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Published in: Community Mental Health Journal 8/2022

21-03-2022 | Original Paper

Community-Based Recreational Therapy for Veterans with Behavioral Health Disorders: Impacts on Quality of Life, Participation, and Happiness

Authors: Jessie L. Bennett, Patricia Craig, Semra Aytur, Tye Thompson, Heather S. Roscoe, Jill Gravink

Published in: Community Mental Health Journal | Issue 8/2022

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Abstract

Identifying evidenced-based interventions that improve health outcomes for Veterans with behavioral health disorders is a national priority. Thus, this study examined the outcomes of a community-based recreational therapy (RT) program focused on health promotion for Veterans with behavioral health disorders. Fifty-five Veterans with disabilities completed pretest and posttest questionnaires that assessed Quality of Life (QOL), Participation, and Happiness. Significant improvements were found in Overall QOL, Environmental QOL, Psychological QOL, QOL Rated, Satisfaction with Health, Participation, and Happiness. Younger age and female gender were significantly associated with improved Overall QOL. Factors significantly associated with improved Environmental QOL included younger age and non-Caucasian race. Older age was significantly associated with improved Participation. Female gender was positively associated with improved Happiness, while being divorced/separated was negatively associated with Happiness. These results have important implications for the use and expansion of community-based RT health promotion programs for Veterans with behavioral health disorders.
Literature
go back to reference Anderson, L., & Heyne, L. (2013). A strengths approach to assessment in therapeutic recreation: Tools for positive change. Therapeutic Recreation Journal, 47(2), 89–108. Anderson, L., & Heyne, L. (2013). A strengths approach to assessment in therapeutic recreation: Tools for positive change. Therapeutic Recreation Journal, 47(2), 89–108.
go back to reference Ariss, J. J., Gerlach, A., Baker, J. B., Barry, K., Cooper, L., de Vries, T. L., Halligan, K., & Lacroix, M. (2019). Community-based recreation therapy and mental health recovery: A mixed-media participatory action research study. Progress in Community Health Partnerships: Research, Education, and Action, 13(2), 161–170. https://doi.org/10.1353/cpr.2019.0016CrossRef Ariss, J. J., Gerlach, A., Baker, J. B., Barry, K., Cooper, L., de Vries, T. L., Halligan, K., & Lacroix, M. (2019). Community-based recreation therapy and mental health recovery: A mixed-media participatory action research study. Progress in Community Health Partnerships: Research, Education, and Action, 13(2), 161–170. https://​doi.​org/​10.​1353/​cpr.​2019.​0016CrossRef
go back to reference Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147.CrossRef Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147.CrossRef
go back to reference Bandura, A. (1986a). Social foundations of thought and action: A social cognitive theory. Prentice-Hall. Bandura, A. (1986a). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
go back to reference Bandura, A. (1986b). The explanatory and predictive scope of self-efficacy theory. Journal of Clinical and Social Psychology, 4, 359–373.CrossRef Bandura, A. (1986b). The explanatory and predictive scope of self-efficacy theory. Journal of Clinical and Social Psychology, 4, 359–373.CrossRef
go back to reference Bandura, A. (1988). Perceived self-efficacy: exercise of control through self-belief. In J. P. Dauwalder, M. Perrez, & V. Hobi (Eds.), Annual series of European research in behavior therapy (Vol. 2, pp. 27–59). Swets & Zeitlinger. Bandura, A. (1988). Perceived self-efficacy: exercise of control through self-belief. In J. P. Dauwalder, M. Perrez, & V. Hobi (Eds.), Annual series of European research in behavior therapy (Vol. 2, pp. 27–59). Swets & Zeitlinger.
