Carly M. Rogers, Trudy Mallinson, Dominique Peppers; High-Intensity Sports for Posttraumatic Stress Disorder and Depression: Feasibility Study of Ocean Therapy With Veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Am J Occup Ther 2014;68(4):395-404. doi: 10.5014/ajot.2014.011221.
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© 2019 American Occupational Therapy Association
In this study, we conducted a pretest–posttest investigation of a sports-oriented occupational therapy intervention using surfing in an experiential, skills-based program to support veterans with symptoms of posttraumatic stress disorder (PTSD) in their transition to civilian life. The purpose of this feasibility study was to evaluate the intervention for attendance rates and retention in the program provided in 5 sessions over 5 wk. Fourteen veterans from a specialty postdeployment clinic at a Veterans Affairs hospital were enrolled; 11 completed the study, and 10 attended ≥3 sessions. Participants reported clinically meaningful improvement in PTSD symptom severity (PTSD Checklist—Military Version, Wilcoxon signed rank Z = 2.5, p = .01) and in depressive symptoms (Major Depression Inventory, Wilcoxon signed rank Z = 2.05, p = .04). The results of this small, uncontrolled study suggest that a sports-oriented occupational therapy intervention has potential as a feasible adjunct intervention for veterans seeking mental health treatment for symptoms of PTSD.
Will veterans with PTSD and depressive symptoms consistently attend the program?
Will participants in the 5-session, 5-wk community-based occupational therapy intervention report a reduction in PTSD and depressive symptoms?
Role identity. Many veterans have reported finding that their military service, skills, or leadership positions do not necessarily translate into civilian life, which can lead to frustration and a diminished sense of purpose (Adler, Possemato, et al., 2011). The content of this module is designed to guide participants in identifying their own positive traits and reflecting on the ways in which these traits are strengthened while learning to surf.
Leadership and trust. To address this theme, participants make connections between the leadership skills learned in military training and how they can use those skills in civilian life. Participants also consider how these same skills are manifest in learning to surf (e.g., how their instructors led in the water, how trust was built with their instructor).
Community building. The analogy of the “surfing family” is used to explore ways to build community or “brotherhood” (an important concept in military culture) among civilians. For example, participants reflect on the friendships made while surfing and the way their sense of community strengthened over the 5 wk. Participants also reflect on lessons learned in surfing etiquette and how aspects of surf culture facilitate communication skills such as self-advocacy and conflict resolution.
Problem solving. Many veterans have reported difficulty navigating what they perceive to be the less disciplined nature of civilian life in contrast with the order and stability to which they were accustomed in the military (Demers, 2011). In addressing this theme, participants are assisted to identify the particular approaches to problem solving they used during the surfing lesson and how those skills can also be used in negotiating daily life challenges. Partnering with their surf instructor to stay calm in a novel environment is an example of a tangible problem-solving skill applicable to assuming the role of college student or new employee.
Transition. In the last session, participants discuss their surfing progress achieved throughout the five sessions and describe the ways they have begun to use the resiliency themes in their daily lives. Family members or significant others are invited to the session, which is held as a type of graduation.
A complementary sports-oriented treatment program may be incorporated as a part of an occupational therapy practitioner’s treatment plan for veterans with symptoms of PTSD, depression, or both who are experiencing challenges with transition to civilian life or engaging in high-risk behaviors.
Surfing and other high-intensity sports may be a socially acceptable occupation for veterans with symptoms of PTSD and depression.
Complementary intervention approaches that include high-intensity sports may support veterans’ transition to civilian life roles.
Further study of the effectiveness of high-intensity sports is required to support their use in occupational therapy practice with these clients.
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