Serving Those Who Served: Advancing Hand Therapy Practice within the VA

Written by: Collin Cooper, OTR, OTD

Virtual Hand Therapy Fellow '25/'26

Occupational therapists are trained as generalists to address a wide range of needs across

the lifespan that often includes physical, cognitive, and psychosocial components.

However, a therapist quickly becomes aware that people require a deeper level of

knowledge. For me, that understanding has led me down the path of becoming a Certified

Hand Therapist (CHT) while serving within the Department of Veterans Affairs (VA).

This journey of becoming a CHT is about answering a call to serve those who have already

given so much.

The upper extremity is essential to almost all meaningful occupations. From basic self-care

to complex tasks, the function of the arm and hand has a direct impact on independence,

identity, and quality of life for many. I have worked with the Veteran population, I have come

to realize that most Veterans present with complex diagnoses, including orthopedic

injuries, neurological conditions, and chronic pain syndromes that require clinical

reasoning and judgement as well as specialized intervention beyond foundational

education.

Occupational therapy at the VA works to improve the lives of those who have served our

country. Veterans do not present as textbook cases. Their lives are layered with

experiences that shape who they are, what their impairments are, and their approach to

recovery. As therapists, we are challenged to integrate the biomechanical model with a

holistic understanding of each individual’s lived experience and the impacts that they have.

This is where specialization in hand therapy becomes essential.

The Virtual Hand to Shoulder Fellowship has allowed me to bridge this gap of mastering

anatomy, biomechanics, tissue healing timelines, surgical interventions, precautions,

orthotic fabrication, and essential clinical decision-making to real world application.

Through this process, I have come to realize that career advancement is developed through

application, repetition, reflection, and the willingness to remain committed to lifelong

learning.

In the VA setting, this path takes on added significance when working with a Veteran who is

recovering from a hand injury looking to regain motion, but to return to meaningful

occupations, which could include employment, parenting, or leisure task engagement or

could include a veteran with chronic upper extremity pain and significant comorbidities

resulting in physical limitations and psychological barriers. These cases demand more

than foundational knowledge; they require client-centered and evidence-based

intervention grounded in advanced clinical practice.

As occupational therapists, we are positioned to address these needs through our focus on

function, engagement, and client-centered care aligns well with the purpose of hand

therapy. Without this, there is a risk of falling short in fully addressing the needs of our

nation’s Veterans. Pursuing the CHT credential represents a commitment to closing that

gap.

The journey to becoming a CHT also reinforces the concept of service.

Veterans have sacrificed in ways that are unseen, not acknowledged, and often

misunderstood. For myself, working with Veterans is a privilege that carries responsibility to

provide the highest standard of care, to advocate for Veteran needs, and to continuously

strive for clinical excellence.

Becoming a CHT is one way I can honor that responsibility through the opportunity to make

a meaningful impact and enriching the ability to serve our Veterans.

As I continue this journey, I am reminded that growth in this field is a lifelong process

because there will always be more to learn and more ways to help Veterans return to

occupations of importance. With each step toward becoming a CHT, I am better equipped

to serve those who have served.