World War II marked the beginning of modern psychiatric rehabilitation as we know it today. Occupational therapy had served, almost alone for a century, to supply the need of the psychiatric patient for normal activity and as a means of teaching him some avocation which he could take home as a therapeutic hobby. Other activities such as sports, movies, and music were added in an occasional and unorganized fashion. By default, these activities often came under the direction of the occupational therapist who was the one person with a formal training in paramedical activities and who was recognized as a qualified technician.
With the extensive application of group psychotherapy came the awareness of problems besetting military psychiatric patients—problems involving attitudes toward illness, attitudes of the self to illness and to the attitudes of others, problems of self-esteem, problems of adjustment within the hospital, and problems of adjustment outside the hospital.