Occupational Therapy and Combat Stress

Please be aware that this clip contains battle scenes and loud noises!
Occupational Therapy
and Combat Stress
“They fight our wars. We fight their battles.”
Karen Miles Bsc (Hons)
• Combat Stress is the UK's leading military charity specialising in
the care of Veterans' mental health.
• We look after men and women who are suffering from a
psychological condition related to their Service career. This might
be depression, anxiety, a phobia or PTSD (Post Traumatic Stress
Disorder). Our services are free of charge to the Veteran.
• Since 2005 the number of ex-Service men and women seeking our
help has risen by 72%. We have a current caseload of more than
4,600 individuals – including 168 Afghanistan and 533 Iraq
There are currently only 3 treatment centres in the whole of mainland
UK! But we are expanding our outreach teams to cover those who are
deemed able to access us whilst in the community.
Occupational Therapy
in Combat Stress, Newport, Shropshire
• One Occupational therapist and two Occupational Therapy Technicians
– meet the team! From left to right – Karen Miles (OT)
• Jo Dovaston (OT tech) Julie Hill (OT tech)
• Regular assistance from Health Care Assistants who show an interest in
• Clients either come in for one weeks assessment – to determine
whether their symptoms are caused by service related trauma or, for
Two weeks treatment, once a year, (more often if able).
Unfortunately having a mental health problem is still a stigma and
many of our clients use annual leave for their treatment to protect
their jobs in “civvi street”.
• OT referrals received from Nursing staff or the client themselves.
• Youngest 18 – Oldest 90 +
• Some also have personality disorders and or physical disabilities
• 28 Clients in the treatment centre at any one time
• Occupational Therapy Department accessible by all who wish to use
the facilities
• OT Department open from 9.30 am until appx. 20.00 hrs. With at
least one member of the OT team present 7 days a week.
Model Used:
Model of Human Occupation Screening Tool
• The Model of Human Occupation is a theoretical model of
occupational therapy practice which OT seeks to explain how
occupation is motivated, patterned and performed. It has become
one of the leading theories in occupational therapy practice
worldwide. (Kielhofner 2001)
• MOHOST (Parkinson & Forsyth 2001) stands for the Model of
Human Occupation Screening Tool – It was developed form the
model of human occupation (MOHO) and addresses the majority
of MOHO concepts (volition, habituation, performance capacity
and environment). Allowing the therapist to gain an overview of
the clients occupational functioning.
The therapist rates 24 skills through assessment of
the client, four in each section:
• Volition (Motivation for Occupation)
• Habituation (Pattern of Occupation)
• Communication & Interaction skills
• Process skills
• Motor skills
• Environment
Using the Occupational Therapy Process:
• Initial Assessment: Information gathered from nursing notes on admission,
feedback from staff and an initial assessment interview with ex service
• Treatment Planning: Using client centred practise, OT & client agree on at
least 3 short term goals whilst attending the treatment centre. These
generally are around self –esteem, confidence, loss of roles, communication
and interaction and lack of motivation.
• Intervention: 1:1 sessions with OT staff, graded exposure, mindfulness
training, engaging in meaningful occupation using facilities provided and
group work.
• Evaluation: OT meets with client just before discharge to discuss progress
and plans for future admissions and gives homework.
• Comprehensive notes are written daily regarding clients engaging in OT in
main nursing notes for MDT to read, plus MOHOST multi observationals.
Giant Jenga is played
as part of our Body
Active Group
When you are afraid to
paint, the OT may
suggest painting your
cap badge!
Special Thanks to my clients who gave
permission for their work to be shown!
If you wish to ask any questions or
would like further information please e
mail me at..
[email protected]

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