As the Depression lengthened, Geraldine Lermit worked to find positions for the School’s graduates. She and other leaders were forced to brainstorm unique solutions in an attempt to mitigate the struggling economy. At a January 1934 meeting of the Missouri Association for Occupational Therapy, it is documented that she suggested asking one or two recent graduates of the School to go on duty in Barnes Hospital without salary, but with meals supplied, with the idea that they would later be paid a salary.
In 1934, in order to meet growing demands in the professional field and because increased opportunities were available through the cooperation of Washington University, courses in recreation and group work were included in the curricular requirements. The name of the school was changed to the St. Louis School of Occupational and Recreational Therapy. Two degree programs were offered – a three-year course leading to a diploma in occupational therapy and a four-year course leading to the degree of bachelor of science in education granted by Washington University. The diploma in occupational therapy granted by the St. Louis School of Occupational and Recreational Therapy was awarded upon completion of both the three- and four-year programs. At the time, nine months of practice work in occupational therapy was required in addition to the academic courses.
Rachel Stix Michael died in September 1936 and bequeathed $232,750 to Washington University, of which $150,000 was to be used to establish a chair in occupational therapy in the Washington University School of Medicine. As director of the School, Lermit was appointed the first Elias Michael Professorship, named in honor of Mrs. Michael’s husband, who died in 1913.