Finding out what makes us happy, productive and healthy – task by task, person by person – is the mind-boggling mission of USC’s occupational therapy department, recognized as America’s premier program in the little-known field.

HAPPINESS. How to attain it has been the obsession of a generation, with pop formulas freely dispensed by the likes of “Peanuts” creator Charles M. Schultz (“a warm puppy”) and scatman Bobby McFerrin (“don’t worry”). Americans are so preoccupied with happiness there ought to be a science devoted to it.
And, in a way, there is. It’s called occupational science, and practitioners whose work is based on it are called occupational therapists.
What, you may ask, is an occupational therapist? That’s just the trouble. Despite over 80 years of mounting achievement, occupational therapy – OT for short – remains largely unfamiliar, though it touches the lives of millions of stroke and burn survivors; people living with Parkinson’s disease, Alzheimer’s disease, arthritis and cancer; children with developmental disabilities; the well elderly; people with amputations or weight problems; and, increasingly, run-of-the-mill, stressed-out urbanites looking to improve their physical and emotional well-being.
Since in all likelihood you know little about occupational science or therapy – let alone that USC offers bachelor’s, master’s and doctoral degrees in it – you probably also didn’t realize that USC is America’s premier institution in the field. In April 2001 (which happened to be “National Occupational Therapy Month”), for the fourth consecutive year the USC Department of Occupational Science and Occupational Therapy ranked No. 1 (out of 68 accredited programs) in the U.S. News & World Report’s guide to best graduate schools.
In 1997, USC set a milestone for the whole profession when the prestigious Journal of the American Medical Association published its very first article on OT research. The landmark JAMA piece reported the findings of the USC Well Elderly Study – a clinical trial headed by department chair Florence Clark PhD ’82 and professor Ruth Zemke – documenting the striking benefits of occupational therapy on independent-living senior citizens.
“We showed that preventive OT actually slowed down the decline associated with aging, and in some cases improved health,” says Clark, who lectures internationally and has appeared on CNN, National Public Radio and at the National Press Club spreading the good word about her under-appreciated profession.
Despite Clark’s persistent efforts and a stream of proven results, OT remainsstubbornly obscure.

Florence Clark
Consider the 1989 death of pediatric OT giant A. Jean Ayres. The pioneering USC professor’s name is practically synonymous with sensory integration, a leading approach for treating children with a host of developmental problems, including autism and dyslexia.
“Dr. Ayres developed all the concepts,” says OT Terri Nishimura MA ’85. “Yet when she passed away, it was so hard to convince the Los Angeles Times to print an obituary. If she had been a silent movie star in just one film....” Nishimura shrugs.
Though a long-established part of rehab and a staple of inpatient psychiatric care, occupational therapy is largely unrecognized in other arenas.
“When I say I’m an OT, I do sense that people are respectful,” says pediatric therapist Kim Wilkinson MA ’01, who is a Ph.D. student in USC’s world-class occupational science program. “The ‘therapist’ word – it’s impressive. Although,” she adds ruefully, “some people expect a massage, and some people want to lie down on the couch and tell me their problems.”
Appropriately enough, by learning about the science of happiness, you, reader, can create a little. Just by reading this article, you’ll make 73,000 people happier. That’s how many occupational therapists there are in the United States, according to the Bureau of Labor Statistics, and most are eager to promote a better understanding of their profession.
“Imagine never having to answer the question ‘what is occupational therapy?’” a wistful Barbara Kornblau mused in her inaugural address as president of the 50,000-member American Occupational Therapy Association last April. “Imagine a world in which everyone knows ... and values what we do.”


SO ONCE, AND FOR ALL, what is occupational therapy? If counseling is “talk therapy,” Clark explains by analogy, then occupational therapy might best be described as “doing therapy.”
It’s a mistake, in this context, to think of “occupation” in the usual sense, the one found at the bottom of your 1040 form. “By occupation, we don’t mean paid employment,” she says. “We mean: that with which we all occupy our time every day, the chunks of daily activity that fill the stream of time and that really comprise the bulk of our existence. It includes work, but it goes beyond that, to what we do for self-care, leisure or spiritual comfort.”
OT practitioners work in a wide range of areas, in pediatrics and geriatrics; with hand injuries and brain injuries; with those disabled from birth as well as those disabled by fire, spinal cord trauma or chronic mental illness; and, increasingly, with “normal” folks struggling to curb behavioral problems like overeating and road rage. “It’s situated in everyday life,” says associate professor Mary Lawlor, “and that’s what makes it obscure.”
OTs don’t have a standard uniform but dress in ways that conform to the diverse settings in which they work. “One of the reasons people don’t have a clear picture
"By occupation, we mean that with which we all occupy our time every day. It includes work, but also what we do for self-care, leisure or spiritual comfort.”
of the profession is that we all look so different from one another,” says professor Linda Fazio.
What all OTs have in common, however, is the broad mission of assisting clients or patients (neither word does justice to the relationship, says associate professor Diane Parham MA ’80, the former being too commercial, the latter too clinical) to achieve satisfaction in their lives, despite physical or psychological constraints or the pressures of modern society, on a case-by-case basis.
The aim of therapy might be as simple as helping a stroke survivor play bridge again, or as complex as helping a cognitively disabled young man achieve his dream of driving a race car (a real-life case study taught at USC describes how this very young man, under an OT’s sustained guidance, went from passing his driver’s test to taking lessons with a racing pro.)
And here’s where the science of happiness comes in. At the cutting edge of occupational therapy is a new movement, called “lifestyle redesign,” invented and actively practiced at USC.
Clark – who with Zemke and faculty colleagues Jeanne Jackson MA ’86, PhD ’95 and Deborah Mandel MA ’95 did the clinical trials reported in JAMA – calls it “a therapeutic approach for redesigning one’s days in such a way that one can be happy, maximally productive and experience emotional well-being.”
The major health problems of the 21st century are lifestyle-induced, argues Clark, whose private practice includes elderly people as well as those with weight problems, diabetes, heart conditions or trouble managing their daily lives.
“Our bodies weren’t designed for sedentary activity,” she says. “For thousands of years, humans were hunter-gathers. Males burned, on average, 3,000 calories a day, running maybe 10 miles a day with 20 pounds of meat on their backs. The women carried children, relocated campsites, gathered vegetables and processed the meat. With our sedentary lifestyles, we burn at most 1,800 calories a day. By comparison,” she says, “we are atrophied.”
Popular magazines and morning talk shows harp on the evils of poor nutrition, stress and a sedentary existence, yet “I still think Americans don’t fully understand the profound effect what they do every day, what they eat, how much they exercise, their level of happiness has on their health,” she adds. “So I think a lot of Americans need lifestyle redesign.”
One of lifestyle redesign’s basic tenets flies in the face of conventional wisdom. It holds that a person’s health, happiness and character are shaped not only by life’s crises (a stint in Vietnam, the death of a loved one), but also by the vast stretches of time spent in ordinary pursuits. “The ‘everydayness’ of life should not be underestimated in its overall effect over time on health,” says Clark. “Daily activities are the building blocks of the self. Just as we eat certain things at intervals, we are doing things all day long. And whenever we answer the question ‘how was your day?,’ our stories usually label them.”


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