Reducing Veterans’ Symptoms of Depression, Anxiety, Stress, and Posttraumatic Stress, and Enhancing Engagement in Occupations with SCUBA Diving and Occupational Therapy

Dragana Krpalek,Noha Daher,Heather Javaherian,Naomi Achondo

doi:10.21061/jvs.v6i1.158

Abstract

Veterans face significant occupational and mental health challenges. This article explores whether an occupational therapy program in combination with SCUBA diving can enhance occupational performance and mental health outcomes for veterans more than SCUBA diving alone. A two-group random assignment pretest–posttest design was implemented to compare outcomes across two groups. Veterans in Group 1 (n = 7) completed SCUBA diving while those in Group 2 (n = 8) completed SCUBA diving in combination with occupational therapy. Outcomes were measured using the Canadian Occupational Performance Measure, PTSD Checklist for DSM-5, and the Depression, Anxiety and Stress Scale. Both groups participated in a semi-structured focus group post-participation. Additionally, those in Group 2 engaged in follow-up phone interviews. Trial registration number: NCT03928392. All participants significantly improved their occupational performance and satisfaction with performance, and reduced symptoms of PTSD, depression and stress. Those in Group 2 also experienced significant reductions in anxiety levels and reported applying learned interventions to daily life. Participating in SCUBA diving may contribute to reduced symptoms of PTSD, depression and stress among veterans. Engaging in occupational therapy may additionally contribute to reduced symptoms of anxiety and aid in therapeutic application of interventions to daily life.

Highlights

The United States Department of Veterans Affairs estimates that the incidence of mental health disorders among veterans receiving services from the Veterans Health Administration increased from 27 percent in 2001 to 41 percent in 2014 (USDVA, 2017)
A possible explanation for this is that veterans learned strategies such as mindfulness and breathing exercises as part of the occupational therapy intervention, which could be applied to daily life, resulting in reduced anxiety
Similar results have been reported by Shepardson, Tapio and Funderbunk (2017) who surveyed 182 veterans and found that they employed a range of self-management strategies including deep breathing techniques and relaxation to manage daily stressors, and that 91% of veterans identified these strategies as effective for reducing anxiety

Summary

Introduction

Veterans are at risk of developing mental health conditions, such as posttraumatic stress disorder (PTSD), depression, and anxiety disorders due to encounters with traumatic events during combat (U.S Department of Health and Human Services, n.d.). Morgan and colleagues (2017) conducted a study with 15 veterans in which they investigated the therapeutic benefits of participating in SCUBA diving for veterans who had experienced combat. Their findings suggested that SCUBA diving contributed to reduced symptoms of anxiety, depression, and insomnia, and improved social functioning (Morgan et al, 2017). In a study with individuals with physical disabilities, Carin-Levy and Jones (2007) reported that the sensation of weightlessness enabled individuals to feel

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Conclusion