Aug 28 / Guest blogger and occupational therapist, Peggy Terhune, PH.D., MBA, OTR/L

Why OT Practitioners Need to Understand Trauma

Welcome to guest blogger and OT Peggy Terhune, PH.D., MBA, OTR/L

I have been an OT for over 50 years and could easily tell you the history of OT treatment for psychiatric disorders. However, today, what I have learned is that trauma is often a root cause for mental health disorders.


Keep reading to discover :
  • What helps individuals deal with trauma
  • A specific clinical example from the guest blogger
  • Why its important to address trauma in OT practice

Often misdiagnosed as anxiety, depression, schizo-affective disorder or other diagnoses, if trauma is at the core of the problem, the treatment only covers the symptoms, not the problem.  The person can get better, but never really become the person they want to be.

What helpful for those with trauma?

Trauma experiences don’t go away.  They are always with us. But if we can work through the trauma, we know that we can come out the other side much healthier.  Recent research tells us that talk therapy is NOT the best treatment for trauma, and neither are medications.  Those only treat the symptoms.  It falls on the OT practitioner to identify the sensory issues, emotional issues, physical responses and other concerns that must be worked through.

What might this look like in OT practice?

For example, I will never forget one child in my private practice years ago.  He was a 7-year-old that would lose it when the fire alarm bell went off at school.  When the parents came to me for help, they told me they were trying to fix it by sneaking around and banging pots together behind his back to get him used to the noise.  Needless to say, we stopped that practice.  I identified that the child had numerous sensory issues, dreams of burning alive from a movie he had seen, low tone, and no coping skills.  Eventually, the child was able to manage those fire drills, although treatment was not fast, and had to be modified frequently as I learned more about the child.

Why is it important to address trauma?

I also experienced trauma in my life that impacted my world tremendously.  However, through multiple OT principles, I was able to work through the trauma, and today can identify and manage triggers when they occur.

   Through my experiences and knowledge of trauma, I want other occupational therapists to understand that trauma is often the basis of what we need to treat.  Someone who has had a stroke that impacts their occupations in tremendous ways has experienced a severe trauma.  A child who has been bullied has experienced trauma.  Elderly people who start to forget are experiencing continual trauma episodes as the viable occupations in their world start to shrink.  Occupational therapists and occupational therapy assistants in every single area of practice need to know about and understand trauma.

Guest Writer

Dr. Peggy Terhune has been CEO of Monarch since June 1995. Under Peggy’s leadership as President/CEO, Monarch has implemented evidence-based and best practices in all areas, has successfully added numerous services, enhanced community integration, improved customer satisfaction, reduced turnover, and has effectively developed programs to serve consumers with multiple disabilities. She has grown the company significantly and diligently pursues her methodology to incorporate continuous improvement within the organization. Peggy is a strong advocate for people with disabilities and has presented often at conferences and technical workshops, particularly on emerging practices that are used at Monarch.

Peggy has served as an advocate for people with disabilities for more than 40 years and has presented often at conferences and technical workshops, particularly on emerging practices that are used at Monarch. She is a founding board member of the North Carolina Providers Council and past president of the National Conference of Executives of the Arc. Additionally, Peggy was appointed to the N.C. Department of Health and Human Services Waiver Advisory Committee (DWAC) and has been appointed twice to the N.C. Commission on Mental Health, Developmental Disabilities, and Substance Abuse Services. She is also a board member of the N.C. Council of Developmental Disabilities, also appointed twice by the Governor. Peggy is a past member and officer of the Board of Directors for the National Alliance on Mental Illness (NAMI) North Carolina and former member of the Benchmarks’ Board of Trustees.

Peggy is the recipient of numerous regional and national leadership awards. In 2016, she was the first-ever recipient of the Distinguished Professional Award in Diversity and Cultural Competency by the National Conference of Executives (NCE) of The Arc. In 2017, she was also awarded the Lifetime Achievement Excellence Award from i2i, a health care leadership organization in North Carolina. In 2020, she was awarded the Champion award by the National Conference of Addiction Disorders. In 2020, she was also awarded the highest honor a North Carolina citizen can receive when she received the Order of the Long Leaf Pine award, recognizing her outstanding contributions to the state and its people.

Peggy received a Bachelor of Science degree in Occupational Therapy from Indiana University, a Master of Business Administration (MBA) degree from Rochester Institute of Technology, and a Ph.D. from The University of North Carolina at Greensboro. She has worked with and advocated for people with disabilities for more than 40 years. Her competencies include a wide range of clinical and administrative skills and she is culturally competent.

In addition to her career, Peggy is mother to seven adult children, grandmother to ten and wife to Bob. For more than twenty years, the couple has fostered children with and without disabilities.  A servant leader, Peggy continues to provide community service in many ways. For fun, she serves as an adjunct faculty member at Wingate University in the doctoral program for Occupational Therapy and at Pfeiffer University in the masters’ program for Occupational Therapy. In her spare time, she enjoys needlepoint, knitting, reading and traveling.

Join us to learn more about trauma

Thursday, September 5, we will be hosting a new live webinar Understanding Trauma as an OT Practitioner. Discover how trauma impacts every aspect of occupational therapy and learn to integrate trauma-informed care into your practice.
(Brand new- Just for OT subscribers only)
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