of the occupational therapy intervention is to strengthen the resources of the citizen on the basis of an overall evaluation and in accordance with the citizen's own opinion.

Occupational Therapy Organisation

The Danish Association of Occupational Therapists

The first courses and interest groups were implemented in the 1930s on the Danish Handicrafts Society's premises. 'The Association of Work and Occupational Therapists' was formed in 1938. In 1940, the sheet entitled 'Work and Occupational Therapists' was issued. The Association had 45 active members.

In 1944, the Association entered into a collective agreement with Copenhagen Local Authority. Work was carried out to get influential medical professors and administrators to broaden the knowledge of the profession. In 1948, the Association demanded that the members be salaried as senior clinical nurses. Courses were arranged and the Association was linked to 'The Nordic Countries' Association [Foreningen Norden]' and the 'World Friendship Association'.

In 1949, the Association gained a representative from the Danish National Board of Health on its board of management. In 1952, the Association participated in the establishment of WFOT. In 1956, the designation of 'authorised occupational therapist' came about, and the Association reached a collective agreement with the Hospitals' Association [Sygehusforeningen] and in 1959, the Association was accepted into FTF (Salaried Employees' and Civil Servants Confederation) which covers the majority of public employees with medium training.

In 1960, only 1/3 of all announced positions were occupied, and the Association advocated for the training of more people. At the start of the 1960s, salary and pension conditions became characteristically more organised. In 1962, a collective agreement was reached which meant that a salary structure was determined by seniority over 16 years, and management salaries were divided into pay for 0 - 4 subordinate staff and pay for more than 4 subordinate staff. In 1963, the Association's members became part of the Pension Fund for physiotherapists and occupational therapists. Occupational therapist ('ergoterapeut') became the official job designation in 1967.

In 1970, the Association had 482 active members and 248 passive members, and the chairman was a full-time employee. In 1972, the Association acted for the first time as a trade union, and a strike contingent was introduced. In 1973, occupational therapists went on strike for better salary and employment conditions.

In 1977, the Association established a committee to work with advanced training and to establish a research fund. In 1983, the Association set up a research fund to which the members paid a special membership fee. The objective was to stimulate the commissioning of occupational therapy research. In 1994, the Danish Society for Occupational Therapy Research was formed.

As of the end of the 1980s, the Association pressed for an agreement to be reached with the Health Insurance for independently practising occupational therapists. This has still not been achieved, however.

Most of the initiatives in the development of the profession came from the Association, which supported the advanced training of occupational therapists through an 'academic pool', and research and development projects are supported at the workplaces. In 2005, the first Danish research unit will be set up in occupational therapy at the University of Southern Denmark, financed by the Danish Association of Occupational Therapists for an initial period. The plan is for the research environment to later be able to continue without the financial contributions from the Danish Association of Occupational Therapists .

The Association of Occupational Therapists' contribution broadly lead to the increasing professionalization of occupational therapy. This professionalization is a general tendency of Danish organisations in the social and health areas. There is a growing interest and more effort is being put into expanding research and systematic quality development.

In 201, the Association has 6 000 active members and 1000 student members. This corresponds to around 1 occupational therapists per 1 000 inhabitants. The Association has a central office and 3 regional offices. There are 13 specialist societies within occupational therapy work areas, established under the auspices of the Association. Members can be approved specialist OTs in seven of these specialist areas.

There are around 350 management members and around 315 trade union representatives. The Association organises 91 % of all authorised occupational therapists. Unemployment is at around 3 %. The Association has collective agreements with the government, regions and local authorities, and there are around 70 independently practising / free lance members. The Danish Association of Occupational Therapists is a member of WFOT, COTEC and ENOTHE.

The object of the Association is to safeguard the professional and financial interests of its members, which is reflected in the fact that, in addition to being a trade union the Association is also a professional association with great influence on the development of the profession and the legislation in this area.

Sidst opdateret
31.08.2017