go back to reference Benedek, D. M., & Wynn, G. H. (2016). Posttraumatic stress disorder. In D. M. Benedek & G. H. Wynn (Eds.), Complementary and alternative medicine for PTSD (pp. 203–217). Oxford University Press.CrossRef Benedek, D. M., & Wynn, G. H. (2016). Posttraumatic stress disorder. In D. M. Benedek & G. H. Wynn (Eds.), Complementary and alternative medicine for PTSD (pp. 203–217). Oxford University Press.CrossRef
go back to reference Bennett, J. L., Lundberg, N. R., Zabriskie, R. B., & Eggett, D. L. (2014). Addressing posttraumatic stress among Iraq and Afghanistan veterans and significant others: An intervention utilizing sport and recreation. Therapeutic Recreation Journal, 48(1), 74–93. Bennett, J. L., Lundberg, N. R., Zabriskie, R. B., & Eggett, D. L. (2014). Addressing posttraumatic stress among Iraq and Afghanistan veterans and significant others: An intervention utilizing sport and recreation. Therapeutic Recreation Journal, 48(1), 74–93.
go back to reference Ben-Shalom, Y., Tennant, J. R., & Stapleton, D. C. (2016). Trends in disability and program participation among US veterans. Disability and Health Journal, 9(3), 449–456.PubMedCrossRef Ben-Shalom, Y., Tennant, J. R., & Stapleton, D. C. (2016). Trends in disability and program participation among US veterans. Disability and Health Journal, 9(3), 449–456.PubMedCrossRef
go back to reference Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.PubMedCrossRef Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.PubMedCrossRef
go back to reference Coll, J., Weiss, E., & Yarvis, J. (2011). No one leaves unchanged: Insights for civilian mental health care professionals into the military experience and culture. Social Work in Health Care, 50, 487–500.PubMedCrossRef Coll, J., Weiss, E., & Yarvis, J. (2011). No one leaves unchanged: Insights for civilian mental health care professionals into the military experience and culture. Social Work in Health Care, 50, 487–500.PubMedCrossRef
go back to reference Craig, P. J., Wilder, A., Sable, J., & Gravink, J. (2013). Promoting access, transition, and health: A community-based approach to managing chronic health conditions. ATRA Annual in Therapeutic Recreation, 21, 45–62. Craig, P. J., Wilder, A., Sable, J., & Gravink, J. (2013). Promoting access, transition, and health: A community-based approach to managing chronic health conditions. ATRA Annual in Therapeutic Recreation, 21, 45–62.
go back to reference Department of Veterans Affairs & Department of Defense. (2017). VA/DOD clinical practice guidelines for the management of posttraumatic stress disorder and acute stress disorder. Department of Veterans Affairs & Department of Defense. Department of Veterans Affairs & Department of Defense. (2017). VA/DOD clinical practice guidelines for the management of posttraumatic stress disorder and acute stress disorder. Department of Veterans Affairs & Department of Defense.
go back to reference Dobson, A. J., & Barnett, A. (2008). An introduction to generalized linear models. CRC Press.CrossRef Dobson, A. J., & Barnett, A. (2008). An introduction to generalized linear models. CRC Press.CrossRef
go back to reference Duvall, J., & Kaplan, R. (2013). Exploring the benefits of outdoor experiences on Veterans. Report for the Sierra Club Military Families and Veterans Initiative. Duvall, J., & Kaplan, R. (2013). Exploring the benefits of outdoor experiences on Veterans. Report for the Sierra Club Military Families and Veterans Initiative.
go back to reference Fox, A. B., Meyer, E. C., & Vogt, D. (2015). Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans. Psychological Services, 12(1), 49–58. https://doi.org/10.1037/a0038269CrossRefPubMed Fox, A. B., Meyer, E. C., & Vogt, D. (2015). Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans. Psychological Services, 12(1), 49–58. https://​doi.​org/​10.​1037/​a0038269CrossRefPubMed
go back to reference Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members. Therapeutic Recreation Journal, 50(1), 55–74.CrossRef Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members. Therapeutic Recreation Journal, 50(1), 55–74.CrossRef
go back to reference Hutchison, P., & McGill, J. (1992). Leisure, integration, and community. Leisurability Publications. Hutchison, P., & McGill, J. (1992). Leisure, integration, and community. Leisurability Publications.
