Document Type

Critically Appraised Topic

Publication Date

2011

Clinical Scenario

Over the past decade the United States has deployed over two million service members overseas and many into combat (Sayer et al., 2011). It has been estimated that many of these returning veterans will suffer from posttraumatic stress disorder (PTSD) and that a number of these veterans won’t seek help due to the stigma of mental illness. Combat veterans, in general, often have a difficult time reintegrating into society and this is compounded when they are also battling PTSD. This can impact functioning in almost every area of life and is a serious problem. Outdoor recreation, including hiking, backpacking, climbing, kayaking, snowboarding etc., is a valued occupation for many people. Occupational therapists (OT) understand the importance of incorporating meaningful activities into treatment to optimize the personal benefits the client receives from both occupational therapy as well as counselling to reduce symptoms of PTSD. OT’s have the ability to help veterans explore new and lost activities, in this case outdoor recreation. Veterans may then utilize the tools they gain from participation in meaningful occupations to assist them in successfully coping with their symptoms from PTSD reintegrating into civilian life.

Clinical Question

How does outdoor recreation impact PTSD symptoms in returning veterans?

Clinical Bottom Line

War veterans typically avoid seeking help when they are dealing with their symptoms of PTSD. Utilizing innovative, evidence-based interventions to help veterans manage their PTSD and successfully reintegrate into civilian life is much needed. Research suggests that using outdoor recreation as an adjunct intervention may enhance the counselling process and help build rapport between the veteran and care provider. Research has shown that nature-assisted therapy, including outdoor recreation, to have a significant effect on many different psychological and social aspects in diverse populations. However, due to the nature of this research, it is difficult to determine generalizability and whether or not it would have a similar impact on veterans with PTSD. Occupational therapists should consider using outdoor recreation within their treatment plan, if it is a meaningful occupation for the client, because of the multitude of potential benefits including a decrease in depression and anxiety, an increase in self-efficacy and improvement in social interactions.

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