ArticlePublisher preview available

Outcomes of a Therapeutic Fly-Fishing Program for Veterans with Combat-Related Disabilities: A Community-Based Rehabilitation Initiative

Authors:
Jessie L. Bennett
Jessie L. Bennett
Jessie L. Bennett
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Jennifer Piatt at Indiana University Bloomington
Jennifer Piatt
Marieke Van Puymbroeck
Marieke Van Puymbroeck
Marieke Van Puymbroeck
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Read publisher preview
Download citation
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

The purpose of this study was to examine the outcomes of a therapeutic fly-fishing program for veterans with combat-related disabilities. A total of 40 veterans participated in the 4-day therapeutic fly-fishing program and this study. The outcomes examined included reducing symptoms of posttraumatic stress (PTS), depression, perceived stress, functional impairment (i.e., work, relationships, physical, and everyday life), increasing self-determination, and leisure satisfaction. Each research participant completed pretest, posttest, and 3-month follow-up questionnaires. Repeated measures MANOVA and ANOVA were conducted to examine the differences between the three time points on each outcomes. The results indicated significant decreases from the pretest to posttest for symptoms of PTS, depression, perceived stress, and functional impairment, and an increase in leisure satisfaction from pretest to 3-month follow-up. These results highlight the use of therapeutic recreation programming for veterans with disabilities as a holistic approach to treatment and recovery.
A preview of this full-text is provided by Springer Nature.
Learn more
Content available from Community Mental Health Journal
This content is subject to copyright. Terms and conditions apply.
Vol:.(1234567890)
Community Ment Health J (2017) 53:756–765
DOI 10.1007/s10597-017-0124-9
1 3
ORIGINAL PAPER
Outcomes ofaTherapeutic Fly-Fishing Program forVeterans
withCombat-Related Disabilities: ACommunity-Based
Rehabilitation Initiative
JessieL.Bennett1· JenniferA.Piatt2· MariekeVanPuymbroeck3
Received: 13 September 2016 / Accepted: 7 March 2017 / Published online: 16 March 2017
© Springer Science+Business Media New York 2017
Introduction
The United States has an estimated 21.8million veterans,
with 3.8 million of these veterans reporting a service-
connected disability (Census Bureau 2015). As the United
States continues in the War on Terror, the number of veter-
ans and those requiring rehabilitative services will continue
to increase. Operation Iraqi Freedom (OIF) and Opera-
tion Enduring Freedom (OEF) have been identified as the
most physically and psychologically destructive conflicts in
United States history (Aronson 2005; Warden 2006). Due
to the improvements in protective armor, medical care,
and evacuation procedures in the OIF/OEF wars, nine out
of ten people survive their initial injury in combat (Mea-
gher 2007). In addition, the two signature wounds from
these conflicts are posttraumatic stress (PTS) and traumatic
brain injury (TBI) (Tanielian and Jaycox 2008), and it is
estimated that 20% of OIF/OEF veterans experience PTS,
while 15–20% experience a TBI (Hoge etal. 2004).
PTS is a mental disorder originating from experiencing
a traumatic event (e.g., witnessing a violent act, sustaining
a debilitating physical injury, combat). The symptoms of
PTS cluster into three groups, last for more than 1 month,
and range in severity (American Psychiatric Association
2000). Re-experiencing, one cluster of symptoms, include
flashbacks, hallucinations, or nightmares. Hyperarousal,
another cluster of symptoms, include hyper-vigilance,
heightened startle response, or difficulty falling asleep.
Avoidance/emotional numbing, the last cluster of symp-
toms, include avoiding people or places that are reminders
of the trauma, reduced participation in activities, or pulling
away from loved ones. These symptoms make it difficult
for individuals with PTS to relax, enjoy, and participate in
activities with others due to the fear of triggering symp-
toms (Schiraldi 2009). PTS symptoms can lead to impaired
Abstract The purpose of this study was to examine the
outcomes of a therapeutic fly-fishing program for veter-
ans with combat-related disabilities. A total of 40 veterans
participated in the 4-day therapeutic fly-fishing program
and this study. The outcomes examined included reducing
symptoms of posttraumatic stress (PTS), depression, per-
ceived stress, functional impairment (i.e., work, relation-
ships, physical, and everyday life), increasing self-determi-
nation, and leisure satisfaction. Each research participant
completed pretest, posttest, and 3-month follow-up ques-
tionnaires. Repeated measures MANOVA and ANOVA
were conducted to examine the differences between the
three time points on each outcomes. The results indicated
significant decreases from the pretest to posttest for symp-
toms of PTS, depression, perceived stress, and functional
impairment, and an increase in leisure satisfaction from
pretest to 3-month follow-up. These results highlight the
use of therapeutic recreation programming for veterans
with disabilities as a holistic approach to treatment and
recovery.