go back to reference Iwasaki, Y., Mactavish, J., & MacKay, K. (2005). Building on strengths and resilience: Leisure as a stress survival strategy. British Journal of Guidance and Counseling, 33(1), 81–100.CrossRef Iwasaki, Y., Mactavish, J., & MacKay, K. (2005). Building on strengths and resilience: Leisure as a stress survival strategy. British Journal of Guidance and Counseling, 33(1), 81–100.CrossRef
go back to reference Kehle-Forbes, S. M., Meis, L. A., Spoont, M. R., & Poulsney, M. A. (2015). Treatment initiation and dropout from prolonged exposure and cognitive processing therapy in a VA outpatient clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 107. https://doi.org/10.1037/tra0000065CrossRef Kehle-Forbes, S. M., Meis, L. A., Spoont, M. R., & Poulsney, M. A. (2015). Treatment initiation and dropout from prolonged exposure and cognitive processing therapy in a VA outpatient clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 107. https://​doi.​org/​10.​1037/​tra0000065CrossRef
go back to reference Kleiber, D. A., Hutchinson, S. L., & Williams, R. (2002). Leisure as a resource in transcending negative life events: Self-protection, self-restoration, and personal transformation. Leisure Sciences, 24, 219–235.CrossRef Kleiber, D. A., Hutchinson, S. L., & Williams, R. (2002). Leisure as a resource in transcending negative life events: Self-protection, self-restoration, and personal transformation. Leisure Sciences, 24, 219–235.CrossRef
go back to reference Kleiber, D. A., Reel, H. A., & Hutchinson, S. L. (2008). When distress gives way to possibility: The relevance of leisure in adjustment to disability. NeuroRehabilitation, 23, 321–328.PubMedCrossRef Kleiber, D. A., Reel, H. A., & Hutchinson, S. L. (2008). When distress gives way to possibility: The relevance of leisure in adjustment to disability. NeuroRehabilitation, 23, 321–328.PubMedCrossRef
go back to reference Lundberg, N., Bennett, J., & Smith, S. (2011). Outcomes of adaptive sports and recreation participation among veterans returning from combat with acquired disability. Therapeutic Recreation Journal, 45(2), 105–120. Lundberg, N., Bennett, J., & Smith, S. (2011). Outcomes of adaptive sports and recreation participation among veterans returning from combat with acquired disability. Therapeutic Recreation Journal, 45(2), 105–120.
go back to reference Lyubomirsky, S., & Lepper, H. S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46, 137–155.CrossRef Lyubomirsky, S., & Lepper, H. S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46, 137–155.CrossRef
go back to reference Maguen, S., & Burkman, K. (2013). Combat-related killing: Expanding evidence-based treatments for PTSD. Cognitive and Behavioral Practice, 20, 476–479.CrossRef Maguen, S., & Burkman, K. (2013). Combat-related killing: Expanding evidence-based treatments for PTSD. Cognitive and Behavioral Practice, 20, 476–479.CrossRef
go back to reference Miller, S. M., Pedersen, E. R., & Marshall, G. N. (2017). Combat experience and problem drinking in veterans: Exploring the roles of PTSD, coping motives, and perceived stigma. Addictive Behaviors, 66, 90–95.PubMedCrossRef Miller, S. M., Pedersen, E. R., & Marshall, G. N. (2017). Combat experience and problem drinking in veterans: Exploring the roles of PTSD, coping motives, and perceived stigma. Addictive Behaviors, 66, 90–95.PubMedCrossRef
go back to reference Mowatt, R. A., & Bennett, J. (2011). War narratives: Veteran stories, PTSD effects, and therapeutic fly-fishing. Therapeutic Recreation Journal, 45(4), 286–308. Mowatt, R. A., & Bennett, J. (2011). War narratives: Veteran stories, PTSD effects, and therapeutic fly-fishing. Therapeutic Recreation Journal, 45(4), 286–308.
