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Occupational Therapy and Post Traumatic Stress Disorder

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ResearchFOI 25/26-0805paper

DOCUMENT 3

Occupational Therapy and Post Traumatic Stress Disorder

The content of this document is OFFICIAL.

Please note:

This document is intended to assist Technical Advice and Practice Improvement Branch (TAPIB) staff with provision of technical advice or practice improvement activities. Branch Manager clearance is required before research documents are shared outside the branch.

The TAPIB Research team take care to ensure the research presented is accurate at the time of writing. Due to the nature of our work, we are not able to ensure that all relevant research has been considered in the development of this document or that information remains accurate after publishing.

Research question: How does dissociation present in PTSD? What is the efficacy of occupational therapy interventions for PTSD? What is the efficacy of occupational therapy interventions for dissociation?

Date: 02/06/2026

Contents

OT and PTSD Page 1 of 17 OFFICIAL 16 of 50

Contents

6.3 Practice Documents ……………………………………….. 11

6.4 Service Providers …………………………………………….. 12

7. Occupational Therapy and Dissociation …………………. 13

8. References ……………………………………………………….. 14

OT and PTSD Page 2 of 17 OFFICIAL 17 of 50

Summary

Post-traumatic stress disorder (PTSD) is mental health disorder that can occur after experiencing a traumatic event. It can be diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) or the International Classification of Diseases (ICD) 11. The DSM-5-TR recognised a dissociative subtype of PTSD. Only the ICD-11 recognised complex PTSD (CPTSD) as a diagnosis distinct from PTSD. PTSD and CPTSD diagnoses can include but do not require features of dissociation.

These diagnoses are further complicated by the need for differential diagnoses of dissociative disorders which may or may not be preceded by exposure to a traumatic event and may or may not have co-occurring PTSD symptoms.

Dissociation can range from benign experiences to more severe states that impair functioning. Dissociative features play a role in conditions such as dissociative identity disorder, depersonalisation-derealisation disorder, and may play a role in schizophrenia, eating disorders, panic disorders, affective disorders, and obsessive-compulsive disorder. Some research indicates that individuals with CPTSD score more highly on dissociation measures than those with PTSD, and that individuals with PTSD dissociative type have elevated PTSD and depression symptom severity.

There is a lack of high-quality research on the efficacy of occupational therapy for individuals with PTSD both in Australia and worldwide, and studies often focus on the veteran rather than civilian population. However, occupational therapy is promoted by government and peak bodies and service providers as an effective therapy in assisting individuals with PTSD and trauma. Occupational therapy approaches in supporting these individuals tend to focus on rebuilding healthy routine, relaxation and mindfulness techniques, sensory-based interventions, symptom management strategies, and gradual and consistent exposure to avoided situations.

We find very little information on the role of occupational therapy in treating dissociation. Research in this area tends to have been published in the early 1990s and to focus on multiple personality disorder (now called dissociative identity disorder).

Post Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is mental health disorder that can occur after experiencing a traumatic event. In order to diagnose PTSD, health practitioners use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) or the World Health Organization’s International Classification of Diseases (ICD) 11 criteria.

Previous TAPIB Research Papers which discuss PTSD are listed below:

  • Exposure Therapy for PTSD. OT and PTSD Page 3 of 17 OFFICIAL 18 of 50

Diagnostic and Statistical Manual of Mental Disorders

According to the DSM-5-TR (2022, pp. 301-303), the diagnostic criteria for PTSD for individuals older than 6 years old include:

  • exposure to actual or threatened death, serious injury or sexual violence by directly experiencing or witnessing the traumatic event(s), or learning about the event in relation to a loved one, or repeated or extreme exposure in the work environment
  • intrusion symbols such as distressing memories of or dreams about the traumatic event(s), dissociative reactions (e.g., flashbacks). Duration must be over 1 month
  • avoidance of stimuli associated with the traumatic event(s). Duration must be over 1 month
  • negative alterations in cognitions and mood such as the inability to remember an important aspect of the traumatic event (usually caused by dissociative amnesia), negative beliefs, negative emotional states. Duration must be over 1 month
  • marked alteration in arousal and reactivity including irritable behaviour, self-destructive behaviour, hypervigilance, exaggerated startle response, problems with concentration and sleep disturbance. Duration must be over 1 month
  • clinically significant distress or impairment in social, occupational, or other important areas of functioning caused by the disturbance
  • the disturbance is not attributable to the physiological effects of a substance or another medical condition.

