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

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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.
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
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... 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. ...
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... 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. ...
... 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 ...
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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.
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