go back to reference Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice, 16(2), 172–180.CrossRef Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice, 16(2), 172–180.CrossRef
go back to reference Porter, H. (2016). Recreational therapy and the international classification of functioning, disability, and health. Idyll Arbor. Porter, H. (2016). Recreational therapy and the international classification of functioning, disability, and health. Idyll Arbor.
go back to reference Price, W. D., Lundberg, N. R., Zabriskie, R. B., & Barney, K. W. (2015). I ties flies in my sleep: An autoethnographic examination of recreation and reintegration for a veteran with posttraumatic stress disorder. Journal of Leisure Research, 47(2), 185–201.CrossRef Price, W. D., Lundberg, N. R., Zabriskie, R. B., & Barney, K. W. (2015). I ties flies in my sleep: An autoethnographic examination of recreation and reintegration for a veteran with posttraumatic stress disorder. Journal of Leisure Research, 47(2), 185–201.CrossRef
go back to reference Reisman, M. (2016). PTSD Treatment for Veterans: What’s working, what’s new, and what’s next. P & T: A Peer-Reviewed Journal for Formulary Management, 41(10), 623–634. Reisman, M. (2016). PTSD Treatment for Veterans: What’s working, what’s new, and what’s next. P & T: A Peer-Reviewed Journal for Formulary Management, 41(10), 623–634.
go back to reference Rutz, W. (2003). The European WHO mental health programme and the World Health Report 2001: Input and implications. The British Journal of Psychiatry, 183(1), 73–74.PubMedCrossRef Rutz, W. (2003). The European WHO mental health programme and the World Health Report 2001: Input and implications. The British Journal of Psychiatry, 183(1), 73–74.PubMedCrossRef
go back to reference Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P. (2009). Posttraumatic stress disorder and quality of life: Extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review, 29(8), 727–735.PubMedCrossRef Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P. (2009). Posttraumatic stress disorder and quality of life: Extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review, 29(8), 727–735.PubMedCrossRef
go back to reference Schwarzer, R., & Fuchs, R. (1996). Self-efficacy and health behaviours. In M. Conner & P. Norman (Eds.), Predicting health behaviour: Research and practice with social cognition models (pp. 163–196). Open University Press. Schwarzer, R., & Fuchs, R. (1996). Self-efficacy and health behaviours. In M. Conner & P. Norman (Eds.), Predicting health behaviour: Research and practice with social cognition models (pp. 163–196). Open University Press.
go back to reference Strauss, J. L., Coeytaux, R., McDuffie, J., Nagi, A., & Williams, J. W. (2011). Efficacy of complementary and alternative therapies for Posttraumatic Stress Disorder: VA Evidence-based Synthesis Program. Department of Veteran Affairs, Veterans Health Administration, Health Services Research and Development Service. Strauss, J. L., Coeytaux, R., McDuffie, J., Nagi, A., & Williams, J. W. (2011). Efficacy of complementary and alternative therapies for Posttraumatic Stress Disorder: VA Evidence-based Synthesis Program. Department of Veteran Affairs, Veterans Health Administration, Health Services Research and Development Service.
go back to reference Tanielian, T., & Jaycox, L. H. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. RAND Corporation. Tanielian, T., & Jaycox, L. H. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. RAND Corporation.