For children under 6 years of age, the criteria differ slightly. PTSD may be caused by learning about a traumatic event occurring to a parent or caregiver but not from repeated or extreme exposure in the work environment, and intrusion symptoms may be expressed as play re-enactment.

According to the DSM-5-TR, a diagnosis of PTSD should be specified as to whether it is with dissociative symbols. Dissociative symbols include:

  • depersonalisation - persistent or recurrent experiences of feeling detached from and as if one were an outside observer of one’s mental processes or body (e.g., feeling as though one were in a dream)
  • derealisation - persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).

International Classification of Diseases 11

According to the World Health Organization’s ICD-11 (2026), diagnostic requirements of PTSD include:

  • exposure to an event or situation (either short- or long-lasting) of an extremely threatening or horrific nature
  • re-experiencing the traumatic event in the present (lasting for at least several weeks)
  • deliberate avoidance of reminders likely to produce re-experiencing of the traumatic events
  • persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises
  • the disturbance results in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort.

According to the ICD-11 (2026), additional clinical features of PTSD may also include general dysphoria, dissociative symptoms, somatic complaints, suicidal ideation and behaviour, social withdrawal, excessive alcohol or drug use to avoid re-experiencing or manage emotional reactions, anxiety symptoms including panic, obsessions or compulsions in response to memories or reminders of the trauma, and emotional experiences such as anger, shame, sadness, humiliation, or guilt, including survivor guilt.

In terms of differential diagnosis, the ICD-11 (2026) describes boundaries between dissociative disorders and PTSD. It states:

Following an experience of a traumatic event(s), a variety of dissociative symptoms can occur, including somatic symptoms, memory disturbances, flashbacks or other trance-like states, alterations in identity and sense of agency, and experiences of depersonalization, especially during the episodes of re-experiencing. If the dissociative symptoms are confined to episodes of re-experiencing in an individual with Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, an additional diagnosis of a Dissociative Disorder should not be assigned. If significant dissociative symptoms are present outside of episodes of re-experiencing and the full diagnostic requirements are met, an additional Dissociative Disorder diagnosis may be assigned.

Complex Post Traumatic Stress Disorder

Complex Post Traumatic Stress Disorder (CPTSD) is not consistently recognised as a diagnosis separate from PTSD, and there is ongoing debate in the scientific community about whether CPTSD is a separate condition (Cutlip et al., 2023; Ford & Courtis, 2014). For example, the DSM-5-TR does not recognise CPTSD as a separate diagnosis.

CPTSD

CPTSD is diagnosed separately from PTSD in the latest version of the ICD; ICD-11 (2026). According to the ICD-11, CPTSD has three symptom clusters that are absent for PTSD. These involve disturbance in self-organisation: difficulties with emotional regulation, an impaired sense of self-worth, and interpersonal problems (ICD-11, 2026; Phoenix Australia, 2022, p. 9; PTSD UK, n.d.). Dissociation is also described as a possible feature of CPTSD (ICD-11, 2026).

According to Health Direct (2025), a service funded by the Australian Government, CPTSD is similar, but separate to PTSD. It can develop after experiencing traumatic events repeatedly or over a long period of time (HealthDirect, 2025). Other organisations such as the UK Trauma Council, PTSD UK, and the U.S. Department of Veterans Affairs provide information about CPTSD.

Research published in this area may or may not differentiate between PTSD and CPTSD. When reporting on studies in this paper, we use the term (PTSD or CPTSD) present in the original source.

Dissociation

Dissociation is a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity (Better Health Channel, 2023). The phenomenon of dissociation can range from relatively common and benign experiences such as being completely absorbed by an activity to more severe states that impair functioning (Boyer et al., 2022, p. 2; Lyssenko et al., 2018, p. 37).

Dissociation often occurs in response to trauma. This kind of dissociation can resolve without the need for treatment. However, it may also develop into a dissociative disorder that requires treatment. Such dissociative disorders include dissociative amnesia, depersonalisation- derealisation disorder and dissociative identity disorder (Better Health Channel, 2023).

