A virtual interview with guest poster Deborah Harrison, MSc, BA, Dip COT: Dr. Harrison is a UK occupational therapist with extensive experience working in the NHS, higher education and third sector organizations (the focus of the post). Her focus of research and lecturer at the University of East Anglia, School of Health Sciences is mental health, combat injury and occupational science. [https://www.uea.ac.uk/health-sciences/people/profile/deborah-harrison]
We asked her: “How did you begin volunteering with wounded veterans?”
Mrs. Harrison: I began my journey working with veterans in 2011 by being part of a motorsport team. Race2Recovery [http://race2recovery.com/r2r/ ] came about when two friends, having been through their rehabilitation, were wondering what to do next with their lives. They decided that their recovery would be helped by being involved in motorsport; but not just any motorsport, the most challenging race in the World, the Dakar Rally. The desire to face the most difficult and extreme goals is not unusual, Walking with the Wounded [weblink] and Row2Recovery [weblink], both UK based charities, being further examples.
“How do occupational therapists work with veterans in these types of charities?”
Mrs. Harrison: Occupational therapists work with people to enable them to participate fully in life and to make the most of every opportunity. For people recovering from combat injury there is a sense of loss of previous occupational roles and identity; it is important to support the creation of a life that has new meaning and purpose. Activities have to be relevant and appropriate to the individuals in recovery; sport has many features which appeal to the younger and often male participant (although not exclusively of course).
Mrs. Harrison: Motorsport has some advantages over other forms of sport because it does not have a special category for people with disabilities. The amputee drivers, with their race suits on, look like any other driver or co-driver. It is a physically and mentally challenging sport that earns respect and therefore brings status. Veterans with a disability do not want to be defined by that disability and a positive self-image and self-esteem are vital to successful functioning and full recovery. In motorsport, integration and social inclusion are possible. A huge difficulty with motorsport however is the cost and the lack of an evidence base for its efficacy; many of the benefits can be achieved in other ways.
“What are some exceptional experiences you have had volunteering?”
Mrs. Harrison: One of the most significant experiences of being a part of Race2Recovery was the close team work, often in difficult and challenging situations. This is a vital element for people who have been in the military when they are recovering. The team work in Race2Recovery provided a bridge from the military and helps veterans to adjust to working in close proximity with civilian team members (not always easy). Team activities forge lasting friendships with other veterans and civilians, even when separated by thousands of miles, thanks to social media connections.
I have seen first-hand that wounded veterans often overcome multiple and ongoing problems. Recovery is a long haul when you’ve had long periods as an inpatient, multiple injuries including amputation, brain injury and mental health problems. It is important to take into account not only the physical aspects of rehabilitation and but also the psychological and social aspects. The combat injured veterans need support over an extended period of recovery. Many kinds of help are needed with relationships, finances, finding work, management of pain and mental health problems. If any one aspect of the rehabilitation goes wrong then life can come to a complete halt. Participating in a sport might give everyone a happy feeling, but there needs to be other help available and readily accessible.
“What are some current authors, researchers and or occupational therapists readers can draw on regarding overcoming combat related injury?”
Mrs. Harrison: Having noted the need for signposting to further help, overcoming huge challenges and excelling at a sport or in a particular event can be hugely rewarding and transforming. Dr Mick Collins (2014) discusses this peak experience in his book ‘The Unselfish Spirit’; from the lowest point in your life, which might be seen as a spiritual emergency or complete loss of meaning and purpose, you can be ‘re-born’ and reach self-actualisation and a new sense of self. Occupational therapists believe that this has to be achieved through ‘doing’ (engagement with activity) to achieve our full potential. Those of us who were a part of the team during the Dakar Rally in 2013 will never forget the intense emotions of that moment when the race car, called Joy, crossed the finish line against the most extraordinary odds (see Colene Evans-Allen’s blog for the full story).
