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Post
Traumatic Stress Disorder
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My guess is that
each of you is experiencing some stress since last Tuesday's
tragedies in New York City and Arlington, Virginia.
As health care professionals, you know this is posttraumatic
stress and that most of us will be able to work through it,
while others will experience it more severely and for a longer
period of time and need professional help.
You will find multiple
web sites for information on this topic. Three that
I visited and recommend are:
*Includes a new
article on "PTSD in adolescents and children."
Following is a
list of references specific to occupational therapy intervention
and PTSD due to varying types of trauma. There were
some articles in last week's list that also addressed stress
from traumatic experiences.
Clarke, C.
(1999). Opinion: Treating post-traumatic stress disorder:
Occupational therapist or counsellor? The British Journal
of Occupational Therapy, 62(3), 136-138.
Davis, J. (1999).
Effects of trauma on children: Occupational therapy to support
recovery. Occupational Therapy International, 6(2),
126-142.
ABSTRACT: Each
year millions of the world's children witness, are victimized
by or participate in traumatic events, placing them at risk
for developing post-traumatic stress disorder. If this
disorder is left untreated, a child's developmental trajectory
can be compromised. Occupational therapists are in key
positions to recognize the signs and symptoms of post-traumatic
stress in children that interfere with functioning. Expressive
therapies, long used in occupational therapy practice, are
well suited to help children achieve an adaptive response
to trauma. Two brief case studies are presented, describing
the application of occupational therapy using expressive media
with children who experienced post-traumatic stress disorders.
The results of this preliminary investigation suggest that
occupational therapists working in early intervention programmes
can be helpful in identifying children in need and in providing
treatment based on expressive therapies, stress management
and cognitive-behavioural modalities. Further research
is recommended to examine the efficacy of different occupational
therapy frames of reference in treating children with post-traumatic
stress disorder. Key words: paediatric occupational therapy,
post-traumatic stress disorder, cognitive-behavioural therapy,
and expressive media.
Davis, J. &
Kutter, C.J. (1998). Independent living
skills in posttraumatic stress disorder in women who are homeless:
Implications for future practice. The American Journal
of Occupational Therapy, 52(1), 39-44.
ABSTRACT: OBJECTIVE.
Service delivery through community-based programs is the future
of occupational therapy. This study examined independent
living skills, traumatic experiences, and symptoms of Posttraumatic
Stress Disorder (PTSD) in a sample of women residing in a
supportive housing program for women and families who are
homeless in order to determine the needs of this population
and the possible role of occupational therapy in such a community-based
program. METHOD. Twenty-four women residing in
a supportive housing shelter in Kansas City, Missouri volunteered
to participate in this study. The participants were
evaluated for independent living skills with the Kohlman Evaluation
of Living Skills. A structured interview format was
used to determine whether participants experienced a trauma
and whether they met diagnostic criteria for PTSD. RESULTS.
Results indicated that women who are homeless have deficits
in independent living skills, especially in the area of money
management. Results also indicated that traumatic experiences
and PTSD are more prevalent among women who are homeless than
among women in the general population. The relationship
between independent living skills and PTSD among women who
are homeless was not made clear in this study. CONCLUSION.
The information gathered in this study underscores the importance
of identifying and addressing occupational and mental health
issues of women who are homeless. Results suggest that
occupational therapists have a major role to play, evaluating
and facilitating independent living skills, as members of
multidisciplinary treatment teams in supportive housing programs
for persons who are homeless.
Froehlich, J. (1992).
Occupational therapy interventions with survivors of sexual
abuse. Occupational Therapy in Health Care, 8(2/3),
1-25.
ABSTRACT: Many
clients treated by occupational therapists in psychiatric
settings are survivors of sexual abuse. The diagnosis of post-traumatic
stress disorder (PTSD) and multiple personality disorder (MPD)
most accurately reflect the experience of these clients, yet
misdiagnosis is common. An overview of these diagnoses is
presented. Psychotherapeutic principles are reviewed and a
dual approach to occupational therapy is suggested. Within
this dual approach, the model of human occupation (Kielhofner
& Burke, 1980) is useful in addressing a client's present
daily living concerns. Object relations theory guides an occupational
therapy focus on recall and emotional recovery from past abuse
experiences. A case study illustrating a dual approach to
occupational therapy is presented.
Joe, B.E. (1998).
Ghosts of wars past. OT Week, 12(35), 16-17.
ABSTRACT: Certain
triggers-like Steven Spielberg's graphic depiction of WWII
in "Saving Private Ryan" - can cause PTSD to surface
in older veterans.
Phillips, M.E.,
Bruehl, S. & Harden, R.N. (1997). Case Report: Work-related
post-traumatic stress disorder: Use of exposure therapy in
work-simulation activities. The American Journal
of Occupational Therapy, 51(8), 696-700.
Raweh, D.V. (1997).
Evaluation of veterans of military service suffering from
post-traumatic stress disorder. The Israel Journal of Occupational
Therapy, 6(3), E93-E94.
ABSTRACT: Until
1994, a soldier who was injured during his military service,
was examined by three doctors for just a few minutes. This
was the official way he could receive recognition of his mental
disability from the Israeli Ministry of Defense. This
medical board could identify whether a connection existed
between the soldier's military service and his injury; however,
it could not establish a specific level of function or dysfunction.
The deficiency in the functional evaluations of the soldier
injured in combat resulted in numerous errors in both evaluation
and treatment. Thus a commission composed of a representation
from the Ministries of Defense and Health, established national
evaluation centers. Today these four centers assess the injured
person interdisciplinarily and transmit their findings to
the Board, in order to increase understanding of the degree
of disability. This article presents the evaluation
battery of occupational therapy and its underlying principles
that are presently implemented in these centers. Most
of the clients suffer from Post-Traumatic Stress Disorder.
The evaluation battery was initially developed for this population,
but due to its comprehensive view of clients' functioning
can be used as well for assessing other mental disorders.
Short-DeGraff,
M.A. & Engelmann, T. (1992). Activities
for the treatment of combat-related post-traumatic stress
disorder. Occupational Therapy in Health Care, 8(2/3),
27-47.
ABSTRACT: The purposes
of this article are to review some of the common causes and
symptoms of Post-Traumatic Stress Disorder (PTSD), particularly
as it applies to combat-related trauma experienced in the
Vietnam veteran, and to offer a variety of treatment activities.
These activities may be graded for use with other types of
combat-related trauma or other forms of PTSD. The activities
are listed so that they may be used cumulatively to result
in a final ceremony that becomes a ritual for resolution of
ambivalent emotions and/or the expression and release of powerful
negative feelings of guilt, rage, or hurt. The objective is
for these activities to be included with other treatment approaches
aimed at enabling the client to let go of past trauma and
make a positive transition to healthful and productive living. |
