Work hardening: occupational therapy in industrial rehabilitation.

Work hardening, presented in this paper as a "new" service for the industrially injured, is actually well grounded in the traditional models and practices of occupational therapy. From the profession's early roots in industrial therapy to the development of a variety of programs for the industrially injured through the 1950s and 1960s, the historical and philosophical bases of occupational therapy support the use of work as an evaluative and therapeutic medium. What is actually new is the adoption of terminology, technology, and a program format that fits in with the needs of consumers in the 1980s. Recent developments that created the need for the specialized services that occupational therapists are uniquely qualified to provide include growth of private sector vocational rehabilitation, changes in workers' compensation laws, and increasing costs of vocational rehabilitation. This paper describes work hardening in its present form. A case example is given that demonstrates how work hardening can be a cost-effective and time-saving bridge which spans the gap between curative medicine and the return to work.