Military Service Member Perspectives About Occupational Therapy Treatment in a Military Concussion Clinic

Cogan, Alison M.; Huang, Janice; Philip, Joyce

doi:10.1177/1539449218813849

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…The second author (Haines) was an active-duty service member at the time of the study, which informed her interpretations of the data. Results of the main research questions for the study related to occupational therapy treatment are published elsewhere (Cogan, Haines, Devore, Lepore and Ryan 2019; Cogan, Philip, and Huang 2018). All names used are pseudonyms.…”

Section: Methodsmentioning

confidence: 99%

Intersections of US Military Culture, Hegemonic Masculinity, and Health Care among Injured Male Service Members

Cogan¹,

Haines

Devore

2019

Men and Masculinities

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In this paper, we explore how socially constructed hegemonic masculinity permeates military culture, and how this cultural context intersects with the seeking and receiving of health care by active duty US military service members with chronic mild traumatic brain injury (mTBI) (n = 18). Data were collected through individual interviews and focus groups. Using Bourdieu’s theory of practice as an analytical framework, we identified four themes: maintenance of social capital, remaining in the field, reframing health care use to bolster social capital, and risk of health care use as not being rewarded. Each emerged from statements about why participants had avoided seeking health care for physical and psychological needs during their military service. We consider our findings in the context of maintaining status within an institutional steeped in hegemonic masculinity and describe implications for reframing caring for the body and dealing with problems as masculine acts.

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Section: Methodsmentioning

confidence: 99%

Intersections of US Military Culture, Hegemonic Masculinity, and Health Care among Injured Male Service Members

Cogan¹,

Haines

Devore

2019

Men and Masculinities

Self Cite

View full text Add to dashboard Cite

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Outcomes of Art Therapy Treatment for Military Service Members with Traumatic Brain Injury and Post-traumatic Stress at the National Intrepid Center of Excellence

Walker

2019

Springer Series on Bio- And Neurosystems

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Therapeutic Relationship in mTBI Rehabilitation: The Disparity Between the Illness Experience and Clinical Definitions

Cogan

Bailie

2023

Military Medicine

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Introduction A positive therapeutic relationship is characterized by trust and mutually perceived genuineness. It is positively associated with patients’ adherence to treatment, satisfaction, and health outcomes. When service members with a history of mild traumatic brain injury (mTBI) present to rehabilitation clinics with nonspecific symptoms, a disparity between their experience of disability and clinical expectations of mTBI may disrupt the establishment of a positive therapeutic relationship between patients and providers. The objectives of this study are to (1) explore disparities between military service members and rehabilitation clinicians about the clinical diagnosis and illness experience of mTBI and (2) identify barriers to the establishment of a positive therapeutic relationship. Materials and Methods This is a qualitative descriptive study of military service members with prior mTBI (n = 18) and clinicians (n = 16) who participated in interviews and focus groups. Data were analyzed thematically using Kleinman’s framing of illness experience and clinical diagnosis. Results Three themes reflected the potential breakdowns in the therapeutic relationship. The first theme, clinical expectations for post-injury recovery versus patients’ experience of ongoing disability, reflects the inconsistency between clinicians’ expectations of symptom resolution within 90 days following mTBI and service members’ experiences of symptoms that worsened over several months or years. The second theme, symptom attribution to mental health conditions versus tissue injury, describes the difficulty in attributing symptoms to the physical impact of the mTBI or mental health diagnoses that may also stem from the injury event. The third theme, suspected malingering versus valid disability, describes clinicians’ reports of frustration with cases in which they suspected malingering for secondary gains in contrast with service members’ feelings that their problems were not taken seriously by clinicians. Conclusions This study extended previous research on therapeutic relationships by examining the situation of mTBI rehabilitation services for military service members. The findings reinforce the best practice recommendations of acknowledging patients’ experiences, addressing the presenting symptoms and problems, and encouraging progressive return to activity following mTBI. Acknowledgment of and attention to patients’ illness experience by rehabilitation clinicians is necessary and important for supporting a positive therapeutic relationship and ultimately to optimize patients’ health outcomes and reduce disability.

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Military Service Member Perspectives About Occupational Therapy Treatment in a Military Concussion Clinic

Cited by 3 publications

References 24 publications

Intersections of US Military Culture, Hegemonic Masculinity, and Health Care among Injured Male Service Members

Intersections of US Military Culture, Hegemonic Masculinity, and Health Care among Injured Male Service Members

Outcomes of Art Therapy Treatment for Military Service Members with Traumatic Brain Injury and Post-traumatic Stress at the National Intrepid Center of Excellence

Therapeutic Relationship in mTBI Rehabilitation: The Disparity Between the Illness Experience and Clinical Definitions

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