Year Authors, Title, & Journal: Pub: Purpose: This study was done to see if EMRD (eye movement desensitation and reprocessing) is a efficient and effective form of therapy. The final consensus was established as EMRD is not a credible form of treatment among combat injuries in our current war, Albright, D., & Thyer, B. Does due to lack of research in current war and contexts. EMDR reduce posttraumatic They found that EMRD is not much different from stress disorder symptomatology exposure therapy. Furthermore, EMRD is not a real in combat veterans? Behavioral life therapy that acknowledges exposures in relation Interventions 2010 to context. The main idea of this article was to analyze the Brenner, L.,& Vanderploeg, R. current situation of PTSD and TBI affecting the Assessment and diagnosis of mild military personnel. This paper discusses assessment traumatic brain injury, and intervention strategies and proposes we focus on posttraumatic stress disorder, understanding cumulative disadvantages along with and other polytrauma conditions: implementation of early screening and treatment, burden of adversity hypothesis. 2009 combined with decreasing adversities and burdens. This study was done to look at the effects of goal directed therapy. The research explores goal directed therapy in clients with TBI. Not only did they explore the planning/process of the program for the client Doig, E., Fleming, J., Cornwell, P., they also explored the process involvement when & Kuipers, P. Qualitative their families or friends are involved in the decision exploration of a client-centered, making with the therapist. Results showed the goal-directed approach to positive enhancements that are made with goal community-based occupational directed therapy involved within a community base. therapy for adults with traumatic Goal directed therapy provides meaning, brain injury. American Journal of encouragement, purpose, power, and enhanced Occupational Therapy 2009 perception to all of those involved. The main purpose was to took into test results of patients with mTBI. They hypothesized that patients would experience deficits in awareness, participation, and executive functioning. What they found was that Erez, A., Rothschild, E., Katz, N., there was an increase in executive functioning such as Tuchner, M., & Hartman-Maeir, planning and shifting, yet they were aware of their A. Executive functioning, own deficits. They also found that the major issues awareness, and participation in faced among people with mTBI is problems with daily life after mild traumatic IADL's and difficulty finding employment. Future OT's brain injury: A preliminary study. should focus on these areas by using a top down American Journal of Occupational assessment approach that better measures real life Therapy 2009 situations. Investigated "explicit problem solving skills training Fong, K., Dorothy, H. Effects of program." They wanted to test and see what an explicit problem -solving skills therapies worked best among those with brain training program using a injuries. What they found is that the tests were not metacomponential approach for able to analyze real life situations with limited them in outpatients with acquired brain validity. Despite this, they found that injury. American Journal of metacomponential therapy with focus on executive Occupational Therapy 2009 functioning seem to be the best fit or intervention. Goal was to synthesize data from military populations on assessments and treatments for OIF/OEF veterans returning back from war who are recovering polytraumas. There are many challenges to over come that include a combination of dysfunction and integration back into society. These commorbid dysfunctions include any of the following: cognitive, Gironda, R., Clark, M., Chait, S., medical, emotional, and integration back into society. Walker, R., Ruff, R., Craine, M., & These dysfunctions are partly due to the increasing Scholten, J. Traumatic brain among of TBI and posttraumatic stress experienced as injury, polytrauma, and pain: a result of combat. They found there is a need to challenges and treatment provide early prevention care and pain management strategies for the polytrauma strategies. We need to integrate clinical care with rehabilitation. Rehabilitation other specialties to incorporate a holistic model of Psychology 2009 reference. TBI's are increasing and affecting thousands of people every year. Previous researched focused on Giuffrida, C., Demery, J., Reyes, L. "repetitive practice." This research paper promotes Lebowitz, B., Hanlon, R. diversity in practice schedules and show how change Functional skill learning in men and dynamic environments increases performance with traumatic brain injury. skills in TBI's. Therapists should integrate more American Journal of Occupational randomized therapy techniques to enhance Therapy 2009 treatment. Humphrey, K. Responding to the This research paper explores the psychological psychological impact of war on damage that has affected both the U.S. and Iraq. This the Iraqi people and U.S. looks at the necessities to improve services to the veterans: mixing icing, praying for military personnel and the limitations that need to be cake. American Psychologist 2009 addressed in the health care services provided. Brain injuries within the department of defense are increasing. Rates of concussions are increasing and Jaffee, M., Helmick, K., Girard, P., the causes are unknown. An increasing amount of Meyer, K., Dinegar, k., & George, these concussions are going undiagnosed or treated. K. Acute clinical care and care This is a major concern. This article looks at the coordination for traumatic brain assessment, treatment, and care that hospitals offer injury within department of for TBI and also provides new ideas on how increase defense. Journal of