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


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


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 personnel.

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]