Nick Caddick (2014) whilst working in the Peter Harrison Centre for Disability Sport at Loughborough University published a literature review demonstrating the value of sport and physical activity for supporting the well-being and rehabilitation of veterans with disabilities and those with Post Traumatic Stress Disorder (PTSD). His findings have a strong resonance for occupational therapists. His themes include (among others): focus on ability, identity and self-concept, a sense of achievement and accomplishment. The evidence reviewed by Nick demonstrates clear physical, psychological and social benefits of sport (Caddick 2014).
Nick has also published research about veterans who are finding that surfing can play a part in recovery from PTSD. In addition to the benefits discussed above, surfing has the transformative element of being an activity in nature, or ecotherapy. The ‘spiritual awareness of a connection with the natural world’ (Dustin et al 2011 cited in Caddick & Smith 2014) is also a key message in ‘The Unselfish Spirit’ (Collins 2014).
In the United States an occupational therapist has been delivering ‘Ocean Therapy’ for veterans from the conflicts in Iraq and Afghanistan with PTSD to facilitate their transition to civilian life (Rogers et al 2014). She used quantitative methods in a small study and demonstrated that a 5 week surfing programme had a positive impact on PTSD and depression symptom severity. Although Nick and colleagues reject medical model concepts of PTSD, there are many similarities in their findings. The interaction with the ocean was found to be an important part of developing coping strategies; storytelling and relationship building were key positive factors in the efficacy of the programme. The veterans developed a new kind of brotherhood with its own language and culture, similar to being in the military, which aided transition. There were aspects of surfing that appealed to male participants, also a benefit of motorsport previously mentioned. Rogers et al (2014) concluded that surfing and other high impact sports could be incorporated into occupational therapy programmes with veterans but that more research is needed. The charity in the UK providing ocean therapy is Surf Action and I provide free consultancy to the team working as a non-executive director on the board of trustees.
“So what’s in store for you now?”
Mrs. Harrison: Since leaving Race2Recovery in 2014 I have become involved with supporting a number of small charities and organisations that provide opportunities for veterans to become engaged in challenging activities as part of their recovery, usually outdoors in the natural environment. I have been inspired by a growing evidence base to support this work.
I am also facilitating volunteering for occupational therapy and physiotherapy students from the University of East Anglia with the Re-Org Trust who support veterans living with PTSD. I was deeply moved by Jonathan Weaver, representing the Re-Org Trust, when he spoke at a student seminar ‘Actively Supporting Veterans’. He bravely shared his story and reminded our healthcare students that they have precious skills, pleading with them not to forget our veterans. Students are now going out to France to work alongside veterans on the Re-Org Trust farm and are learning a huge amount from the experience.
Finally, I also volunteer my time to The Baton. This is a charity with the primary mission to raise and maintain awareness within the British public and our Allies about the reality of life for Armed Services personnel and their families. It exists to ensure that they are given the level of support that they are rightfully due. People carry The Baton around the world to share the message; we must never forget.
MAVAN would like to thank Mrs. Harrison for her time with responding to our request to gather information from her about experiences working with veterans in the UK.
For a first person account of Tony Harris’ recovery through motorsport in Race2Recovery and a good account of Dakar Rally 2013 read this blog from Colene Evens-Allen: http://inspirationatspeed.blogspot.ca/p/race2recovery.html
Carly Rogers’ TED Talk on Ocean Therapy: https://youtu.be/Wfb8tHn8Xv4
Caddick N & Smith B (2014), The impact of sport and physical activity on the well-being of combat veterans; A systematic review. Psychology of Sport and Exercise 15, 9-18.
Collins M (2014), The Unselfish Spirit. Permanent Publications, Hampshire.
Rogers C, Mallinson T, Peppers D (2014), ‘High-Intensity Sports for Posttraumatic Stress Disorder and Depression: Feasibility Study of Ocean Therapy With Veterans of Operation Enduring Freedom and Operation Iraqi Freedom’, American Journal of Occupational Therapy 68, 395-404.