Rehabilitation awareness and procedures for providing the care that Research & Development 2008 is needed. This editorials purpose is to challenge our OT's to getting more involved in the rehabilitation research. This article explains why it was so hard for me to find AJOT articles on combat treatment and related topics. "A search of the occupational therapy literature using key words such as disaster, terrorism, and PTSD Josman, N., & Josman Z. Is reveals an alarming scarcity of articles." OT's really Occupational Therapy in step need to become involved because psychological and with the extreme events of our psychiatric literature fails to recognize the need for time? OTJR: Occupation, occupation and participation as key components in Participation, and Health 2007 recovery. This is huge! This paper analyzes the care that is administered to the military's Department of Defense and Veterans Affairs Polytrauma System of Care. TBI treatment is Meyer, K., Helmick K., Doncevic, of main focus. Polytrauma centers focus on holistic S., Park, R. Severe and care through a team approach to therapy. Also noted penetrating traumatic brain is that family/friends support contributes to higher injury in the context of war. recovery rates. Also provided is a continuum of care Journal of Trauma Nursing 2008 which helps to ensure stability in recovery. This research journal acknowledgement the stresses that couples face in their relationships when one or both come back from war with conditions such as PTSD; before now there was lack of evidence or treatment strategies to monitor or combat these issues. This journal presents cognitive-behavioral Monson, C., Fredman, S., & Adair, conjoint therapy to acknowledge the effects of war in K. Cognitive behavioral conjoint relation to integration of the military personnel back therapy for posttraumatic stress into their home environment. CBCT seems to show disorder application to operation significant improvement but further tests and enduring and Iraqi freedom research needs to be done in order to validate such veterans. Journal of Clinical claims. "...We are called to innovate and provide the Psychology 2008 best possible services..." Objective: to explain and explore current issues pertaining to combat injuries (physical and Uomoto, Jay M., & Williams, psychological symptoms) that have affected soldiers Rhonda M. Post acute in the past and are relative to present day OEF and polytrauma rehabilitation and OIF (Operation Enduring Freedom & Operation Iraqi integrated care of returning Freedom). Discussion is on historical concepts that veterans: Toward a holistic can provide a holistic view on developing approach. Rehabilitation rehabilitation strategies we can integrate into current Psychology. 2009 day soldiers coming home from war. This paper looks at the minority veterans (of different race and ethnic background) with ABI (Acquired Brain Injury). The paper brings to light they variety of impairments in cognition and vocation that lead to Wehman, P., Gentry, T., West, physical, social, and economic hardships that these M., & Arango-Lasprilla, J. individuals face. Further suggested are ways to help Community integration: current such individuals. They found that cognitive therapy issues in cognitive and vocational needs to focus on real life application, in a rehabilitation for individuals with multidisciplinary approach, using compensation and ABI. Journal of Rehabilitation technology as assists. Community therapy also Research & Development 2009 proved to be an effective form of treatment. Subject Characteristics: Key Words: Comments: EMRD is a cognitive behavioral therapy that has been used for the last twenty years. Combat injuries in our current war include: mental disorders, PTSD, anxiety disorders, sexual assault, natural disasters, and Research was collected accidents. Therefore, current studies from databases, websites, and further research should and manual services. acknowledge factors such as: multiple Specifically six Wiley Inter deployment, longer rotation theatre, experiments and three Science: Operation more women experiencing combat, quasi studies were Iraqi Freedom and and more involvement of The analyzed. combat injuries. National Guard and Reserve Units. 1.64 million troops in OEF/OIF. Combat injuries include: one wounds, traumatic brain, spinal cord, eye, ear, Operation and musculoskeletal injuries, Enduring amputations, and mental health Freedom; problems. These diverse factors Operation Iraqi introduces us to the term polytrauma Freedom, to describe the war injuries of our Traumatic Brain time. Mindsets and biases keep Subjects were exposed to injury; military personnel from reporting all emotional trauma, posttraumatic their symptoms. Treatment of sleep military personnel, stress disorder; problems could reduce other areas of posttraumatic stress war; poly trauma; concern. We need to educate, assess disorder, traumatic brain and military early, look at past history, decrease injury and war. personnel. stigmas, twelve people with TBI were put on a twelve week program. The goals were designed by the client their significant others, and collaboration brain injuries with the therapist. community health Afterwards interviews services were given to gather goals information from the 12 patient clients, 10 significant participation group goal directing is better than others, and 3 therapists. rehabilitation individual in the case of TBI. The most common issues in mTBI 13 participants with mTBI. include: reduced processing speed, Time of injury had been attention, memory verbal fluency, on average 4.7 months and executive functioning. BADS previous. The mean age (Behavioral assessment of was 43.4. Study was awareness dysexecutive syndrome) seemed to conducted at an out brain injuries attain the most accurate results. Also patient rehabilitation cognition there is suggestion of using the hospital in Israel. self-concept Executive Function Performance Test. Solving problems in real life is an essential component to a persons executive functioning skills. Such training should focus on solving brain injuries; problems in real life scenarios. 