Dorset House: the early years (1929 - 1939)

  • Inspiration

    Dorset House, the first School of Occupational Therapy in the UK, was established by its visionary Medical Director, Dr Elizabeth Casson (1881 - 1954) ( pictured, aged 21), in the latter part of the 1920s. Funded with a loan of £1,000 from her actor brother, Sir Lewis Casson, she bought the first Dorset House in Clifton, Bristol and quickly went about making her dreams reality.

    Dr Casson had been inspired by her own early psychiatric hospital experience, when she realised the therapeutic benefits enjoyed by patients who were presented with tasks and activities rather than mere convalescence:

    When I first qualified as a doctor …I found it very difficult to get used to the atmosphere of bored idleness in the day rooms of the hospital. Then, one Monday morning, when I arrived at the women's wards, I found the atmosphere had completely changed and realised that preparations for Christmas decorations had begun. The ward sisters had produced coloured tissue paper and bare branches, and all the patients were working happily in groups making flowers and leaves and using all their artistic talents with real interest and pleasure. I knew from that moment that such occupation was an integral part of treatment and must be provided.

    Quoted in The story of Dorset House School of Occupational Therapy 1930 - 1986, [Oxford: Dorset House School of Occupational Therapy, 1987], p.1

    This Road to Damascus experience was reinforced by Dr Casson's dealings with Dr David Henderson, who had established a small Occupational Therapy department at Gart Naval Hospital, Glasgow and visits to American hospitals -notably Bloomingdale Hospital, New York and the Boston School of Occupational Therapy - in the mid-1920s.

    The aim of Dorset House, as expressed by Dr Casson, was:

    to form a community where every individual was encouraged to feel that she had a real object; for a patient the object was to get well and go out to a worth-while life; for a member of the staff it was to serve others with all the talents she possessed; for a student, to develop all her capacities for her life as an Occupational Therapist and to find the individual job that only she could do.

    Quoted in The story of Dorset House School of Occupational Therapy 1930 - 1986, [Oxford: Dorset House School of Occupational Therapy, 1987], p.3

    Dr Casson's dreams were finally realised with the appointment of Constance Tebbit as first Principal of the School in the summer of 1929. Miss Tebbitt had trained in Philadelphia and had developed a wide understanding of Occupational Therapy (OT) practice and education in the United States. She returned to England for Christmas 1929 and the School opened on New Year's Day 1930, with Dr Casson as Medical Director.


    Dorset House as a School of Occupational Therapy began life as part of Dorset House, Bristol, a nursing home for the treatment of patients suffering from neurotic and psychotic disorders. Consequently, for the first three years the bulk of the clinical experience offered to the students was psychological. In many ways, this was quite appropriate as most demand for trained Occupational Therapists at this time was from Mental Hospitals, and -on a practical front- it was also far easier to provide facilities for this type of experience. Dr Casson, though, never lost sight of the physical aspects of OT and by 1939 she was able to open an Occupational Therapy Department at Bristol General Hospital, offering ward work and treatment for patients with cardiac conditions. For the students, clinical practice was obtained largely with Dr Casson's own patients. Therapy at this time would invariably cover such diverse activities as netball, country dancing (including the Margaret Morris dancing, usually led by the redoubtable Joy Blew Jones), theatre, gardening and picnics, alongside the more traditional crafts so often associated with OT.

    The early 1930s witnessed a period of expansion for the School. Teaching grew from taking up part of one room to half a house. All early Dorset House students and staff have vivid memories of The Grange, the School's first residential quarters.

    Conditions were very primitive, as one student at the time, Margaret Hancock, recalled:

    The Occupational Therapists lived over the garages. Their ancient lavatory was a nightmare, which Doctor [Casson] eventually inspected. Among other defects they complained that when seated their feet dangled, so Doctor, ever sympathetic, asked the carpenter to build a platform round the pedestal, thus ensuring 'enthronement'!

    Quoted in The story of Dorset House School of Occupational Therapy 1930 - 1986, [Oxford: Dorset House School of Occupational Therapy, 1987], p. 53

    Staffing was -at first- limited. Dr Casson gave lectures on anatomy, physiology and medical subjects, whilst Miss Tebbitt taught the theory and practice of OT, ran the department and supervised the students' work. As the School grew so did the staffing, with Miss Goscombe joining as Senior Assistant to the Principal, and Miss Becky Lummis and Miss Albons bringing practical experience from America and Sweden (respectively) to the Team.

    1933 marked the end of the first phase in the development of Dorset House with the departure of Miss Tebbitt. In April of that year she was appointed Occupational Therapist to the County Mental Hospital, Chester and became Director of Mental Hospital Practice. Although this was a great loss to the School, it did provide a new avenue of opportunity for the students who could gain hospital practice in a wider field. Miss Goscombe took charge of the School, assisted by Becky Lummis. When Miss Lummis returned to America some months later, the event was celebrated by a pantomime, written by some of the patients in tribute. The Archives of Dorset House are filled with such memories, such as the performance of Pride and prejudice in 1934, when Dr Casson played Mr Collins.

    In 1934 Miss Goscombe married Owen Reed, Dr Casson's nephew, so a new Principal had to be sought. Another alumnus of the School of Occupational Therapy at Philadelphia, Martha Jackson, now joined to become Head of the Dorset House Occupational Therapy Department and School. This was a time of further expansion and building, including a much needed upgrading of the students' living quarters. Despite valiant efforts, Bristol's accommodation could scarcely keep up with increasing numbers. More wholesale expanding -or moving- would need to be considered.

    In September 1934 there was an intake of eight new students, including one Mary Macdonald. Miss Macdonald quickly became active as a member of the newly formed Association of Occupational Therapists and was soon taking the opportunity to travel to the United States and Canada (after being awarded grants from the Pilgrim and York Trusts) to study developments in OT education. All this stood her in good stead, for in August 1938 Miss Jackson left the School for America and "Mac" -as she became affectionately known- took over as Principal. By this point, this role included supervision of the patients' occupational treatment in Dorset House itself and several surrounding hospitals, plus the administration and planning of the School, now with 18 students. On top of this was a new duty: the establishment of the Allendale Curative Workshop for out-patients suffering from a variety of physical disabilities. The first 40 cases at the Workshop were given free treatment and their progress recorded in full and illustrated reports, some of which can be found in the Dorset House Archive. This project formed the basis of a paper later published in The Lancet (Casson, E. Forty cases treated at the Allendale Curative Workshop, The Lancet, 1 November 1941, p.516).