go back to reference Thompson, C. V., Bennett, J. L., Sable, J. R., & Gravink, J. (2016). Northeast Passage PATH™ program: A strengths-based recovery oriented approach for veterans who experience mental health issues. Therapeutic Recreation Journal, 50(2), 138–154.CrossRef Thompson, C. V., Bennett, J. L., Sable, J. R., & Gravink, J. (2016). Northeast Passage PATH™ program: A strengths-based recovery oriented approach for veterans who experience mental health issues. Therapeutic Recreation Journal, 50(2), 138–154.CrossRef
go back to reference Turchik, J. A., & Wilson, S. M. (2010). Sexual assault in the U.S. Military: A review of the literature and recommendations for the future. Aggression and Violent Behavior, 15(4), 267–277.CrossRef Turchik, J. A., & Wilson, S. M. (2010). Sexual assault in the U.S. Military: A review of the literature and recommendations for the future. Aggression and Violent Behavior, 15(4), 267–277.CrossRef
go back to reference Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M., & Pull, C. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88(11), 815–823.PubMedPubMedCentralCrossRef Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M., & Pull, C. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88(11), 815–823.PubMedPubMedCentralCrossRef
go back to reference Vella, E. J., Milligan, B., & Bennett, J. L. (2013). Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: A pilot study. Military Medicine, 178(3), 254–260.PubMedCrossRef Vella, E. J., Milligan, B., & Bennett, J. L. (2013). Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: A pilot study. Military Medicine, 178(3), 254–260.PubMedCrossRef
go back to reference Walton, G., Schleien, S. J., Brake, L. R., Trovato, C., & Oakes, T. (2012). Photovoice: A collaborative methodology giving voice to underserved populations seeking com- munity inclusion. Therapeutic Recreation Journal, 46(3), 168–178. Walton, G., Schleien, S. J., Brake, L. R., Trovato, C., & Oakes, T. (2012). Photovoice: A collaborative methodology giving voice to underserved populations seeking com- munity inclusion. Therapeutic Recreation Journal, 46(3), 168–178.
go back to reference Wenger, J. W., O’Connell, C., & Cottrell, L. (2018). Examination of recent deployment experience across the services and components. RAND Corporation.CrossRef Wenger, J. W., O’Connell, C., & Cottrell, L. (2018). Examination of recent deployment experience across the services and components. RAND Corporation.CrossRef
go back to reference Wheeler, M., Cooper, N. R., Andrews, L., Hughes, J. H., Juanchich, M., Rakow, T., & Orbell, S. (2020). Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomized controlled trial. PLoS ONE, 15(11), 1–22.CrossRef Wheeler, M., Cooper, N. R., Andrews, L., Hughes, J. H., Juanchich, M., Rakow, T., & Orbell, S. (2020). Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomized controlled trial. PLoS ONE, 15(11), 1–22.CrossRef
go back to reference WHOQoL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558.CrossRef WHOQoL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558.CrossRef
go back to reference Wilder, A., Craig, P. J., Sable, J. R., Gravink, J., Frye, J., & Carr, C. (2011). The PATH-way home: Promoting access, transition, and health for Veterans with disabilities. Therapeutic Recreation Journal, 45(4), 268–285. Wilder, A., Craig, P. J., Sable, J. R., Gravink, J., Frye, J., & Carr, C. (2011). The PATH-way home: Promoting access, transition, and health for Veterans with disabilities. Therapeutic Recreation Journal, 45(4), 268–285.
go back to reference World Health Organization. (2002). ICF beginners guide. Towards a common language for functioning, disability and health: ICF The International Classification of Functioning, Disability and Health. World Health Organization. World Health Organization. (2002). ICF beginners guide. Towards a common language for functioning, disability and health: ICF The International Classification of Functioning, Disability and Health. World Health Organization.
go back to reference Zabriskie, R., Lundberg, N., & Groff, D. (2005). Quality of life and identity: The benefits of a community-based therapeutic recreation and adaptive sport program. Therapeutic Recreation Journal, 39(3), 176–191. Zabriskie, R., Lundberg, N., & Groff, D. (2005). Quality of life and identity: The benefits of a community-based therapeutic recreation and adaptive sport program. Therapeutic Recreation Journal, 39(3), 176–191.
Metadata
Title
Community-Based Recreational Therapy for Veterans with Behavioral Health Disorders: Impacts on Quality of Life, Participation, and Happiness
Authors
Jessie L. Bennett
Patricia Craig
Semra Aytur
Tye Thompson
Heather S. Roscoe
Jill Gravink
Publication date
21-03-2022
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 8/2022
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-022-00962-6

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