Tracing the roots of occupational therapy: A qualitative systematic review of pre-1917 influences on the profession’s development

Background: Occupational therapy was formalised as a profession in the United States in 1917. The origins of the profession pre-1917 are fragmented in the literature and have yet to be reviewed systematically. Objectives: To identify the key historical influences, practices and ideologies that contributed to the development of occupational therapy before its formalisation in 1917. Methods: A qualitative systematic review was conducted across five databases: CINAHL, JSTOR, Scopus, Web of Science and PubMed. Inductive content analysis was employed to identify recurring themes and synthesise fragmented perspectives on the history of occupational therapy. Results: Twenty-six articles were included in the review. Methodological quality was rated ‘Moderate-High’ for six papers and ‘High’ for 20 papers. Four broad content categories were established: ‘Philosophical and Medical Ideologies of Occupational Therapy’, ‘Influence and Practices of the Arts and Crafts Movement’, ‘Ideological Change in the Progressive Era’, and ‘The Historical Influence of World War I on the Profession’s Development’. Conclusion: This review synthesises peer-reviewed historiography on pre-1917 influences on occupational therapy and identifies four recurring thematic domains. The findings clarify dominant historical narratives in the published literature, while also highlighting geographical and source-related limitations in the existing evidence base.