Keywords Fly-fishing· Mental health· Therapeutic
recreation· Veterans
* Jessie L. Bennett
Jessie.bennett@unh.edu
1 University ofNew Hampshire, 4 Library Way, Durham,
NH03824, USA
2 Indiana University, HPER Building 133, 1025 E. Seventh
Street, Bloomington, IN47405-7109, USA
3 Clemson University, 128 McGinty Court, 283 Lehotsky Hall,
Clemson, SC29634-0735, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... The findings have been promising, demonstrating that participation in TR programs can lead to reductions in symptoms of PTSD, depression, anxiety, and negative emotions, while simultaneously increasing social support, coping skills, positive emotions, and marital satisfaction among veterans with combatrelated disabilities. [46][47][48][49][50][51][52] Nonetheless, further research is necessary to explore the breadth of outcomes associated with different types of TR programs for veterans with combat-related disabilities. It is important to recognize that the impact of combat-related disabilities extends beyond veterans themselves, affecting their families as well. ...
... 42,51 Implications for recreation therapy The findings of decreased PTSD and depression symptoms in response to trip-type TR programs for veterans with combat-related disabilities and their significant others are consistent with previous research. [46][47][48][49][50][51][52] Therefore, these types of programs seem to have an impact on the body functions component of the ICF for both veterans and their significant others. Recreational therapists (RTs) and other allied health professionals can use these findings to support the use of trip-type TR programs as a valid treatment approach for this population. ...
... 44 In addition, trip-type TR programs can serve as effective introductory programs for veterans with combat-related disabilities and their significant others to learn or enhance skills in specific recreational activities and begin to manage their symptoms of mental health disorders. [46][47][48] Even though it is important to note that these programs positively impact symptoms of combat-related disabilities, they did not significantly affect family functioning, family leisure involvement, or community reintegration in the present study. It was anticipated that family leisure involvement and community reintegration would increase after participating in a family TR program. ...
Impacting mental health: Adaptive snowsports as a therapeutic approach for veterans with combat-related disabilities and their significant others
Article
  • Sep 2024
This study aimed to investigate the effects of adaptive snowsports programs on veterans with combat-related disabilities and their significant others. The study focused on outcomes related to the International Classification of Functioning, Disability, and Health (ICF) components, including body function, participation, and contextual factors. The variables examined encompassed post-traumatic stress disorder (PTSD), depression, family leisure involvement, community reintegration, and family functioning. Friedman tests were employed to compare pretest, post-test, and 1-month follow-up data for 18 veterans and 11 significant others. The results revealed significant reductions in the ICF component of body function, specifically in PTSD symptoms among veterans and depression symptoms among the significant others. These findings suggest that trip-type family therapeutic recreation programs for veterans with combat-related disabilities and their significant others have the potential to influence body functions. The study concludes by discussing implications for recreational therapists.
View
... The findings have been promising, demonstrating that participation in TR programs can lead to reductions in symptoms of PTSD, depression, anxiety, and negative emotions, while simultaneously increasing social support, coping skills, positive emotions, and marital satisfaction among veterans with combatrelated disabilities. [46][47][48][49][50][51][52] Nonetheless, further research is necessary to explore the breadth of outcomes associated with different types of TR programs for veterans with combat-related disabilities. It is important to recognize that the impact of combat-related disabilities extends beyond veterans themselves, affecting their families as well. ...
... 42,51 Implications for recreation therapy The findings of decreased PTSD and depression symptoms in response to trip-type TR programs for veterans with combat-related disabilities and their significant others are consistent with previous research. [46][47][48][49][50][51][52] Therefore, these types of programs seem to have an impact on the body functions component of the ICF for both veterans and their significant others. Recreational therapists (RTs) and other allied health professionals can use these findings to support the use of trip-type TR programs as a valid treatment approach for this population. ...
