Expanded Roles of the Occupational Therapist While Deployed

Deployed OTs must often juggle additional work responsibilities in addition to managing their therapy programs. They must be prepared to assume duties required of a military unit deployed to a combat zone. CPT Bash, provided his account from a deployment to Iraq in 2005 with a Massachusetts Reserve COSC unit. He described some examples of additional roles incumbent of an Army officer while deployed (Fig. 5.4).

CPT Daniel Bash sitting on a berm, Iraq, October 18, 2005 (Courtesy of CPT Daniel Bash)

Fig. 5.4 CPT Daniel Bash sitting on a berm, Iraq, October 18, 2005 (Courtesy of CPT Daniel Bash)

Following the short time spent at a remote base in Iraq, I was transferred to a large division headquarters base, where I was assigned as the Officer in Charge of a treatment prevention team being relocated from the Baghdad Green Zone. I was given a team of Soldiers in which some had remained from the original prevention team and others were transferred to my team because of behavior issues or incidents with their previous teams.

Essentially, I was tasked to create an effective treatment team with a group of young Soldiers, some experienced, others not. In short order, we had to be a cohesive and well trained treatment team able to effectively manage the COSC mission at hand, which did not occur without challenges.

We quickly evolved having to manage one of the busiest COSC missions our unit had experienced during our yearlong deployment. We were treating a rate of over 100 contacts a week and simultaneously housing as many as eight Service Members in need of longer term restoration at any given time.

No senior enlisted personnel were available to assist at the time. Since my team consisted primarily of young and inexperienced Soldiers, I not only performed as a clinician and senior officer, but also as a surrogate father, role model, disciplinarian, and an educator. I also had to perform as a diplomat in dealings with other base units, facilities, and higher command to advocate for proper staffing and support for my clinic and team. All the while, I was mindful of ensuring best practice treatments were performed and my team remained safe.

CPT Daniel Bash, OT, US Army Reserves

I had the opportunity to perform both my OT BH clinical role as well as additional duties as assigned. Some of those duties included being the OIC of a firing range, a court-martial investigator, unit movement officer, and other pertinent unit level positions.

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

It is evident from these accounts that role delineation for an OT is neither finite nor confined to clinical activities. Assigned roles can be fluid throughout a deployment. Success is measured by having the flexibility to assume expanded roles while effectively performing primary responsibilities. Amongst the many roles OTs are assigned, it is critical to maintain professional identity and ensure clinical care is within their scope of practice, and meets the mission of returning Soldiers to duty as quickly and safely as possible.

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