"The human hand is one of the most precise and wonderful mechanical devices in creation and vastly more impressive than any mechanical device that man has made."

– Stuart Burgess, Professor of Mechanical Engineering

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ASHT Establishes Excellence in Hand Therapy

By Mary Kasch, OTR, CHT, Executive Director, Hand Therapy Certification Commission

The American Society of Hand Therapists (ASHT) was incorporated in 1977 to advance the specialty of hand therapy through communication, education, research and the establishment of clinical standards. At that time, membership in ASHT was restricted. Therapists needed to complete an extensive application and submit clinical hours, a patient log and case studies to be considered for membership. ASHT membership became a de facto form of certification, because of the stringent application process required. ASHT members were recognized in the field as being experts.

Governmental Influences

In the mid-1980s, antitrust laws against organizations with strict membership qualifications were being enforced. It was felt that restricting membership was a form of discrimination and that membership in an organization should be open to a broad range of individuals in a professional field.

Since the late-1970s, the federal government had also been encouraging the formation of voluntary certification programs that would not be federally regulated. These two trends led ASHT to establish a certification committee in 1984 to study other organizations and present options to its members. The committee discovered that the National Organization for Competency Assurance (NOCA) in Washington, D.C., had established guidelines for organizations that offer professional certification. Those guidelines were used to form the framework for hand therapy certification.

First Practice Analysis

The first step in the process was a role delineation study (now commonly known as a practice analysis) of hand therapy. A survey was written with consultation from a professional testing company and sent to ASHT members and non-members who practiced hand rehabilitation. The results of the survey formed the basis of the Scope of Practice and were used to write the original test blueprint. The results of the survey were published in the Journal of Hand Therapy (JHT) in 1987. Based on the report of the certification committee, ASHT members voted to proceed with hand therapy certification at the 1987 Annual Meeting.

HTCC Separates from ASHT

To legally ensure an unbiased certification program, HTCC incorporated as a separate entity from ASHT in 1989, prior to the administration of the first Hand Therapy Certification examination in 1991. Since then, ASHT and HTCC have maintained a close relationship to promote the missions of both organizations. However, they are administratively independent and do not have influence over the policies, procedures or activities of the other organization. The leadership of both organizations maintains close communication throughout the year.

Future Trends

HTCC recently completed their third practice analysis. The results were published in the 25th anniversary issue of the JHT (July/September 2002 issue). For the first time, competencies in hand therapy were also studied and presented at ASHT’s 25th Annual Meeting in Ottawa.

In an effort to continue to develop an interactive and user-friendly Web site, HTCC is excited to announce that Certified Hand Therapists can now enter and track their continuing education and work experience online. They simply visit the “CHTs Only” section, enter their hours, then fax or mail their certificates to HTCC for approval. Once approved, the hours are posted on the Web site for no additional fee.

HTCC maintains the only online directory of CHTs. Not only can therapists use this resource to find each other, but this is the most popular public page of the Web site.  For an additional fee, CHTs can have an expanded listing in the directory or place an advertisement on this page.

Recent changes to certification include an increase in clinical practice hours from 2,000 to 4,000 required for initial certification eligibility. In re-certification, therapists who are in the second cycle no longer have to submit clinical hours, but they continue to need work experience hours related to hand therapy. Work hours obtained in Great Britain and Australia are now accepted for re-certification. HTCC is continually working to meet the needs of hand therapists. Visit www.htcc.org for more information on certification.