... 44 In addition, trip-type TR programs can serve as effective introductory programs for veterans with combat-related disabilities and their significant others to learn or enhance skills in specific recreational activities and begin to manage their symptoms of mental health disorders. [46][47][48] Even though it is important to note that these programs positively impact symptoms of combat-related disabilities, they did not significantly affect family functioning, family leisure involvement, or community reintegration in the present study. It was anticipated that family leisure involvement and community reintegration would increase after participating in a family TR program. ...
View
... TR and leisure play an important role in supporting meaningful experiences that enhance recovery by helping individuals live well with a mental health diagnosis (e.g., Bennett et al., 2017;Cripps & Hood, 2020;Davidson et al., 2005;Hopper et al., 2020;Iwasaki et al., 2014;Iwasaki et al., 2015;Montoya et al., 2020;Moxham et al., 2015;Reid & Alonso, 2018;Snethen et al., 2012). Yet, there is limited information about the potential role TR can play in addressing one of the biggest barriers to living ...
... Reid and Alonso (2018), for example, argued that when TR practitioners work in mental health settings aligned with biomedical paradigms, they might unintentionally reinforce stigma and discriminatory practices by focusing on individual treatment and ignoring injustices faced by individuals with mental illness, such as experiences of stigma and social exclusion. Certainly, there are examples in the literature of TR reducing common symptoms and functional impairments associated with mental illness (e.g., Bennett et al., 2017;Litchke et al., 2022;Moxham et al., 2015). There have also been calls for TR practitioners to claim their place as health care professionals and use recreation and leisure as tools to ameliorate illness and disability (Austin & Van Puymbroeck, 2016). ...
Re-Reading Mental Illness : A Living Library as a Pedagogical Tool for Unlearning Stigma
Article
Full-text available
  • May 2023
Living with mental illness often results in varying levels and experiences of stigma. Stigmatizing experiences in health care settings are particularly detrimental because they cause reluctance to seek mental health care, which impedes recovery. While therapeutic recreation (TR) services and programs aim to support recovery, there is a gap in what we know about TR’s role in combatting the stigma of mental illness. To address this gap, this study examined the experiences of TR students who participated in a contact-based initiative known as a living library. This initiative provides opportunities for individuals living with mental illness to become living books and talk openly to readers about their experiences of illness and recovery. In this study, TR students undertook the role of readers. Findings highlight how students shifted their focus from the diagnosis to the person and started questioning their previously held stereotypes about mental illness. Findings also capture how the living library helped to contextualize students’ classroom learning by humanizing course material. We draw from these findings to demonstrate the merit of using contact-based approaches in TR to combat stigma of mental illness. This study has implications for practice and suggests that initiatives aimed at unlearning stigma can be impactful for TR students embarking on careers in health care settings that support the recovery of individuals living with mental illness.
View
... These results suggest that both Surf Therapy and Hike Therapy can provide benefits beyond the reduction of depression symptoms in service members with MDD, and that Surf Therapy may provide enhanced immediate effects on positive affect and pain. Results were consistent with prior research reporting postprogram improvements in psychological and functional outcomes for outdoor exercise and recreation programs (Lundberg et al., 2011;Duvall and Kaplan, 2014;Rogers et al., 2014;Bennett et al., 2017;Crawford, 2017;Townsend et al., 2018;Walter et al., 2019Walter et al., , 2021Walter et al., , 2023. Though, in the current study, improvements in negative affect and social functioning were contingent on the number of sessions attended, with a greater number of sessions yielding stronger effects. ...
