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Brief History of Occupational Therapy in Military Populations

Adolf Meyer was the first psychiatrist to recognize the importance of the “total person” in his theoretical development of psychobiology. He believed purposeful human action was more than a simple integration of detachable parts. Rather, the total person required “blending in consciousness, integrating our organism into simple or complex adaptive and constructive reactions of overt and implicit behavior” [2].

Meyer’s professional contributions to mental health rehabilitation were formative through his assertions of the importance of ergasias (a term meaning “to work, to do, and to act”). Ergasias was utilized in early mental health therapeutic practice as the formal description of purpose-driven and goal-directed activity demonstrated by the patient [3]. From under the branches of Meyer’s educational tree grew the OT practice in guiding “purposeful activity” for SMs in need of mental health recovery following wartime service. The historical association of OT in the U.S. military was developed during and following World War I with the inception of reconstruction aides [4].

Early OTs assisted injured SMs by promoting meaningful and purposeful activities that developed skills needed for vocations following military service [4]. Traditionally OTs work with those recovering from amputations, burns, orthopedic injuries, and Trauma-related psychological conditions.

The U.S. military later committed to the occupational needs of SMs by incorporating the OT profession into active military service [4]. In 1918, the Division of Physical Reconstruction was created by the U.S. Army and became the first organized OT division in the U.S. military. “The intent was, through use of mental and manual work, to restore maximum function, to any military person disabled in the line of duty.” [4].

Since that time, OT expanded to its current role as part of active duty military service. Military OTs identify both behavioral health challenges and physical limitations which require specific interventions to restore work engagement and improve functioning [5-7]. The role of OT for military BH was further developed in response to battle fatigue with the development of combat and operational stress control teams [5, 8-14]. As a result, there has been an increasing awareness of the occupational needs of injured Service Members and veterans reintegrating into service or home environments. These needs include refocusing energies, coping with change in work environments, and reconstructing meaning [15].

Throughout the last 15 years of continuous deployment in Iraq and Afghanistan, OT utilization has been robust and wide-ranged. As many as 62 OTs have deployed as part of over 34 unit deployments in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) [16].

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