Amy Adler

27 Pages·2017·1.45 MB·English

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