Occupational therapy for military personnel and military veterans experiencing post‐traumatic stress disorder: A scoping review

Abstract

Introduction: As the rate of post-traumatic stress disorder (PTSD) among military personnel and military veterans continues to rise, occupational therapists are increasingly concerned with the impact of this disorder on health, occupational performance, and quality of life. However, the literature on occupational therapy for military personnel and military veterans with PTSD has not been summarised. Method: The objective was to identify what is known from the published, peerreviewed literature, about the services provided by occupational therapists to military personnel and military veterans experiencing PTSD. Arksey and O'Malley's five steps for scoping reviews were utilised. A search of three databases identified 27 articles. Results: Of the 27 papers reviewed, 13 papers discussed military personnel, 13 for military veterans, and 1 reported on both populations. Of these 27, 9 research papers provided data to support the efficacy of interventions, whereas 2 papers reported occupational performance issues. Eight opinion and eight service description papers were included. The most commonly mentioned interventions across the reviewed papers were stress and anger, or coping skills (n = 11), returning to duty (n = 9), physical training (n = 7), and sleep hygiene (n = 6). Conclusion: Occupational therapists provide services to military personnel who are vulnerable to PTSD from combat and operational stress. Rarely did publications address intervention efficacy for military personnel. Additionally, there is a paucity of literature that addresses occupational therapy interventions following transition from military service for veterans with PTSD specific to facilitating reintegration to civilian life. Despite this, occupational therapists are well suited to enable military veterans to build upon their existing strengths, skills, and professional identities to minimise the impact of PTSD on daily life and to reach their full potential.

Enhancing occupational therapy service provision with military veterans through policy reform: Findings from a national survey

“…Consistent with a recent review of occupational therapy interventions for current and former service members (Kerr et al, 2020), the present study highlights a critical need for provision of specialised mental health interventions. Advanced skills in facilitating occupational participation with former service members experiencing mental health conditions are needed to support positive health and adjustment after military service.…”

“…However, while needed, these interventions do not represent a full scope of occupational therapy practice with former service members. Interventions identified in international literature, including sleep hygiene, mindfulness‐based cognitive therapy, mindfulness‐based stress reduction, and social and leisure participation (Brininger et al, 2019; Edgelow et al, 2019; Kerr et al, 2020), were either not described by participants or were identified as underutilised areas of clinical practice. As identified by the Australian Government Productivity Commission (2019), review of policies guiding the provision of compensation and rehabilitation services through the Department of Veterans' Affairs is urgently required to enable use of effective, evidence‐based interventions with this population.…”

“…Occupational therapists have unique skills to address occupational disruption with former service members and the impact of underlying health conditions on occupational participation in settings including transition care and community‐based service provision (Brininger et al, 2019). Internationally, evidence‐based interventions used by occupational therapists include sleep hygiene, vocational and life skills training, mindfulness‐based cognitive therapy (MBCT), mindfulness‐based stress reduction (MBSR), goal‐directed therapy and social and leisure participation (Brininger et al, 2019; Edgelow et al, 2019; Kerr et al, 2020). These interventions have a common goal of enhancing participation in meaningful occupations (Brininger et al, 2019), however, require use of trauma informed therapy and development of military cultural competence (Edgelow & Cramm, 2020; Tam‐Seto et al, 2019).…”

Quality of life at 3 and 6 months in military personnel with a history of thoracic trauma suffered in combat

“…The results of this study show that, despite being young subjects and receiving surgical medical management for chest trauma, the quality of life remains affected during the entire time they are being monitored, and it is necessary for these patients to enter a multidisciplinary and inclusive rehabilitation plan that approaches all the possible issues that can be derived from a trauma event suffered in combat. In the last few years, in countries like Colombia, this type of centers have been created in order to improve the quality of life of combat veteran, where training processes can be conducted for family, social, cultural, and work inclusion 30,31 .…”