Psychological and functional outcomes following a randomized controlled trial of surf and hike therapy for U.S. service members
Article
Full-text available
  • Jun 2023
Introduction Exercise-based interventions have established benefits for the treatment of depression and other psychological outcomes; however, limited data exist evaluating psychological, social, and functional outcomes for exercise outdoors. Methods The current study sought to expand knowledge about the breadth of effects following outdoor exercise interventions by using data from a randomized control trial comparing Surf and Hike Therapy among 96 U.S. active duty service members with major depressive disorder (MDD). Assessments examining psychological symptoms and functioning were completed before and after the 6-week programs, and 3 months following program completion. Participants also completed assessments before and after each exercise session. Multilevel modeling was used to determine whether psychological and functional outcomes (anxiety, positive and negative affect, resilience, pain, and physical and social functioning) improved for service members receiving Surf or Hike Therapy, and whether improvements differed by intervention. Results Study findings showed improved anxiety (p < 0.001), negative affect (p < 0.001), psychological resilience (p = 0.013), and social functioning (p < 0.001) following program participation, with no differences by intervention. Positive affect, pain, and physical functioning did not significantly improve after the program. Within sessions, positive affect (p < 0.001) and pain (p = 0.036) changed, and to a greater extent for those in the Surf Therapy condition. Conclusion Study results suggest that both Surf Therapy and Hike Therapy can improve psychological symptoms and social functioning impairments that commonly co-occur among service members with MDD, but Surf Therapy may provide enhanced immediate effects on positive affect and pain. Clinical trial registration ClinicalTrials.gov, NCT03302611.
View
... Furthermore, physical benefits such as increased mobility, strength, and aerobic capacity (Addison et al., 2019;Briggs and Oursler, 2021), weight loss and increased fitness (Brittain et al., 2022), and reductions in the symptomology of mental health conditions such as post-traumatic stress disorder (PTSD) have been identified in veterans with disabilities, traumatic injuries or chronic illness (Walter et al., 2021). Outdoor and nature-based activities, such as fishing, water and snow sports, riding, and archery, have been found to provide a wide range of benefits to veterans, including facilitating positive mood and establishing new coping methods through motivation and challenge (Bennett et al., 2017;Craig et al., 2020), opportunities for social bonding (Lundberg et al., 2016), as well as reductions in PTSD symptomology (Gelkopf et al., 2013;Crawford, 2016;Wheeler et al., 2020). ...
A cross-sectional study of sleep, mood, well-being, motivations, and perceived support in Ukrainian veterans and active-duty military personnel with disability, and their supporters, preparing for a sporting event
Article
Full-text available
  • Mar 2023
Purpose The benefits of sports and exercise to the lives and rehabilitative journeys of military veterans with disabilities is increasingly well-documented but veteran sporting events remain underexplored. Addressing this topic, the current article seeks to provide insight into the health and well-being of Team Ukraine during a 5-week preparatory camp in the UK before attendance at the 2022 Warrior Games. Materials and methods Two surveys were run, one toward the beginning and one toward the end of the camp. Eighteen of the 55 veterans and serving personnel (with disability), support staff, and family members in attendance responded to both surveys. Data on sleep, mood, and competition-related emotions, motivations for participation and perceived support were gathered. Data were analysed descriptively, and sleep, mood, and competition-related emotion responses were categorised to explore improvements, maintenance, or worsening in these areas. Results and conclusion Sleep, mood, and competition-related emotions were relatively stable, although sleep duration was low, and there were some increases in daytime dysfunction, anxiety, nervousness, and feeling tense. Family was the most important source of support and representation of one’s country and raising awareness of Ukraine’s circumstances were the most important motivational factors. Findings offer insight into not only the health and well-being experiences associated with participation in this disabled veteran sporting event, but also the important role played by this event in meeting collective goals relating to this unique time in Ukraine’s history.
View
View
The experiences of attending an international veteran sporting competition and preparatory camp for Team Ukraine during the Russo-Ukrainian conflict
Article
Full-text available
  • Dec 2024
Introduction This article offers unique insight into Team Ukraine's experiences of attending an international sporting event for veterans living with disability and injured active-duty personnel (the United States' Department of Defense Warrior Games, “The Games”) and a 5-week preparatory camp in the United Kingdom (UK). Methods A survey gathered qualitative data at three time points: during the second and final week of training camp, and the in the two weeks immediately following participation at The Games. Forty-four out of 55 members of Team Ukraine (including veterans, active-duty personnel, support staff, and family members) provided responses in Survey 1, 20 in Survey 2, and 18 in Survey 3. These responses were thematically analysed to explore experiences and motivations for participation. Results and discussion Five main themes were identified: Rest and recuperation; The ongoing conflict as a source of motivation; The sporting experience; Veterans in sport; and Relationships. Whilst physically demanding, the camp was an opportunity for respite and emotional processing, and participants reflected on social benefits and improvements to physical health and sporting abilities. Perhaps of greatest significance was the role of the ongoing conflict in their motivations to attend The Games. The conflict brought participants together in their collective goals of representing Ukraine on an international stage, raising awareness of the war, and demonstrating strength through sporting success. Findings highlight the challenges experienced and overcome by Team Ukraine and provides insight into the role that competitive sporting events may play during times of conflict as a means of demonstrating national strength and pride, and meeting individuals' health and well-being needs.
