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Amy Adler PDF

27 Pages·2017·1.45 MB·English
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Lessons in Resilience and High-Risk Occupations Amy B. Adler, Ph.D. Center for Military Psychiatry and Neuroscience Walter Reed Army Institute of Research Prepared for Strategies, Interventions and Policies for Health Promotion, High Risk Behavior Prevention and Increased Performance of the DHS Law Enforcement Workforce: A Workshop 17 January 2018 Disclaimer: Research was conducted in compliance with AR 70-25. Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense Typical Training Programs  Universal  One-size-fits-all  Teach “resilience” skills  Some evidence of efficacy  Small effect sizes (.20-.30) 2 Boosting Effectiveness  Individuals  Teams  Leaders 3 Mindfulness  Investing in mindfulness Intervention efficacy  Implementation science   Mindfulness as a moderator of combat exposure over time Non-reactivity to inner experience (FFMQ sub-scale)  Moderated PTSD symptoms, Depression symptoms, Risk-  Taking, Pain, Functional Impairment Source: Nassif, Start, Toblin & Adler (2017) 4 Stages of Change Stage Description Instructional Strategy Pre- No intention for Engage with information about need for change contemplation change Provide personalized information about risks if no change, emphasize multiple benefits of change Contemplation Starting to look at Emphasize what life would be like if changed, learn pros and cons from people who have changed, Encourage them to work at reducing the cons Preparation Intends to act/ Encourage seeking support, telling people about plan committed to and thinking about how change would feel. Help change create and implement specific action plan; set realistic goals Action Actively working Provide action-oriented planning to strengthen to change commitment and fight urge to slip back Maintenance Has changed, Provide support, positively address slips/relapses prevent relapse Employ reminder systems Source: Mander et al. (2012); Prochaska & DiClemente (1983) 5 Readiness Stage: Utility “How much are you using the skills you’ve learned in resilience training?” 4 *** 3.5 3 2.5 2 1.5 1 PPrree--ccoonntteemmppllaattiivoen CPonretepmarpaltaiotino n AAccttiioonn Source: Sowden & Adler (2016) 6 Behavioral Nudging  Alternative methods to induce change Change the environment  Provide feedback   Actigraph feedback study Sleep Problems Sleep in Hours 5:28 50 5:31 g 38 5:24 n40 it 5:16 r30 o 20 5:09 p 5:03 20 e 5:02 R 10 4:55 % 0 4:48 Actigraph Comparison Actigraph Comparison Group Group Group Group Source: Adler, Gunia, Bliese, Kim & LoPresti (2017) 7 Nudging through Feedback 8 Boosting Effectiveness  Individuals  Teams  Leaders 9 Small-Team Culture  How does emotional culture ensure resilient teams?  Evidence from WRAIR study of 70+ tank crews  Boost for those with initially low scores in crews with • High levels of optimism/hope and pride • Low levels of guilt 900 High Final Hope Qualification Score 800 Low High Pre-Qualification Score 10

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Amy B. Adler, Ph.D. Center for . Source: Adler, Kim, Thomas & Sipos (in press) . I hope resilience training will help me understand myself better.
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