33 outpatient with cognitive training; Dysexecutive questionnaire seems moderate acquired brain decision making; best in pin pointing ideal common day injury. Study was done in metacognition; problems. More tests need to be Hong Kong at a cognitive and problem done to assess the social component rehabilitation hospital. solving. affecting mTBI's. Subtopics of research paper include: polytrauma non headache pain treatment, pharmacologic management of nonheadache pain, rehabilitation modalities for non headache pain, cognitive behavioral interventions for non headache pain, posttraumatic headache, posttraumatic headache diagnosis, pathophysiology of posttraumatic headaches, posttraumatic headache treatment, barriers to effective pain pain; headache; management in polytrauma polytrauma; populations, pain assessment in the traumatic brain communication impaired, pain Empirical data from injury; management among those with civilian and veteran postconcussive multiple somatic and cognitive populations. OEF/OIF syndrome; symptoms of mixed or personnel with posttraumatic undifferentiated etiology, and polytrauma. stress disorder. conclusions. "randomly ordered practice schedule results in depressed performance in acquisition but enhanced performance in retention and transfer brain injuries; in contrast to a blocked ordered cognitive practice schedule." Could this be due disorders, to plasticity? Possible implications for six men with TBI. Men learning, motor rebuilding neurons through new had problems with skills, task environmental regimes. This article processing and motor performance and has further implications in functions. analysis. neuroscience. subjects included military Psychological issues need to be veterans with addictions addressed in our countries military. who utilized mental The sad part is that IRAQ only dreams health services due to posttraumatic about being able to address such PTSD in relation to war. stress disorder; issues. Future Occupational therapist Common themes and addiction; can help the reintegration and be personal experiences of veterans; Iraq; apart of the team to holistically the author were also mental health approach these issues. Suggestions discussed. systems; and war further presented in research. cognitive assessment; community reentry; loss of consciousness; medical evaluation; according to the concussion polytrauma; management grid Occupational posttraumatic Therapy should be implemented with amnesia; focus in cognition to combat memory, rehabilitation; TBI; concentration, and decreased TBI screening; and executive functioning. Treatment traumatic brain option should be to normalize sleep, military personnel injury. nutrition, and pain control. OT's need to become more apart of the holistic treatment that can be provided not just to the military but to all disaster reliefs (hurricanes, Guest editorial floods, ect.) IT is important to commenting on the lack individuals to maintain a "sense of of information, research, coherence" their perceptions of what and therapeutic designs actually has happened to them. If we to help cater to the do not engage ourselves in this issues changing that is we will cause more problems to our happening in the world PTSD; disaster; visibility and essence to the society at today. recovery large. Occupational therapists need to focus on assisting recovery in musculoskeletal function, coordination, and lifestyle military, (restoration and reintegration into penetrating TBI, society/community). Acute rehab is severe TBI, essential. Time in-between or before traumatic brain treatment begins highly affects the military personnel injury recovery rate of the individual. In relation to a part of chaos theory and the idea of having a butter fly effect (where one butterfly flapping his wings in china creates a tornado in Texas) reminds me of this article and how everyone affects everyone else synthesis of knowledge couples; no matter how insignificant you think gathered from veterans posttraumatic it is. Therefore it only makes sense to and their partners; stress disorder; cater or make therapies not just for present a case study using couple therapy; the patient but also for the people cognitive behavior cognitive- that are important actors in the conjoint therapy (CBCT) behavioral patients life. This is true holistic care for PTSD. conjoint therapy. and room for OT involvement. Key Words: Operation Enduring Freedom; Operation Iraqi Freedom; war; Focus: hysteria, shell shock, and Military veterans who rehabilitation; polytrauma. Challenges are in the experienced brain injuries; neurorehabilitaiton services. The rehabilitation, stress, stress disorders; symptoms are complex and trauma, traumatic brain veterans; interdisciplinary treatment injuries, combat polytrauma; approaches need to accommodate to experience, and war. combat injury. the multiple issues or polytraumas. acquired brain injury; alternative work arrangements; cognitive rehabilitation; community integration; employer With job coaching looking at skill level supports, of individual and specific jobs they posttraumatic could do is important. Try to find the stress disorder; right job position by looking at race/ethnicity; different types, supports, intensities, return to work; challenges, and interests that could veterans; and make a perfect fit for the individual. minority soldiers vocational Make their "limitations returning from war. rehabilitation. accommodated." Quotes or Further Research: "Placebo responses to