Role of Occupational therapy in PTSD

The occupational therapist provides treatment to the patient with PTSD (Post-Traumatic Stress Disorder). The treatment approach is similar to the anxiety, stress-related or depression disorder. The occupational therapist understands the psychology of a patient and treats accordingly. The person with PTSD remains in stress due to a past bad event. The occupational therapist tries to calm down and refocus on daily life skills and occupational performance.

What is Post-Traumatic Stress Disorder (PTSD)-

According to ICD-10, this disorder arises as a delayed response to an exceptionally stressful life event or situation. This can happen to any person who has been under severe stress because of an accident or condition (e.g. Disaster, war, car accident, rape or torture).

The symptoms of PTSD may develop, after a period of latency, within six months after the stress or may be delayed beyond this period.

Symptoms of PTSD –

Recurrent and intrusive recollections of the stressful event, either in flashbacks (images, thoughts) and/or in dreams.
Sense of re-experiencing of the stressful event.
Marked avoidance of a similar event.
Anxiety and increased arousal.
Feeling of numbness.
Anhedonia (inability to experience pleasure).

Occupational therapy Assessment in PTSD-

The occupational therapist assesses all the related areas of stress-related disorder. An occupational therapist generally follows the basic rules of assessment in person with PTSD,

Interview of the patient as well as a family member provides the main details like the history of accident/trauma, patient’s behavior, social interaction, occupational performance, level of anxiety or depression, self-care, etc.

Model of human occupation frame of reference may be used by the therapist to assess and plan treatment. Volition, Habituation, role performance, environment, these areas are evaluated by the therapist.

The Psychodynamic frame of reference is also helpful. Ego boundaries, defensive function, reality testing can be assessed through the use of projective techniques.

Occupational therapy goals and objectives in PTSD-

The goal and objectives set by the occupational therapist after the evaluation. The goals depend upon the severity of illness.

To relieve from the stress.
To accept the truth of loss.
To improve occupational performance.
To improve social interaction.
To improve the ADL skill.

These are the long term goals while short term goals are very simple and easily achievable.

Occupational Therapy Management in PTSD-

Occupational therapist management begins from the assessment of a description of the stressful event, the actual loss of a patient or the real reason for stress.

The management is somewhat similar to depression and anxiety. The rapport building is most crucial to treat patients of post-traumatic stress disorder.

An Occupational therapist may use a different frame of reference and approaches to manage the PTSD. Some are-

Therapeutic use of self-

“The use of oneself in such a way that one becomes an effective tool in the evaluation and intervention process” (Mosey, 1986, p. 199). This can be very useful to deal with PTSD.

It involves a planned interaction with another person to relieve fear, stress and/or anxiety. The process includes many steps like, provide reassurance, obtain necessary information, provide information, give advice, and assist the other individual to gain more appreciation of, more expression of, and more functional use of his or her latent inner resources.

Projective techniques-

Projective techniques can also be used by the therapist. It provides the opportunity for the patient to depict the stress on the papers or though colors. It may be used as an activity.

Relaxation Techniques-

Relaxation techniques can be used to lessen the stress. Yoga, meditation, Jacobson’s relaxation techniques, breathing exercises, are the common techniques used by the occupational therapist.

Relaxation techniques can be learned by the patient and apply it whenever he/she feels stressed.

Reality orientation-

Reality orientation or acceptance of the condition is very crucial for the patient. Sometimes, the loss is unrecoverable like the death of wife in a car accident, but acceptance is necessary to refocus on the better life roles.

Therapeutic Activities for PTSD-

Therapeutic activities are the mainstream of occupational therapy. OT uses the activities for all the patients they treat. The PTSD can affect the children as well as an adult. Play therapy is the best medium in the case of children with PTSD while meaningful, purposeful occupational or leisure activities are more beneficial for the adults having PTSD.

Activities includes-

For kids –

Outdoor activities like football, ball catching-throwing, treasure hunt, sensory play, slides, swings, etc.
Indoor activities like painting, drawing, musical chair, obstacle course, hide and seek.

For Adult-

Gardening, planting, homemaking, dancing, swimming, listening to a favorite song, gymnasium, etc.

Above mentioned activities are general in nature, but effective when a patient does this to divert his/her mind from the stress.

Satisfy Emotional Needs-

Seeking emotional needs is the behavior of an individual with PTSD. He/she may in search of love and feeling of acceptance by others. The Occupational therapist guides the caretaker and family member to accept the condition of the patient and provide support when they need it most.

An Occupational therapist provides occupational activities to the patient, so they can feel self-importance, self values, and most importantly, accept himself as an important individual.

Release of hostility –

The Occupational therapist may suggest activities for the hostile nature if present. Sometimes, due to the stress, the patient suffers from inside and keep their pain inside and do not share with others. It may provoke sudden hostility.

Initially, the use of nonaggressive activities can be given to the patient and when the patient is able to tolerate it, the therapist can introduce aggressive activities, for e.g. hammering, woodwork, bag punching. So the patient can divert their aggression to the nonliving objects.

Summary –

Occupational therapy has an important role in PTSD (Post-Traumatic Stress Disorder). An Occupational therapist helps the patient to relieve the stress and rejoin in an occupational or daily routine task. Purposeful activities and other approaches help the patient to return to normal life.

References –

Scaffa, Marjorie E., et al. “The role of occupational therapy in disaster preparedness, response, and recovery.” The American Journal of Occupational Therapy 60.6 (2006): 642.
Clarke, Channine. “Treating post-traumatic stress disorder: occupational therapist or counsellor?.” British Journal of Occupational Therapy 62.3 (1999): 136-138.

Payal Pawar, OT

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View Comments

Penelope Smith says:

June 29, 2019 at 5:37 am

I liked that you pointed out that you need to satisfy your emotional needs when recovering from PTSD. It might be smart to get a professional to help with treatment. That way, you can hopefully recover faster.