View
Validity and Reliability Study of the Turkish Form of the Pro-Nature Conservation Behavior Scale
Article
Full-text available
  • Dec 2024
Objective: This study aims to adapt the Pro-Nature Conservation Behavior Scale, which was developed to identify pro-nature conservation behaviors, into Turkish. Method: For the validity and reliability study, 371 participants were included in the study. The suitability of the scale for Turkish culture was tested with Confirmatory Factor Analysis (CFA). Results: The scale, which consists of 18 items in total, has 4 sub-dimensions (Individual engagement, planting, collective engagement , wildlife). Overall Cronbach Alpha internal consistency coefficient of the scale was .85; .73 for the individual engagement factor, .86 for the planting factor, .71 for the collective engagement factor and .61 for the wildlife factor, and convergent validity was supported by positive correlations with the Environmental Behavior Scale, the New Ecological Paradigm Scale, the Generalized Self-Esteem Scale and the Warnick-Edinburg Mental Well-Being Scale. Conclusion: Pro-Nature Conservation Behavior Scale is a valid and reliable measurement tool that can be used in Türkiye.
View
View
The Fruits of Labor: Home Food Procurement and Mental Health in the Time of COVID-19
Article
  • Apr 2022
We examine the relationship of home food procurement (HFP) during COVID-19 to emotional eating and stress using a statewide representative survey (n = 600) in Vermont. Women and people with a job change since COVID-19 were more likely to experience higher stress and emotional eating. Engaging in HFP, especially gardening, is associated with less emotional eating. However, people who fished, hunted, or canned more since the pandemic began were more likely to eat for emotional reasons and experience higher stress. These results suggest that gardening, even during a pandemic, may contribute to stress reduction, more so than other nature-based food production activities.
View
Nature-Based Recreational Therapy for Military Service Members: A Strengths Approach
Article
Full-text available
  • Jan 2016
Nature-based interventions have long been used as a strengths-based approach to aid in positive human development. The use of these interventions is underpinned by a strong knowledge base; however, little information exists with regard to the use of nature-based recreation therapy (RT) interventions as a strengths-based approach for working with military service members. This article provides an overview of typical treatment options for injured service members, explores the theoretical and conceptual foundations surrounding nature-based programming, reviews existing research literature on the use of nature with veterans, and offers a conceptual model for nature-based RT interventions for military service members. Recommendations and implications for practice and research are discussed.
View
View
War Narratives: Veteran Stories, PTSD Effects, and Therapeutic Fly-Fishing
Article
Full-text available
  • Jan 2011
Working within a framework of narratology (narrative theory), this study is a gathering and analysis of 67 letters of veterans as they concluded their participation in a therapeutic fly-fishing program in Dutch John, UT along the Green River. The program worked with female and male veterans with confirmed diagnoses of posttraumatic stress disorder that served overseas in each branch of the Armed Forces (except the Coast Guard) during Operation New Dawn, Operation Iraqi Freedom, Operation Enduring Freedom, Operation Desert Storm, Operation Desert Shield, and Vietnam. The collected narratives were analyzed based on a three-part process of reading: Explication; Explanation; and, Exploration. This analysis approach presented a uniquely constructed perspective of veterans as they participated in treatment. The study systematically analyzed the stories to present a narrative and four themes that would inform and guide future empirical studies on the realities of veterans, program experiences, and perspective on treatment.
View
Constant Comparison Method: A Kaleidoscope of Data
Article
  • Mar 2000
This paper will attempt to illustrate the use of a kaleidoscope metaphor as a template for the organization and analysis of qualitative research data. It will provide a brief overview of the constant comparison method, examining such processes as categorization, comparison, inductive analysis, and refinement of data bits and categories. Graphic representations of our metaphoric kaleidoscope will be strategically interspersed throughout this paper.