believable but inert psychosocial treatment can be exceedingly powerful." " Given the incidence of combat related PRSD the costs it exacts upon the disorder their families, and the military, we believe that such well designed intervention research is urgently needed." "Accumulation of disadvantaged genetic and/or environmental factors can result in a cascade of physical and psychiatric risk." "Increasing coping strategies was also suggested as being potentially useful, thereby supporting the idea that addressing specific symptoms or problems early may decrease long term negative outcomes." "Early assessment and treatment is indicated in order to alter negative life course trajectories." Future Research: Look at evidence based treatment with "co-occurring disorders," expectations of recovery, cumulative disadvantage and how this affects OEF/OIF military and their integration back into society " Goals provide structure, which facilitates participation in rehabilitation despite the presence of barriers, including reduced motivation and impaired self-awareness." "Goals facilitate a client centered approach to rehabilitation because they can be uniquely adapted to each person according to his or her profile of strengths and limitations." "A need exists to examine the impact of the mTBI cognitive profile on participation in meaningful life roles." A wider perspective beyond impairment and disability need to be examined. "Innovative cognitive rehabilitation program involving training in problem solving and emotional self regulation could lead to greater improvement in self reports and role play problem solving measures for experimental compared with control participants." "The explicit problem solving training approach emphasizing metacognitive principles and showed greater effectiveness." "An integrated, intensive out patient treatment program may be the most efficient and effective approach for those with PMD…. Specific components of an integrated treatment program would be individual and group based psychoeducation, coping skills training, and cognitive behavioral therapy with an emphasis on instilling proactive self management techniques. Specific psychoeducation topics would include sleep hygiene, anger management, physical conditioning, relaxation training, substance use/abuse moderation or prevention, vocational rehabilitation, analgesic overuse, and cognitive restructuring." "An unexpected finding from the study was that 4 to 5 participants reported that their experience in the study positively changed their view about their abilities after their TBI. One participant reported, "it made me care about myself a lot more." Another stated, "it gave me a better out look on myself and helped my self esteem also." This has great implications for further research and treatment! "on March 20, 2003, the United States and its allies began a devastating "shock and awe" bombing campaign in Baghdad as 300,000 soldiers invaded Iraq in ensuing years, of whom several hundred thousand would return home with psychological problems ranging from depression to drug addiction." " While TBI may result in physical impairment, often the more problematic consequences involve an individual's cognition, emotional functioning, and behavior, These consequences can affect all aspects of life, including development and maintenance of interpersonal relationships and the ability to function in social settings. Community reintegration efforts are therefore aimed at maximizing individual strengths and creating supportive environments that will allow individuals with TBI to return to work and family." "Although we can develop methods for intervening with disaster and trauma victims, we posit that to make a substantial contribution our profession needs to develop a frame of reference for addressing these challenges, in terms of both scope and scale. Moreover, we need to incorporate our unique concept of participating and occupation as key factors in providing services to victimized populations. In addition, we must reassess who our target clients are." "Recognizing that TBI has been labeled a signature injury of the wars in Iraq and Afghanistan much research needs to be done to improve diagnostic tests and treatment of TBI as well as elucidate the pathophysiologic changes that occur with blast injury." A list of stages and sessions included in the 15 wk program: introduction to Tx, safety building, listening and approaching, sharing thoughts and feelings, getting unstuck, problem solving, acceptance, blame, trust issues, power and control issues, emotional closeness, physical intimacy, posttraumatic growth, and review and reinforcement of treatment gains. "Although the robust association btw PTSD and intimate relationship problems are unfortunate, this connection also presents an opportunity to capitalize on the healing power of intimate relationships to improve the health of the individuals and their relationship." "Holistic post acute brain injury rehabilitation has been shown to improve community functioning and quality of life." Conclusion discuss resilience. "Frequent reports from veterans state that much of their suffering is not related to combat or to disability perse, but rather to leaving the military and integrating in a civilian culture. Veterans also often indicate they perceive honor in their experience and their injuries and that some degree of suffering shows respect for the fallen and the sacrifices they have made." "As more service members are returning from conflict, interventions are needed to help them return to productivity, including compensatory strategies job accommodations, and job coaching. Individuals from racial/ethnic minority backgrounds often face even more difficulties in returning to productivity and normalcy."
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