The new culture of therapeutic activity is built around this key premise – that activity is essential to human health and well-being, and that to neglect activity provision leads to ill health and disability. The old culture is one of domination, technique, evasion and buck-passing. This is a long-held view, that certain activities which are most commonly understood as a feature of childhood – such as using a doll, playing with a ball, reading a picture book, watching a children's television programme – are inappropriate for use as therapeutic interventions with older people. No activity is inherently demeaning, insulting or age-inappropriate; positive or negative effect lies in a person's view of, and response to, that activity. No activity is inherently good or bad, therapeutic or counter-therapeutic. With the drift of the occupational therapy profession away from chronic disability settings has come the emergence of a 'new' practitioner, the activities organiser, to make good the deficit.