Erik: I am excited to be back to talk to you about my new adventure into the world of video games. After I left the military back in February, I have taken on a new role and am expanding my outreach as an OT beyond the traditional borders of a hospital. We are going to talk about doing some video games in the hospital but also outside that environment and what is up and coming. The first part of this session I really want to focus on the method behind the madness.
Our History
Centennial Vision
"We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society's occupational needs."
AOTA is turning 100 next year. Our vision is to be a powerful, widely-recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society's occupational needs. This is true for both PT and OT where we strive to make an impact. PT just as much as OT are looking for opportunities to be able to be evidence-based and science-driven.
OT Then and Now
OT started out as reconstruction aides back in World War I (Figure 1).
Figure 1. Reconstruction aides.
The idea was that if you pull a soldier off the front line and engage them in occupation or purposeful activity that would help them decompress and deal with some of those rigors of war. The same is true today. The rigors of war are still tough, but it looks a little bit different than it did back then (Figure 2).
Figure 2. Current OT.
This is a current occupational therapist (me). The birth of OT was during World War I and the reconstruction aides. If you look at some of the crafts back then, they were things like sewing, woodwork and things like that. They were very typical of the time. Fast forward to 2016, Figure 2 shows something you might see for soldiers overseas. It is coming off the front line, perhaps playing some video games, and being able to engage in occupation. It still is just as important to try to get their minds off the rigors of war and to be able to engage them in purposeful activity.
The Initial Interview
The initial interview is going to be the most important thing that you do regardless of what setting you are in. It is all about mental health.
Figure 3. Ways to approach a problem.
I had a mentor named Stuart Gibbs. He said that with "any kind of external compromise, we view it internally as something that stops us from doing something, and as human beings, we are geared to do." If we think about with an orthopedic mindset, it is basically to treat as we would in physical rehab. A patient may say, "As soon as I have my head or my hand or my mind back, I can do x again." OT is different than a lot of professions out there because we have a formal education in both physical rehabilitation but also behavioral health. The OT mindset is that by treating the external compromise that tells him that he cannot do, we have in fact addressed the internal compromise that says that he cannot do. The external compromise is the physical injury or cognitive deficit that tells the internal self that I cannot do. If we can trigger them to think differently, then all of the sudden we have a more powerful potential to be able to get to where we need them to go.
The Army's Center for Enhanced Performance
Several years ago I had an opportunity to visit West Point, it is the Army's military academy in New York. I was introduced to the Army's Center for Enhanced Performance. The basis of the program is that if I can teach the mind to overcome physical experience, then I can have an optimized outcome in the end (Figure 4).
Figure 4. The Army's Center for Enhanced Performance.
They took things like goal setting and visualization, attention control, and coached relaxation into practice for one's day to day life. One of the big reasons this came to be was because their football team was struggling with performance on the field and they used a sport's model at first. They would be out at practice and doing very well, but when it was game time, things became a lot more challenging. The pressure was on and there were many expectations. Due to this, some of the results were not as great as they wanted. For example, their punter was the worst in the country, absolutely dead last in statistics. He was an amazing kicker in practice, but he was having game problems. They started using staged immersion and desensitization prior to games as part of this new program.
The mission of the Center for the Enhanced Performance is:
To develop the full potential of Warriors and Families using a systematic educational and developmental process grounded in cutting edge performance psychology and learning strategies in order to enhance adaptive thinking, mental agility, and self-regulation skills essential to the pursuit of overall personal strength, professional excellence, and the Warrior Ethos across the Army.
It is a lot of words but basically making a soldier and family members resilient. This was laying the groundwork for the program. They started with goal setting. Their plan was to get soldiers to think very differently. Back to the previous example with the kicker, the began giving him positive statements. Instead of him saying "I am going to be the best kicker ever," or "I will have an excellent season next year," they encouraged the "I am" statements. "I am the greatest kicker in the country." "I am the top performer next year." "I kick 50 yard field goals." "I do these things." It is never something that you are anticipating or hoping, you already are that person. Once you have internalized this, you have already done half the battle. From this positive thinking, we start to write down some current goals and then potential goals for the future.
