A Global Perspective: Working with Veterans
Recovering from Traumatic Brain Injury
An expanding area of occupational therapy (OT) practice that I have considerable interest in is the rehabilitation of veterans who have suffered a Traumatic Brain Injury (TBI). The field of occupational therapy made considerable advances and experienced a boom in theory advancement internationally following World War I, World War II, and the Vietnam War when servicemen were returning with considerable physical and cognitive disabilities (Peloquin & Punwar, 2000). Unable to financially contribute to their households, as well as socially readapt, veterans were in need of professionals who could provide new avenues of productivity, as well as strategies for daily
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The treatment of military veterans in the United States, following a return from service, falls to a network of Veterans Affairs (VA) hospitals where occupational therapy practitioners are employed in both inpatient and outpatient settings. This means that a veteran who has suffered a TBI could begin to receive occupational therapy treatment as soon as they awaken from a coma or as soon as they are admitted for treatment. As with most TBI rehabilitation settings, the VA hospitals compile a multidisciplinary group of professionals to comprise a client’s treatment team. Depending on the severity and exact nature of a veteran’s injury, the treatment team could include any number of the following individuals: an occupational therapist, speech therapist, recreational therapist, psychologist, physiatrist, psychiatrist, and a doctor. Often those military veterans being treated in a Veterans Affairs hospital for a TBI have also experienced other injuries of a physical and psychological nature, ranging from amputations to Post Traumatic Stress Disorder (PTSD). It is the traumatic brain injury, however, that seems to open …show more content…
Occupational therapy, however, remains underutilized internationally in the treatment of military personnel who have sustained a TBI. In the United Kingdom (UK), there has been notable research and emphasis on treating the mental health of veterans, tied to this is the high incidence of depression following a TBI. Much like the United States, the UK is heightening its attention to veteran mental health. Occupational therapists within the UK are directing much of their treatment to addressing PTSD after combat in an effort to significantly reduce suicide rates among military personnel. Using a client-centered approach, British occupational therapists work with veterans to “support post-traumatic growth, build social support and a sense of connectedness with their community” (Murtagh). This approach mirrors that of the Occupational Therapy Practice Framework (OTPF), a cornerstone of occupational therapy in the United States
Because of the horrifying effect of war, the need for mental health services is great than ever. 35% of Iraq war veterans accessed mental health services in the year after returning home (Collie, 2006, p.2). However, the issue is that many veterans are not getting the proper help through traditional forms of therapy. Traumatic memories are encoded differently than non-traumatic memories in which they appear locked in the right brain, and therefore less accessible through verbal
In other to make the treatment of TBI more comprehensive and holistic other system of care has been adopted. One of such system is the VA Polytrauma System of Care. Within the Polytrauma System of Care are Rehabilitation Centers which provides “direct care and consultation, as well as research and education related to polytrauma and TBI” (Bagalman, 2011). Each center is staffed with a “rehabilitation physician, registered nurses, social workers, speech-language pathologists, physical therapists, occupational therapists, recreation therapists, a neuropsychologist, a counseling psychologist, and a family therapist, among others” (Bagalman, 2011) in other to provide a comprehensive care for veterans with TBI.
The rehabilitation for people with traumatic brain injury is put into three different stages for medical care (Ross 40). These three stages are: inpatient, community integration, and lifetime of care. Each person’s rehabilitation process is different with the way they go through care. The healing process can last for months, or sometimes years. Those that go through the rehabilitation program function better than those that don’t. The two major goals are relearning and compensation.
The mission statement of the VA Social Workers is to eliminate significant barriers to clients in need and offer interventions for veterans and families. It is accomplished by developing and maintaining integrated, in-depth programs in patient care, research, and education (Hoffer, Elizabeth. F., Dekle, Judith. Ward., & Sheets, Carol., 2014). Its proposed 11 percent to 20 percent of Iraq, Afghanistan veterans as well as 30 percent of Vietnam vets encounter (PTSD) posttraumatic stress disorder traumatic incidents like combat can lead to PTSD, military sexual trauma of military service member, and veterans may possibly deal with depression, anxiety in addition to other mental health concerns. Vets distress from these mental health and cognitive
Traumatic brain injuries (TBIs) in the military are a tangible threat to the men and women of the United States military. Operations in Iraq and Afghanistan have created a spotlight on this injury, as the “signature injury”. Specific criteria makeup the definition of a TBI, which is certain symptoms and severity levels of those symptoms. Due to the capacity of this injury, the Department of Defense (DoD) and Congress have created mandates, along with treatment methods, and the ability to achieve an end goal of aiding an individual’s complete recovery.