View
Posttraumatic stress disorder among military returnees from Afghanistan and Iraq
Article
  • Apr 2006
Although most military personnel returning from recent deployments will readjust successfully to life in the United States, a significant minority will exhibit PTSD or some other psychiatric disorder. Practitioners should routinely inquire about war-zone trauma and associated symptoms when conducting psychiatric assessments. Treatment should be initiated as soon as possible, not only to ameliorate PTSD symptoms but also to forestall the later development of comorbid psychiatric and/or medical disorders and to prevent interpersonal or vocational functional impairment. If evidence-based practices are utilized, complete remission can be achieved in 30%-50% of cases of PTSD, and partial improvement can be expected with most patients. We can all look forward to future break-throughs that will improve our capacity to help people with PTSD.
View
Intrinsic Motivation and Self-Determination in Human Behavior
Book
  • Jan 1985
I: Background.- 1. An Introduction.- 2. Conceptualizations of Intrinsic Motivation and Self-Determination.- II: Self-Determination Theory.- 3. Cognitive Evaluation Theory: Perceived Causality and Perceived Competence.- 4. Cognitive Evaluation Theory: Interpersonal Communication and Intrapersonal Regulation.- 5. Toward an Organismic Integration Theory: Motivation and Development.- 6. Causality Orientations Theory: Personality Influences on Motivation.- III: Alternative Approaches.- 7. Operant and Attributional Theories.- 8. Information-Processing Theories.- IV: Applications and Implications.- 9. Education.- 10. Psychotherapy.- 11. Work.- 12. Sports.- References.- Author Index.
View
Leisure and Health: The Role of Social Support and Self-Determination
Article
  • Apr 1993
This paper reviews the literature on the social context of health to identify the ways in which leisure might contribute to health. Considerable evidence has demonstrated that stressful life circumstances induce physical and mental illnesses. However, this impact has been shown to be moderated by various coping processes including leisure participation. The paper argues that leisure participation facilitates coping with life stress in two ways. First, one of the most effective sources of relief from life stress has been shown to be the perception that social support is available. Leisure has been demonstrated to be highly social in nature and to facilitate development of friendships. Companionship in shared leisure activity appears to provide effective relief for people as they deal with excesses of daily life stresses. In addition, many leisure experiences have the capacity to provide feelings of support. Second, dispositions reflecting self-determination (e.g. hardiness, locus of control) have also been shown to contribute to people's coping capacities and health. Perceptions of freedom, control, competence and intrinsic motivation that are central to many leisure experiences are believed to induce these stable beliefs in self-determination.
View
View
The Contribution of Leisure Participation and Leisure Satisfaction to Life Satisfaction of Older Persons
Article
  • Sep 1982
Employing multiple regression analysis, a set of six variables explained 39% of the variance in life satisfaction (leisure satisfaction, satisfaction with standard of living, satisfaction with family relations and activities, satisfaction with health, leisure participation, and marital status). Leisure satisfaction showed the greatest contribution, accounting for 20% of the variance in life satisfaction (more than 50% of the total variance explained). Also, it was found that: 1) the higher the frequency of participation in leisure activities, the higher the life satisfaction; 2) the more the leisure participation, the higher the leisure satisfaction; 3) the greater the leisure satisfaction, the greater the life satisfaction; and 4) all six leisure satisfaction components correlated positively with life satisfaction.-from Authors
View
Interrelationships Among Leisure Participation Leisure Satisfaction and Leisure Attitudes
Article
  • Apr 1980
Some of the determinants of leisure participation were identified and investigated. Among those determinants were leisure attitude, age, and sex. Studies investigating the relationships among leisure satisfaction and leisure participation and leisure attitude had not been conclusive. In this study, utilizing step-wise analysis and correlation of coefficient satisfaction was found to be the strongest contributor and predicator of leisure participation, more than any other variables, such as; leisure attitude, income, age, mode of employment, or length of marriage. Years of education and sex were found to be additional determinants of participation. Moreover, leisure satisfaction was the only variable which contributed to leisure attitude. Six categories of leisure were utilized. Leisure satisfaction associated with those categories in this order, the strongest relation was with hobbies, then cultural activities, sports activities, social activities, outdoor activities, and mass media activities.
View