A Resiliency Program for WA

Fire & Emergency Service Workers

Petra Skeffington BA(Hons), MCouns, PhD Candidate

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Current Practice

Something Argh! Ok try and

happens deal with it!!

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Current Research

Early intervention
CISD/CISM
POSM (Post-Operational Stress Management)
POPS/ RtAPS

Acute Stress Disorder Treatments

PTSD Treatments

Current approach= Screen and treat

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Where are the gaps?

Current process= screen and treat.

Resilience research appears broad and is not targeted at

preventing pathology.

PTSD Prevention research is limited and in early stages.

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Primary prevention

Ok something
is probably
going to Something Argh! Ok try and deal
happen..lets happens with it!!
get strong and
prepare!

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Where to start?

AIM:

(Eventually get to a)Theory driven and evidence based

targeted intervention.

For now: what evidence is out there?

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Systematic Review

Scour the literature for all pre-trauma resilience building

programs

Could be: resilience building, mental toughness,

psychological fitness, stress inoculation, coping skills,
stress management, prevention, intervention, training,
program

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Eligibility criteria

Participants received a resilience building intervention.

Participants were subsequently exposed to a potentially
traumatic event meeting Criteria A-1 for PTSD as outlined
in the DSM-IV (APA, 2000).
Data was collected regarding psychological well-being.

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 Database Number of Results

PsycInfo 3752

Science Direct 678

ProQuest 6365

Web of Knowledge 11803

TOTAL
15014
(following removal of duplicates)

Exclusions Articles remaining

First Pass- exclude by title 1268

Second Pass- exclude by abstract 51

Final pass- exclude by entire article

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So.what do we have?

Three distinct categories:

Psychoeducation
Psychoeducation + skills building
Simulation training

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Number of randomised controlled trials?

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Summary

Length and content of interventions varies, but common

factors support a cognitive model.
No thorough, randomised controlled trials.
Skills building is more effective than psychoeducation
alone.

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What skills?

Stress management
Relaxation/ Mindfulness
Utilisation of social support
Understanding of growth and resilience
Identification of thoughts, feelings and behaviours

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What will I do with this?

It is clear that controlled trials guided by relevant

psychological theory are needed in this area.

I used the current evidence and a cognitive model of PTSD

to develop a program aimed at the primary prevention of
PTSD, with a view to evaluating this program in a
randomised controlled trial.

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Cognitive Model of PTSD

Therefore, PTSD
Anxiety = result of occurs when a
PTSD = anxiety appraisals relating PTE is processed
disorder to impending in a way which
threat. produces a sense
of current threat.

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Where to intervene?

Appraisal
Of the event
Of symptoms/ reactions
Of personal resources
Of others
Of coping strategies

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Primary prevention

Reduce maladaptive appraisals/ promote adaptive coping

Psychoeducation
Self Care
Social Support
Coping Strategies

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Program Evaluation

Implementation & Evaluation

Deliver the program to approximately 60 recruits completing

their initial training. An additional 60 recruits will serve as a
Training-As-Usual (TAU) group. Participants will be followed
for 12 months following the intervention.

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Implementation & Evaluation

Design
A pre-intervention/ post-intervention/ follow up control group
design with clustered random allocation of participants to
groups will be used.

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Hypotheses

H1: The intervention group will show a greater pre-post increase in trauma
knowledge (as measured by a trauma knowledge test).
H2: The intervention group will report a greater pre-post increase in levels of
perceived social support & satisfaction (as measured by the SSQSR).
H3: The intervention group will report a greater pre-post increase in levels of
adaptive coping (as measured by the COPE total score).
H4: The intervention group will show less increase, or decrease in pathology (as
measured by the PCL-C and DASS-21).
H4: The intervention group will show lower levels of problematic alcohol use (as
measured by the AUDIT).
H5: Any changes in the intervention group will be maintained at 6-month follow-
up.
H6: Any changes in the intervention group will be maintained at 12-month
follow-up.

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Progress

All baseline control data has been collected, with the first
round of recruits currently completing their 12-month follow
up measures.
The intervention school is currently in training, with 1 hour
of the program to be delivered.
Final follow-up data will be available from November 2014.

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Contact Details
petra.skeffington@curtin.edu.au

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