Different Missions/Goals Deployed Occupational Therapists Face

When not in a deployed environment, OTs assist patients in restoring functional skills needed to return to work, daily life, leisure, and social reintegration. When deployed, OT treatment objectives predominantly focus on returning a SM to active duty. The timeline for recovery is much shorter in a war zone. If a SM displays the inability to function safely and productively in a timely manner, a medical evacuation must be considered. OTs must be cognizant of the unique physical and psychological duty requirements of a SM to alter their therapeutic treatment programs accordingly (Fig. 5.3).

Our COSC unit arrived in Baghdad in support of OIF in 2008. Our mission was to coordinate and deliver Combat Health Support to US forces in the Multi-National-Corps-Iraq sector by conserving the fighting strength, preventing injury, or evacuating COSC casualties to higher levels of medical care (Germany), if a patient’s recovery was not in a timely manner or needed more intense medical attention.

In Iraq, I was assigned as the Officer in Charge (OIC) of Restoration (a rehabilitation mission), housed in a facility created by two adjoining trailers, and co-located with the Troop Medical Clinic. My team’s mission was to restore a Soldier’s physical and mental capacity to return them to the fight.

LTC Enrique Smith-Forbes on a visit to Al-Faw Palace, Iraq, 2008 (Courtesy of LTC Enrique Smith-Forbes)

Fig. 5.3 LTC Enrique Smith-Forbes on a visit to Al-Faw Palace, Iraq, 2008 (Courtesy of LTC Enrique Smith-Forbes)

Lieutenant Colonel (LTC) Enrique Smith-Forbes, OT, US Army, Active Duty

Preparing yourself physically and mentally when deploying to an active combat zone is critical for everyone. Therapists must adapt professionally and train to address injuries not experienced back home in a traditional hospital setting. One must be prepared to treat symptoms such as anxiety, depression, workplace violence, and survivor guilt, among others provoked by events such as combat, indiscriminant blasts, death, severe injury, unresolved problems at home, relationship constraints, or financial crises.

The urgency to return SMs to duty is driven by the need to maximize unit strength to meet the requirements of the mission. Treatment goals and priorities must shift to provide these individuals with the rehabilitation they need within a truncated time frame. This differs significantly from civilian or stateside military hospitals where a longer, more ideal rehabilitation timeline is available to maximize psychological recovery.

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