Since the military and VA healthcare systems are familiar with the high prevalence rate of PTSD among combat veterans, Capehart and Bass (2012) sought to address four primary objectives related to managing comorbid PTSD and TBI: cognitive problems, blast as an injury source for TBI, diagnosis and management of PTSD in the setting of mTBI, and management of additional neuropsychiatric comorbidity in the combat veteran with PTSD and mTBI. Although no clear guide exists on the simultaneous management of these conditions and managing PTSD and TBI remains challenging for the Dpartment of Defense (DOD) and VA clinicians in mental health and primary care, the researchers suggest that using psychotherapy, pharmacotherapy,
This papers purpose is to describe to the reader an Occupational therapy treatment plan and therapy session using the OTPF as its base to describe client’s performance. It is based off a case study of a 26 year old male racecar driver who suffered a traumatic brain injury and is now admitted into the hospitals ICU unit under a coma. The paper begins with a brief overview of the clients Injuries and occupational profile. It continues with goals that the therapist has set for the client and caregivers and concludes with the client’s treatment plan, along with a SOAP note which explains the client’s treatment and gives other healthcare workers information about the therapists goals and progress of the client
Each day clients engage in meaningful and purposive occupations that can be affected by a multitude of incidents that may either support or hinder a client’s ability to function. Traumatic injuries are just one example of incidents that may hinder a client’s occupational performance. Injury can often times lead clients to experience disruptions in their capacities to achieve full occupational performance. Clients who do experience diminished occupational performance can find support through an Occupational Therapist (OT). The OT will utilize a therapeutic decision making process to determine the most appropriate theory along with the client’s knowledge of his or her own needs and wishes to guide therapy. Employing and supporting the client as an advocate for their own needs can allow an OT to determine theories of practice that are best suited for the client’s return to wellbeing. An OT should first attempt to realize the needs and wishes of a client and once an understanding has evolved of what is meaningful to the client the therapist can assess performance skills and patterns that can be addressed by theories developed specifically for OT.
To effectively treat Post Traumatic Stress Disorder, PTSD in combat Veterans and service members, therapists use different techniques, which are preceded by addressing any underlying pain associated with the disorder. In their research, Chard et al. (2011) reported significant modifications to the CPT protocol for use with patients in a TBI-PTSD residential treatment facility, including increasing the number of sessions per week, combining group and individual therapy, and augmenting the treatment with cognitive rehabilitation. However, their research was marred with the use of few participants which provides doubts regarding the outcome of the proposed treatment procedures. Moreover, the researchers do not state with certainty as to the
Post-traumatic stress disorder, PTSD is a psychiatric disorder that may develop after experiencing or seeing a traumatic or a brutal life threatening event. It is increasingly on the rise in war veterans. For those with PTSD only 53 percent have seen physicians or a mental health care provider. And for those who sought out care, roughly only 50 percent received adequate treatment when returning from combat. Although there are many treatments available most patients disregard the obvious signs of PTSD. Because some are afraid of the stigma of PTSD and being labeled as a crazy or violent person, If we create awareness and stop this ignorant notion, people with the disorder would
In their article, Depression and Cognitive Complaints Following Mild Traumatic Brain Injury, Dr. Silver, Dr. McAllister, and Dr. Arciniegas (2009) states that “Traumatic brain injury (TBI) is a common occurrence with multiple possible neuropsychiatric sequelae, including problems with cognition, emotion, and behavior.” A traumatic brain injury is a physiological disruption of brain function due to the application of external physical force, including acceleration/deceleration forces. Neuropsychiatric sequelae, a term used to describe a cluster of post-TBI symptoms to include: cognitive, emotional, behavioral, physical, and psychosocial problems, is a significant source of disability in TBI survivors and their families. This review will examine symptoms of depression and cognitive impairment in individuals that have experienced a mild TBI, as well as the clinical approach to treating such people (Silver, McAllister, & Arciniegas, 2009).
A traumatic brain injury (“TBI”) occurs when the brain is somehow injured, rattled, or wounded from an external source of force. The means of acquisition and the severity of TBIs are unique to each patient; therefore, symptoms and rehabilitation can vary greatly depending on the patient’s condition following the incident and how they sustained the injury. The severity of a TBI is generally classified into one of three categories: mild, moderate, or severe, and this type of diagnostic criteria influences how a patient with TBI is treated by medical staff and rehabilitation specialists. TBIs can affect a specific part of the brain that was directly impacted, leaving the patients with only one or a few areas of impairment, or the damage can
My objective in the long term is to provide therapeutic and counseling services that assist persons suffering with traumatic brain injury (TBI) or acquired brain injury (ABI) in coping and recovering from the mental illnesses that often accompany such tragedies. TBI/ABI has shown a proven link with “anxiety, depression, personality changes, aggression (National Alliance on Mental Illness Veterans Resource Center May 8, 2009 Traumatic Brain Injury)”, as well as many other issues. As the caregiver for a survivor of a rare and deadly strain of encephalitis, I have a personal perspective that I feel brings much to the discussion. I see the information I am currently gathering at Empire State College as the building blocks that pave the way
Traumatic brain injury occurs when a person is hit in the head with a blunt force. This significant force to the head can happen playing recreational sports, on the playground, being in a car or motorcycle accident, falling down at home and your head impacting something, a blast or explosion. Traumatic brain injuries are also the leading cause of fatality rate and disability, especially in children, young adults and elderly. TBI is a devastating condition that affects millions of people nationwide, because it can affect the nervous system permanently, it also messes with the neurological, musculoskeletal, cognitive and much more. TBI force a family to deal with not just the physical disability, with the behavioral and emotional roller
LITERATIVE REVIEW The purpose of my literature review is to examine the various therapeutic intervention strategies being administered to adult and children who have perceptual, spacial, gross and fine motor proficient disabilities. Furthermore what approaches appear to be working in their rehabilitation process. adults with perceptual dysfunction secondary to brain injury often includes Occupational therapy has been one of the main therapeutic strategies used for perceptual retraining according to (Holzer, Strassny, Senner-Hurley & Lefkowitz, 1982; Hopkins & Smith, 1983; Prigitano, 1986; Siev Freishtat, & Zoltan, 1986; Trombly, 1983, Van Deusen, 1988; Wahlstrom. 1983). A