Symptoms of dissociative disorders include:

  • feeling disconnected from oneself
  • issues handling intense emotions
  • sudden and unexpected shifts in mood
  • depression and/or anxiety issues
  • feeling as though the world is distorted or not real (derealisation)
  • memory problems that are not linked to physical injury or medical conditions
  • other cognitive issues such as problems with concentration
  • significant memory lapses such as forgetting important personal information
  • feeling compelled to behave in a certain way
  • identity confusion - for example, behaving in a way that the person would normally find offensive or abhorrent (Better Health Channel, 2023).

As mentioned in section 3.1, according to the DSM-5-TR, a diagnosis of PTSD can include the ‘dissociative subtype’ specifier. However, the DSM-5-TR (2022, p. 313) also states that differential diagnosis of PTSD with dissociative symptoms should consider dissociative amnesia, dissociative identity disorder and depersonalisation-derealisation disorder which may or may not be preceded by exposure to a traumatic event and may or may not having co- occurring PTSD symptoms.

Dissociative features may also play a role in conditions such as schizophrenia, eating disorders, panic disorders, affective disorders, obsessive-compulsive disorder and CPTSD (HealthDirect, 2024; Lyssenko et al., 2018, p. 37).

Previous TAPIB Research Papers which discuss dissociation are listed below:

5. Dissociation in Post Traumatic Stress Disorders

The DSM-5-TR (2022, p. 308) states that a significant subgroup of individuals with PTSD experience persistent dissociative symptoms of depersonalisation and derealisation. However, nо estimate оf thе prevalence оf dіsсоciаtivе symрtomѕ іn individuals wіth PTЅD is gіven.

A scoping review by Fung еt аl. (2023) on the relationship between dissociation and CPTSD found some evidence that individuаls witһ СРТSО scored higher on dissociation measures (e.g., the Dissocia­tive Experience Scale) than those with PTSD. The authors also noted a lack of studies looking at the preva­lence иnd correlates of dissociat ive sympto ms among people with CP Т SD . Anoth er study b y Fun г et al. (2024 ) invest igated disso ciat iv e sy mpto ms i n 165 in div id u als wi t h a diag no s is o f C P T S D . Th e Dis so ci ativ e Ex pe rie nc es Sc ale - Ta xo n wa s us ed to assess clinically significant levels of dissociative symp toms. Such leve ls were reported in 42.3% of participants. Researchers also found that dissociative symptoms wer e associated wit h depre ss ion symptom s an d wo rk an d soc ia l im pa irm en ts ind ep end ent оf thе effe ct s of trauma exposure, CPTSD sym ptoms а nd di st ur ba ne sсs вn se lf-оr ga ni za ti on сy mp tom s. Th е authors also not ed tha t there іѕ a la ck of re sea rc h on тh e pr eva len ce of diss ocia te d symp тоm s in individuals with СРТЅD.

Other studies have identified that individuаls witһ CP Т SD ha ve sign ifi ca nt ly hi ghe r le vel s of dissociat ive ex per ie nce s co mpa red to tho se w it h PT SD and those wi th no diag nos is (see Hyland et al., 2020).

Oth er res ear ch (se e Jark as et al . , 2025 ) sug ge sts indiv id u als wit h P T S D dis so ciat iv e ty pe have elevated PTSD и depression sympto m severity compared to in dividua ls with a non- disso ci ativ e typ e o f PTS D.

Occupational Therapy and Post Traumatic Stress Disorders

It has been suggested that occupational therapy practitioners can be in the forefront of the rehabilitation process following a traumatic event. They can support mental health care, resilience and adaptation, establish intervention strategies that meet the needs and capabilities of clients and assist with maintaining and enabling occupational performance (Edgelow et al., 2019; Lopez, 2011, p. 35).

Australia

In Australia, OTs can apply to be recognised as a Mental Health Occupational Therapist through the Occupational Therapy Australia Mental Health Endorsement Program. This program recognises additional knowledge, skills and experience of OTs in the area of mental health.

Occupational Therapy Australia also has the Mental Health Capability Framework which outlines knowledge and skills that foundational OT practitioners, intermediate OT practitioners and senior OT practitioners have in a range of mental health areas such as trauma-informed practice, sensory modulation interventions, cognitive and behaviour therapy, and dialectical behaviour therapy.

Occupational Therapy Australia has a Trauma Informed Care Interest Group that connects and supports OTs across Australia who are interested in developing and advancing their understanding and practice of trauma informed care principles and approaches.

