Gail and Jay Fidler interpreted "psychoanalytic and object relation concepts as part of the communication process with patients in mental health settings" (Cole & Tufano, 2020).

Other theoretical developments that were applied to practice later include but are not limited to sensory integration, reflex development model, Bobath’s neurodevelopmental therapy (NDT).

There was a steady rise in individuals seeking OT education, but this declined drastically when OT transitioned from a bachelor's entry level to a master's entry level in order "[T]o raise the level of professionalism for occupational therapy to that of related health care disciplines such as physical therapy and speech-language therapy" (Cole & Tufano, 2020). Despite this decline, the need for OT services is steadily on the rise.

"Occupation-based models initiated in the 1990s have guided occupational therapists in learning to include contexts and environments within their interventions, embracing the view that their practice also includes adaptation of activity demands or expectations and the removal of environmental and social barriers to occupational justice (Cole & Tufano, 2020).

Decades later this idea was written as the, "[t]he kinetic model, published by Sidney Licht in 1947, provid[ing] a scientific basis for the analysis of activities using a biomechanical frame of reference. Claire Spackman interpreted this model for treating patients with physical injuries in the first edition of Occupational Therapy, which she edited with Helen Willard in 1947" (Cole & Tufano, 2020).

"[P]atients and staff met together each day (community meeting) to discuss treatment goals; structure the day’s educational, recreational, and vocational opportunities; encourage mutual responsibility for carrying out these goals; and engage in group problem solving to address issues with living and working together toward recovery (Cole & Tufano, 2020).

There were so many new theories and frames of reference that some suggested a need to return to the "original" paradigm of occupational therapy and this caused "[an] resurgence of interest in the history of occupational therapy" (Cole & Tufano, 2020).

"[O]ccupational science, as an academic discipline, is not concerned with practicality or usefulness. It is a purer form of study that seeks a better understanding of the form, function, and meaning of occupation for its own sake" (Cole & Tufano, 2020). This way, occupational therapy could uniformly focus on applying the research in a practical way.

"The Uniform Terminology for Occupational Therapy, Second Edition... [defines the] intersection of occupational performance areas and performance components (Dunn & McGourty, 1989). For example, a child’s sensory awareness (a performance component) could be addressed by occupational therapists during self-care, play, and classroom activities (performance areas). This process clarified occupational therapy’s role in health care by always addressing and reporting occupational therapy interventions in the context of occupations" (Cole & Tufano, 2020).

"[I]n order to adhere to the scientific objectivity of the biomedical model,...[occupational therapists use] procedural reasoning to [address] the client’s functional limitations through the specific assessment and intervention techniques appropriate for that area of disability in order to remediate, adapt, or compensate for lost occupational abilities" (Cole & Tufano, 2020).

However, the other two ways of reasoning (interactive & conditional) "tracks more closely resembled the client-centered approach, demonstrating that occupational therapists had retained the ideals of earlier years despite their lack of importance in medical settings" (Cole & Tufano, 2020).