The Management of Battle-Fatigued Soldiers: An Occupational Therapy Model

Abstract

Battle fatigue is a soldier's response to the overwhelming environmental and psychological stressors associated with combat. Management efforts that emphasize replenishment of physiologic needs, structured occupation, and support of the affected soldier's occupational roles have yielded high return-to-duty rates. Although such effective battle-fatigue management principles, or "principles of battlefield psychiatry," are well described, they have not been explained in terms of theoretical foundation. The model of human occupation, an occupational therapy treatment model, is presented as a theoretical framework to explain the success of current battle-fatigue management principles and to guide continued refinement of the process of restoring battle-fatigued soldiers to duty.

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

“…During these 72 hr, importance is placed on establishing and maintaining a military environment rather than a medical environment. Authors argue that this supports military personnel experiencing combat stress to preserve their valued military “warrior” identity and occupational engagement (Gerardi, 1996, 1999; Gerardi & Newton, 2004; Smith‐Forbes et al., 2014). A key intervention component in sustaining the “warrior” identity is the use of structured therapeutic environments and occupations.…”

“…A key intervention component in sustaining the “warrior” identity is the use of structured therapeutic environments and occupations. The intent of this approach is to replicate a military routine which is predictable and familiar (Gerardi, 1996, 1999; Gerardi & Newton, 2004; Smith‐Forbes et al., 2014; Smith‐Forbes, Quick, & Brown, 2016).…”

“…The occupational therapy profession has continued to provide services to military personnel and veterans experiencing diminished occupational performance since World War I (Ellsworth, Sinnott, Laedtke, & McPhee, 1993). For deployed military personnel who experience combat and operational stress reactions, occupation‐based interventions establish therapeutic environments where individuals engage in therapeutic occupations which support soldier identity, build confidence in perceived self‐efficacy and encourage their return to duty (Ellsworth et al., 1993; Gerardi, 1996, 1999). Structured therapeutic environments are used to maintain a “military” setting, rather than a “medical” or ward setting.…”

The Role of Occupational Therapy in Disaster Preparedness, Response, and Recovery

“…Occupational engagement reduces the intensity of stressful events and helps reestablish a sense of mastery in a situation in which a person feels a loss of control. The military has long used occupational therapy to help soldiers overcome occupational dysfunction due to the stress of war (Ellsworth, Laedtke, & McPhee, 1993;Laedtke, 1996), to support their role identity, and to restore their confidence in their ability to function (Gerardi, 1996(Gerardi, , 1999Gerardi & Newton, 2004). Participation in occupation facilitates restoration of adaptive habits and routines, supports a person's sense of identity, and helps establish a spiritual connection in the disaster situation (McColl, 2002).…”

The Role of Occupational Therapy in Disaster Preparedness, Response, and Recovery

“…Participation in occupation facilitates restoration of adaptive habits, supports a person's sense of identity, and helps establish a spiritual connection in the disaster situation (McColl, 2002). The military has long used occupational therapy to help soldiers overcome occupational dysfunction due to the stress of war (Ellsworth, Laedtke, & McPhee, 1993;Laedtke, 1996), to support their role identity, and to restore their confidence in their ability to function (Gerardi, 1996(Gerardi, , 1999Gerardi & Newton, 2004).…”