The Australian Capital Territory Government (n.d.) published a document titled Healing trauma through occupational therapy. The document states that occupational therapy can support a child’s healing and help children to feel safe by helping them to learn to manage their emotions, build their skills and confidence to join in daily activities, and develop their self-awareness. This can occur in the following ways:

  • developing a ‘sensory profile’ that explores how the child responds to different sensory information
  • exploring different sensory activities to help the child manage their emotions throughout the day (e.g., creating safe sensory spaces, deep pressure activities or brainstem calmers that help the child calm down)
  • setting up spaces that promote feelings of safety, connection and engagement

  • doing gross and fine motor activities to support the child’s development and

      participation (e.g., jumping, running or pushing for gross motor skills and

 handwriting, drawing or doing puzzles for fine motor skills)

  • play based approaches

  • pet assisted therapy.

A 2022 article by Mason and Stagnitti examined OTs’ practice with children (aged 0–12) with complex trauma in New Zealand and Australia. Based on responses from 25 OTs, authors identified that the most common practice used was sensory-based practices (sensory modulation interventions) and play-based interventions. Results also showed that most respondents reported a lack of experience in working with complex trauma.

6.2 Research

In a scoping review on occupational therapy and PTSD, Edgelow et al. (2019) found that individuals with PTSD may experience issues in the areas of sleep, management and maintenance of health, community mobility, meal planning, managing personal finances, education, employment, driving, a decrease in interests, decreased motivation to engage in hobbies and activities, and interpersonal problems. There is also evidence that PTSD can affect social cognition, social functioning and contribute to significant functional impairment (see Janssen et al., 2022, Jellestad et al., 2021, Scoglio et al., 2020).

Edgelow et al.’s 2019 scoping review was based on 50 studies which explored different occupational therapy treatment approaches for PTSD. These included expressive therapies such as dance, drawing, role-playing, habit and routine creation, coping skills, sensory approaches, and breathing and relaxation exercises. However, few of the studies included in the review examined the efficacy of the interventions and some of them lacked explicit detail (p. 153). The authors state that “literature to support the efficacy of occupational therapy practice with clients who have PTSD requires more attention” (p. 152).

In 2019, Torchalla et al. published an article on the role of occupational therapy in trauma- focused treatment for individuals with PTSD. They state that OTs can support clients by:

  - promoting a healthy and balanced lifestyle (daily structure and routine, regular

      exercise, sleep hygiene strategies, optimal nutrition, reconnecting with family and

       friends, and resuming meaningful roles and relationships)
  - training a client in diaphragmatic breathing, relaxation, and mindfulness techniques
  - teaching skills and symptom management strategies
  - assisting the client to systematically and gradually confront avoided and feared

       situations repeatedly and for an extended period of time
  - discussing workplace modifications with the employer

  • reviewing coping skills and communication strategies, challenging unhelpful beliefs,

      normalising symptoms, processing difficult or unforeseen circumstances, and

managing setbacks (with a psychologist and OT).

A 2020 scoping review on occupational therapy for military personnel with PTSD by Kerr et al. note the paucity of literature regarding the role of occupational therapy for any individual with PTSD (p. 480). However, they also note that OTs are increasingly concerned with the impact of PTSD on health, quality of life, occupational performance in sleep, work, motivation, and engagement in leisure pursuits (p. 480). The scoping review identified that OTs utilise psychological therapies and frames of reference such as Cognitive Behaviour Therapy, cognitive processing therapy, trauma-focussed techniques, exposure therapy, trauma counselling, psychological first aid, gatekeeper training and motivational interviewing when providing support to military personnel and veterans with PTSD (p. 490). Other interventions identified included physical training, sleep hygiene, animal-assisted therapy, problem solving strategies, relaxation techniques, stress and anger management or coping skills, biofeedback, and resilience training. However, the efficacy of these interventions was not examined in the original papers.

Interventions whose efficacy was tested include cranial electrotherapy stimulation (CES) (authors warn OTs require advanced certifications to use physical agent modalities), driving rehabilitation programs using simulators, the Ocean Therapy surfing skills-based intervention, interdisciplinary residential programme which included biofeedback, communication skills, self- awareness and regulation tools, relapse prevention, CogSmart, and sensory regulation groups. Results from these interventions indicated a decrease in PTSD symptoms and depression, and improvements in self-perception and satisfaction with occupational performance. There was also evidence that interventions such as human-animal interaction programmes and animal-assisted therapy may help in reducing PTSD-like symptoms, misuse of prescription medication, alcohol, and suicidal ideations, and help in improving sleep, imotional regulation, anger and anxiety management. Importantly, these studies included small participant cohorts, did not use blinding and tended not to employ randomisation.

