Program History
History of Occupational Therapy in the Military
Army occupational therapy has a history of innovation in healing, born from the unique challenges of warfare. While the concept of therapeutic activity is ancient, its formalization as a therapeutic milieu for injured or disabled service members was forged during World War I (WWI). The war introduced a new, devastating scale of physical injury and invisible wounds known then as "shell shock." In response, the Army pioneered the use of "reconstruction aides" who used purposeful activity, from arts and crafts to vocational skills, restoring not just a service member’s body but their mind and spirit.
Reconstruction aides pioneered the use of meaningful occupation as remedial work for Soldiers injured in WWI to return to duty or to earn a living in civilian society. Under the direction of Major General William Gorgas, reconstruction programs were created to support neuropsychiatrists and orthopedic surgeons across England, France, and Canada. In 1918, occupational therapy aides were trained in the Army War Emergency Course to deliver ward occupations, shop and farm work, and curative workshops in reconstruction hospitals. Occupational therapy aides were a critical component of holistic rehabilitation laying the groundwork for Army occupational therapy. In December 1926, the Surgeon General’s office formally redesignated reconstruction aides providing occupation to occupational therapy aide thus, identifying the activities for which they were employed.
The first Army occupational therapy aide training course in military hospitals began in October of 1924 at Walter Reed General Hospital. The training course started as a 6-month course, however, was lengthened to a 9-month course in 1932. Occupational therapy was used in the treatment of patients with empyema, pneumonia, tuberculosis, mental illness, defective sight and hearing, amputations, fractures, and cardiac conditions. Occupational therapy aides continued to provide services in military hospitals although total numbers of practitioners declined during peacetime. In 1939, the U.S. president declared a national emergency due to Germany’s invasion of Poland and the buildup of Army strength began for the second world war.
World War II marked a period of dramatic expansion and cemented the profession's identity in neuropsychiatric and orthopedic rehabilitation. The demand for therapists rose dramatically for overseas deployment during wartime and to care for Soldiers in the U.S. during peacetime. This era validated occupational therapy as an essential element of combat readiness and recovery. On 16 April 1947, President Truman signed Public Law 80-36 establishing the Women's Medical Specialist Corps (WMSC), which granted occupational therapists, physical therapists, and dietitians Regular Army commissions. Recognizing that skill and leadership know no gender, the Corps began accepting men in 1955 and was aptly renamed the Army Medical Specialist Corps (AMSC).
Today, Army occupational therapists serve in a wide range of settings, from combat support hospitals in operational theaters to major medical centers like Walter Reed and Brooke Army Medical Center. The scope of modern Army occupational therapy is vast with practitioners recognized as specialists in post-surgical orthopedic rehabilitation to the highly specialized management of TBI, post-traumatic stress, and Soldier performance optimization.
Army-Baylor OTD Program History
The Army-Baylor OTD program creation was directed by Army executive order to meet the requirements of the Holistic Health and Fitness (H2F) System mission. The H2F System is the Army’s primary investment in Soldier readiness and lethality, optimal physical and non-physical performance, reduced injury rates, improved rehabilitation after injury, and increased overall effectiveness of the Total Army.
The Army-Baylor OTD program began admitting students in the Spring of 2022. The program received initial accreditation for 7 years by the American Council for Occupational Therapy Education (ACOTE) in 2024. The program curriculum requires 18 months of academic coursework, 12 months of clinical fieldwork, and a capstone to prepare students to become Army occupational therapists (65A) ready to serve the Army in a variety of practice areas. The program is scheduled for re-accreditation in 2031.
Graduates of the entry-level Army-Baylor OTD program are eligible to take the national certification examination administered by the National Board for Certification in Occupational Therapy (NBCOT) and apply for licensure that is required for practice in most states. Graduates apply for clinical privileging at a military treatment facility located at their first military duty assignment. Graduates only require licensing from a single state as they transition between duty assignments.
Graduates of the Army-Baylor OTD program deliver advanced clinical practice services to maximize Soldier performance and improve unit readiness. They address psychosocial, cognitive, physical, occupational, and environmental barriers and opportunities to prevent injury, mitigate injury risk, and facilitate rapid return to duty following injury. Some of these services address performance behaviors to include lifestyle habits, routines, sleep patterns, self-awareness, communication, cohesion, anger/stress management, and problem-solving skills. U.S. Army OTs have a rich tradition of providing healthcare during operational deployments with U.S. Forces. Army OTs have been assigned to Army Combat and Operational Stress Control (COSC) Detachments and have demonstrated historical success with 98% return to duty rates for service members experiencing combat and operational stress reactions. These results later supported employment of Army OTs in deployed concussion care centers and the 75th Ranger Regiment in support of operational deployments to Iraq and Afghanistan. The performance of Army OTs in the 75th Ranger Regiment led to the discipline’s inclusion in a four-battalion pilot program known as Forces Command’s (FORSCOM) Soldier Readiness Training and Test Program (SRT2P). The outcomes of the SRT2P led Army Senior Leaders to establish the H2F System whereby Army OTs are now routinely assigned to deployable units such as the 75th Ranger Regiment, Special Forces Groups, Army Brigade Combat Teams, and Army Medical Brigades.
Graduates of the Army-Baylor OTD program are well prepared to meet the health needs of the Army’s H2F System’s mission. They are servant leaders who drive change in Army Medicine to prepare the Army to compete and win in large scale combat operations (LSCO) against peer threats in multi-domain contested environments.
