Canadian Armed Forces and Veterans
Occupational therapists (OTs) have a long and rich history of working with active Canadian Armed Forces (CAF) military members and veterans. Occupational therapy came into being in 1915 to assist soldiers who were returning from WW1, transition to civilian life.
The Canadian Association of Occupational Therapists (CAOT) has worked and continues to work closely with the CAF through the Department of National Defence (DND) and veterans through Veteran Affairs Canada (VAC) to promote occupational therapy as an essential service for the health and well-being of military personnel, veterans, and their families.
Today, OTs work within the military community to provide client-centred and holistic care to assist with the reintegration of meaningful activity and return to active duty or the transition into civilian life. OTs help to address a broad range of physical and mental health issues shown to directly impact everyday function.
As experts in managing transitions, OTs work with clients and their families to identify the occupations and activities that are important for family, personal and work life, and to help to plan, initiate and track short- and long-term goals that enable participation in those activities. OTs teach practical, non-pharmacological ways of coping with PTSD, chronic pain, and disturbances in everyday functioning. Through occupational therapy services, CAF members are given practical and results-focused strategies to increase engagement in the meaningful activities of their lives.
Canadian Armed Forces (CAF)
Within the Canadian Armed Forces (CAF), there are two categories of members: Regular Forces and Reserve Forces.
OTs provide services to serving CAF military members in two capacities:
- As part of the Department of National Defence (DND) Rehabilitation Occupational Therapists (DND OTs); and
- Blue Cross Occupational Therapists (Blue Cross OTs).
The overarching goal of occupational therapy interventions with CAF members is return to duty (RTD), leading to the ability of CAF members to sustain active military duty. OTs work with members of the CAF to address a broad scope of issues that impact RTD including physical health issues, pain, and vocational challenges (Brown & Marceau-Turgeon, 2015).
Veterans Affairs Canada (VAC)
OTs working for VAC can work in different roles:
- Field occupational therapy services officers
- Case managers
- Clinical care managers
Occupational therapy interventions with veterans are commonly associated with home assessments and recommendations for adaptive equipment to assist with safety, mobility and independence (Card, 2015). Intervention strategies can vary and may include cognitive rehabilitation and mental health services for veterans who may present with traumatic brain injury or mental health issues, including PTSD (Card, 2015).
OTs also provide support in creating new routines and daily structure related to sleep, hygiene, pain management, and coping skills (Craig, 2016).
- CAOT attended and hosted a booth at the 2018 Canadian Institute for Military & Veteran Health Research Conference (CIMVHR), in Regina. CAOT continues to make the case for hiring more OTs as an essential part of promoting the holistic health and well-being of the CAF members and veterans.
- CAOT produced a guidance document to better prepare OTs for effective, client-centred work within the mandates of the DND and VAC. “Working for the Canadian Armed Forces and Veterans Affairs Canada: A Guidance Document for Occupational Therapists.”
- CAOT hosted a webinar on the guidance document to familiarize members with working with DND and VAC, and the ways to work hand in hand with those respective departments.
- CAOT commented on the release of the Government of Canada defence policy “Strong, Secure, Engaged”, («Protection, Sécurité, Engagement» – Une nouvelle politique de défense pour le Canada) to support the range of investments in the Canadian Armed Forces to implement a new Total Health and Wellness Strategy. The Strategy will include promotion, prevention treatment and support and will take into account physical, mental, spiritual and familial aspects of members lives (Defence, 2017), which aligns with occupational therapy’s approach to holistic, client-centred care.
- CAOT is committed to continuing and strengthening the long-standing relationship with DND and VAC to:
- advance the profession of occupational therapy as a valued part of interprofessional care teams for CAF members and veterans;
- advocate for increased recruitment and retention of OTs in VAC and DND;
- present policy options that push for a holistic approach to care with a focus on occupation; and
- put forward non-pharmacological solutions to chronic pain management, PTSD and other mental health and functional challenges as part of a holistic approach to long-term care.
Occupational therapy value proposition
- OTs are experts in transitions. From reintegrating CAF members into civilian life or supporting rehabilitation goals to meet operational readiness and re-enter active duty, OTs are front-line case managers that provide comprehensive assessments, referrals, and tailored interventions to service men and women and veterans. OT interventions help promote resilience, mental health and wellness, physical well-being and a sense of purpose. By focusing on meaningful occupation, and valued roles and routines, OTs help to meet the care needs of CAF members and Veterans as part of an interprofessional primary care team.
- OTs work with CAF and veterans in many different capacities and address a broad range of physical and mental health issues shown to directly impact everyday function. These include but are not limited to:
- orthopedic problems
- musculoskeletal problems
- sleep disorders
- chronic pain
- post traumatic stress disorder
- traumatic brain injury
- need for assistive devices
- home or vehicle modification or adaptations
- dysregulated routines and habits
- mental health
- home safety
- medication and health management
- cognitive screening
- social support
- Through targeted assessment plans and interventions, OTs work with active military members experiencing functional difficulties that are impeding their ability to meet the occupational demands of military service. OTs solution-oriented, practical approach to return to duty, they are an essential link to rehabilitation and reintegration back into military duty.
- Following honourable discharge, veterans are often placed with OTs, who help to successfully transition veterans back into civilian life. Occupational therapy interventions with veterans are commonly associated with home assessment and recommendations for adaptive equipment to assist with safety, mobility and independence (Card, 2015). OTs provide support for cognitive rehabilitation and mental health services and provide support in creating new routines and structure. Commonly addressed issues include:
- chronic pain
- physical limitations
- need for mobility aids
- PTSD, anxiety and depression
- substance abuse
- dysregulated routines and habits, and
- social isolation.
- Because of OT interventions, veterans are better able to gain meaningful employment, and thrive in post-duty civilian life.