Johnson et al. (2021) provide preliminary data that therapeutic horseback riding delivered by OTs and certified riding instructors may be clinically beneficial for military veterans with PTSD. Another study by Lanning et al. (2017) found benefits (a clinically significant decrease in PTSD symptoms, improved social functioning, vitality, less interference of emotions on daily activities and increased participation) for veterans and active duty service members who participated in an 8-week therapeutic riding program. The paper states that each session was taught by Professional Association of Therapeutic Horsemanship (PATH)-certified instructors and an occupational therapist and a physical therapist participated as site coordinators and co- investigators.

Intervention Approaches for Individuals with Trauma and Stressor-Related Disorders

In the book Occupational Therapy in Mental Health: A Vision for Participation, Champagne (2019, p. 221) lists some common intervention approaches for individuals with trauma and stressor-related disorders, including PTSD. These include:

  • cognitive behavioural approach
  • dialectical behaviour therapy
  • Dunn model of sensory processing
  • sensory rooms
  • therapeutic writing and other creative media
  • self-esteem development in children
  • trauma-informed care
  • mindfulness meditation
  • permanent supportive housing
  • ADL and IADL skill training
  • combat and operational stress control units.

Evidence suggests that sensory-based interventions delivered by OTs may have an effect on trauma survivors. McGreevy & Boland (2020) published an integrative review of occupational therapy literature on sensory-based interventions with adult and adolescent trauma survivors. Diagnoses included PTSD, disorders of extreme stress (DESNOS), post-traumatic stress response (PTSR), PTS symptoms, and histories of trauma. Based on 18 papers, the authors concluded that sensory-based interventions for this cohort are emerging as a promising area of practice and research. Results suggested that sensory-based interventions (e.g., customised sensory kits to help regulate overwhelming sensory and emotional stimuli, the Wilbarger Therapressure Programme (WTP), sensory motor arousal regulation treatment (SMART), sensory modulation programs) may help improve occupational performance, Canadian Occupational Performance Measure (COPM) scores, and trauma symptoms. However, there were limited high-quality empirical data found and small sample sizes, lack of control groups and longitudinal studies were noted as issues.

Importantly, the literature emphasises a multi-disciplinary approach to treating PTSD wherein OTs work with other practitioners such as psychologists (see Edgelow et al., 2019; Mackoff et al., 2025; Torchalla et al., 2019).

Practice Documents

The Canadian Association of Occupational Therapists published an OT Practice Document for Trauma in 2025. According to this document, OTs’ role in assisting with trauma includes but is not limited to:

  • working with the person to plan, initiate and track short- and long-term goals that

support participation in daily activities and occupational balance for health, healing,

and wellbeing

  • teaching practical ways to cope with adverse symptoms related to trauma (e.g.,

sleep hygiene, nervous system regulation, mindfulness skills, and stress reduction

techniques) as well as skills that support participation in daily activities, including

social activities (e.g., relationship-building skills, assertiveness training, activity

planning, boundary-setting)

  • partnering with clients to identify ways to use activities (visual arts, music, and

movement) to express thoughts and emotions as well as reconnect with oneself and

one’s sense of identity

  • using psychotherapy modalities (individually and in group format) such as trauma- focused cognitive behavioural therapy, acceptance and commitment therapy, dialectical behavioural therapy, prolonged exposure therapy, play therapy, and somatic psychotherapy (notably, these modalities require additional post-graduate training)
  • helping clients develop a repertoire of self-regulation strategies, including sensory and embodied approaches, mindfulness, and nature based practices to increase participation in meaningful activity and improve quality of life.

The American Occupational Therapy Association has a page with guidance on trauma and PTSD, and the Canadian Association of Occupational Therapists also advertises occupational therapy for PTSD.

6.4 Service Providers

Service providers in Australia such as Act for Kids (n.d.) and OT Works (n.d.) advertise occupational therapy as helping individuals to heal from trauma, including PTSD.

Act for Kids (n.d.) reportedly does this by creating an environment in which the child can regain a sense of personal safety, competence, and pleasurable connection to others. This is said to create the opportunity for learning, skill development and healing. They also report providing occupational therapy in joint sessions with speech pathology or counselling, whereby the OT facilitates the child’s engagement in sensory-motor activities to support regulation, enabling the child to engage in higher-level cortical tasks required in speech pathology or talking therapies such as counselling.

OT Works (n.d.) reports:

  • creating a safe space for unmasking (helping individuals build self-awareness and
  • learn emotional regulation techniques that reduce overwhelm and increase a sense
  • of control)
  • helping with daily routines and independence (managing triggers, rebuilding routines
  • that conserve energy and reduce stress, teaching pacing and prioritisation,
  • implementing gradual exposure)
  • assisting with mind-body connection and regaining control (using sensory based
  • interventions such as mindfulness strategies and breathing techniques)
  • supporting work and social life (strategies for reintegrating into the workplace,
  • techniques to reduce social isolation, support in accessing community resources).
  1. Occupational Therapy and Dissociation

We found limited evidence on the role of occupational therapy in treating dissociation.

Some older research exists (see Fike, 1990, Frye, 1990 and Waid, 1993) on the role of occupational therapy in treating dissociative identity disorder (previously known as multiple personality disorder) which suggests occupational therapy can be beneficial.

There is evidence of occupational therapy interventions used in treating functional neurological disorder (FND) which can involve dissociative seizures. Nicholson et al. published occupational therapy consensus recommendations for FND in 2020. With regards to dissociative seizures, the recommendations are psychological therapy delivered by specially trained clinicians, learning to identify triggers and warning signs of a dissociative seizure, and Sensory Grounding Techniques such as noticing detail in the environment, cognitive distractions and sensory-based distractors.

References

Act for Kids. (n.d.). How Occupational Therapy helps kids to heal from trauma. https://www.actforkids.com.au/the-issue/how-occupational-therapy-helps-kids-to-heal- from-trauma/

ACT Government. (n.d.). Healing trauma through occupational therapy. https://www.act.gov.au/ data/assets/pdf file/0005/2390279/Healing-trauma-through- occupational-therapy.pdf

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders : DSM-5-TR (5th edition, text revision).

Better Health Channel. (2023, February 17). Dissociation and dissociative disorders. Victoria State Government. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dissociation-and- dissociative-disorders#dissociative-amnesia

Boyer, S. M., Caplan, J. E., & Edwards, L. K. (2022). Trauma-Related Dissociation and the Dissociative Disorders:: Neglected Symptoms with Severe Public Health Consequences. Delaware Journal of Public Health, 8(2), 78–84. https://doi.org/10.32481/djph.2022.05.010

Burback, L., Brémault-Phillips, S., Nijdam, M. J., McFarlane, A., & Vermetten, E. (2024). Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Current Neuropharmacology, 22(4), 557–635. https://doi.org/10.2174/1570159X21666230428091433

Canadian Association of Occupational Therapists. (2025). OT PRACTICE DOCUMENT: TRAUMA. https://caot.ca/document/8459/Trauma%20EN.pdf

Champagne, T. (2019). Trauma and Stressor- Related Disorders. In C. Brown, V. Stoffel, & J. P. Muñoz (Eds.). Occupational therapy in mental health : a vision for participation (Second edition.). F.A. Davis Company.

Cutlip, H. A., Ang-Rabanes, M., & Mogallapu, R. (2023). Unknown, Underserved, Underreported: A Case for Differentiation in Trauma Disorder Classification and Diagnosis. Curēus (Palo Alto, CA), 15(5), e39157. https://doi.org/10.7759/cureus.39157

Edgelow, M. M., MacPherson, M. M., Arnaly, F., Tam-Seto, L., & Cramm, H. A. (2019). Occupational therapy and posttraumatic stress disorder: A scoping review. Canadian Journal of Occupational Therapy (1939), 86(2), 148–157. https://doi.org/10.1177/0008417419831438

Fike, M. L. (1990). Considerations and Techniques in the Treatment of Persons With Multiple Personality Disorder. The American Journal of Occupational Therapy, 44(11), 999– 1007. https://doi.org/10.5014/ajot.44.11.999

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Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1(1), 9–9. https://doi.org/10.1186/2051-6673-1-9

Frye, B. (1990). Art and Multiple Personality Disorder: An Expressive Framework for tOccupational Therapy. The American Journal of Occupational Therapy, 44(11), 1013– t1022. https://doi.org/10.5014/ajot.44.11.1013

Fung, H. W., Yuan, G. F., Liu, C., Lin, E. S. S., Lam, S. K. K., & Wong, J. Y.-H. (2024). tPrevalence and clinical correlates of dissociative symptoms in people with complex posttraumatic stress disorder: Is complex PTSD a dissociative disorder? Psychiatry Research, t339, Article 116076. https://doi.org/10.1016/j.psychres.2024.116076

Fung, H. W., Chien, W. T., Lam, S. K. K., & Ross, C. A. (2023). The Relationship Between tDissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review. Trauma, Violence & Abuse, 24(5), 2966–2982. https://doi.org/10.1177/15248380221120835

HealthDirect. (2025, December). Complex post-traumatic stress disorder (PTSD).

Hyland, P., Shevlin, M., Fyvie, C., Cloitre, M., & Karatzias, T. (2020). The relationship between tICD-11 PTSD, complex PTSD and dissociative experiences. Journal of Trauma & tdissociation, 21(1), 62–72. https://doi.org/10.1080/15299732.2019.1675113

Janssen, P. G. J., van Est, L. A. C., Hilbink, M., Gubbels, L., Egger, J., Cillessen, A. H. N., & van Ee, E. (2022). Social cognitive performance in posttraumatic stress disorder: A meta-analysis. Journal of Affective Disorders, 297, 35–44. https://doi.org/10.1016/j.jad.2021.09.082

Jarkas, D. A., Robillard, R., Malenfant, C.-R., Richards, C., Lanthier, M., Beaurepaire, C., tNicholson, A. A., Jaworska, N., Cassidy, C. M., Shlik, J., Kaminsky, Z., & McQuaid, R. tJ. (2025). Exploring the dissociative subtype of PTSD: The role of early-life trauma, tcortisol, and inflammatory profiles. Psychoneuroendocrinology, 175, Article 107406. [t]https://doi.org/10.1016/j.psyneuen.2025.107406

Jellestad, L., Vital, N. A., Malamud, J., Taeymans, J., & Mueller-Pfeiffer, C. (2021). Functional impairment in Posttraumatic Stress Disorder: A systematic review and meta-analysis. Journal of Psychiatric Research, 136, 14–22. https://doi.org/10.1016/j.jpsychires.2021.01.039

Johnson, R. A., Albright, D. L., Marzolf, J. R., Bibbo, J. L., Yaglom, H. D., Crowder, S. M., tCarlisle, G. M., Grindler, K., Harms, N., Willard, A., Wassman, M., & Russell, C. L. (2021). Experiences of Military Veterans in a Therapeutic Horseback Riding Program.Clinical Nursing Research, 30(7), 923–933. [t]https://doi.org/10.1177/10547738211003580

Kerr, N. C., Ashby, S., Gerardi, S. M., & Lane, S. J. (2020). Occupational therapy for military personnel and military veterans experiencing post-–traumatic stress disorder: A scoping

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OT and PTSD

References

Scoglio, A.A.J., Reilly, E.D., Girouard, C., Quigley, K.S., Carnes, S., & Kelly, M.M. (2022).

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Torchalla, I., Killoran, J., Fisher, D., & Bahen, M. (2019). Trauma-Focused Treatment for Individuals with Posttraumatic Stress Disorder: The Role of Occupational Therapy. Occupational Therapy in Mental Health, 35(4), 386–406. https://doi.org/10.1080/0164212X.2018.1510800

UK Trauma Council. (n.d.). Post-traumatic stress disorder (PTSD) and Complex PTSD. https://uktraumacouncil.org/trauma/ptsd-and-complex-ptsd?cn-reloaded=1

U.S. Department of Veterans Affairs. (2025, March 26). Complex PTSD. https://www.ptsd.va.gov/understand/what/complex ptsd.asp

Waid, K.M. (1993). An Occupational Therapy Perspective in the Treatment of Multiple Personality Disorder. The American Journal of Occupational Therapy, 47(10), 872–876. https://doi.org/10.5014/ajot.47.10.872

World Health Organization. (2026). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/

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                       OFFICIAL                                      32 of 50
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