Military Psychology: The Life Cycle of a Military

Service MemberAugust 3, 2013

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Resilience and Fitness Building Techniques

Scott L. Johnston, PhD, ABPPCAPT, MSC, USN, Director NCCOSC

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Total Force Fitness (TFF)

www.nccosc.navy.m

An initiative from the Chairman of the Joint Chiefs of Staff

(DCoE adapted from Military Medicine, 2010)

Mind• Psychological• Behavioral• Spiritual• Social

Body• Physical• Medical &

Dental• Nutritional• Environmental

TFF Addresses Multiple Needs

Achieving multi-dimensional wholeness and balance to meet the challenges of changing environments

• Engaging senior leaders• Providing key terms and definitions for DoD• Providing framework for cataloging programs

and integrating resilience-focused policy and doctrine

• Starting point for developing standardized metrics

(Durgin, 2012)

DCoE Resource and Efforts

RAND studies • On web: Resilience and Suicide Prevention • New studies: Stigma Reduction, Sleep Issues, Family

Resilience

White papers reviews • Integrate three areas: scientific evidence, current

programming, stakeholder inputs • DCoE Integrative Health and Wellness website• Topics: Mind-body skills, peer support, worksite

health promotion/wellness programs, leveraging technology, well-being, reintegration programs

(Durgin, 2012)

Force Health and Wellness Award, or the Green "H."

Comprehensive Soldier and Family Fitness

Overview Five Dimensions Five Pillars

$240 Million mandatory program for all Soldiers

PhysicalGlobal Assessment Tool (GAT). GAT II & III in near

future

Five dimensionsFive pillars

Emotional Master Resilience Trainers

CSF is not a treatment programSocial Performance Enhancement

Train specific mental and physical resilience techniques

through a program of continuous self - development

SpiritualInstitutional Resilience

Training

Four Technical Report published on Effectiveness Family

Comprehensive Resilience Modules

Air Force Resilience Initiatives

Overview Resources Strategies

Domains- Physical, Mental, Social, Spiritual

Deployment Transition Center (DTC)

Cross Organizational efforts

Provide tiered Resilience training

Leadership Toolkit on Portal/Leadership Pathways

Master Resilience Trainers (MRT)Train 446 MRTs – 4 per AD base – 1 per Guard/Reserve

High Performing Airmen Developing learning goals for AF Learning

Front-line supervisors are the key to building resilience

Framework that provides the status of Air Force health and well-being

Wingman Day resources on Portal

Small Groups or Peer-to-Peer Learning

Tools to build stronger personnel to perform at work, home and in community

Community Support Coordinator positions (71)for wings

Strategic Communication

Marine Total Fitness

www.nccosc.navy.mil

Social Mind Body Spirit

Marines and families that engage in socially healthy behaviors

Marines and families that engage in psychologically healthy behaviors

Mission-capable units whose Marines are physically able to perform current and future missions

Marines and families living out their spirituality in a way that enables them to successfully meet their duties

E-Marine Integrate Behavioral Health

Physical Fitness Policy Review & Overhaul

Spiritual Fitness Guide

Single Marine Program Representative

Operational Stress Control and Readiness Program (OSCAR) GEN II

Enhanced nutrition, fatigue mgt, combat conditioning instruction

Chaplain Referral Tool

Pilot Operation Adrenaline Rush (O.A.R.)

MCFIT- web-based tool to inform and equip Marines IRT “Marine Total Fitness

Sports Medicine and Injury Prevention

Standardized CREDO Programming

Pre/Post-Deployment Unit Cohesion

Behavioral Health Information Network

Physical Fitness Website Chaplain Billet Structure Review

MCFTB Curriculum Refresh

Human Factors Program Post PT Nutritional Enhancements

Revision CREST-chaplain training.

Navy Operational Stress Control (OSC)

www.nccosc.navy.mil

Functional Areas Programs Unit Resilience

Policy- Develop/update Doctrine & CONOPS and Fleet guidance

Returning Warrior Workshops(RWWs)

OSC Awareness GMT

Training- Deliver annually and all career milestones (pre- and post-deployment; and complemented by regular Unit-level training.

FOCUS (Families Over Coming Under Stress)

Navy OSC Leaders CourseDPL OSC Course

Strategic Communications- Focuses on informing leadership, changing behavior, and developing partnerships

Caregiver OSC (CgOSC) Command Stress Assessment/DEOCS

Assessment and Analysis Measure program effectiveness

Psychological Health Outreach Programs (Mobile Care Teams, OSCAR Embedded Provider)

Organizational Resilience Assessment Pilot

(Joint Service Resilience Chiefs' Working Group, 2012)

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Ready Reacting Injured Ill

Good to Go

Well-Trained

Fit and Focused

Cohesive Units

Ready Families

Distress or Impaired

Mild and Temporarily Anxious,

Irritable or Sad

Physical or Behavioral Changes

More Severe or Persistent Stress or

Impairment

May Leave Lasting Memories, Reactions

and Impressions

Stress Injuries That Don’t Heal Without

Help

Symptoms Persist Get Worse or Initially Get

Better Then Return Worse

The Operational Stress Continuum

Unit LeaderResponsibility

CaregiverResponsibility

Individual, Shipmate, FamilyResponsibility

(US Navy NTTP 1-15M and US Marine Corps MCRP 6-11C, 2010)

Five Core Leader Functions

StrengthenLeadership that is Firm, Fair, a Source of Courage, Communicates Plans and Listens

Expose to Tough, Realistic Training

Foster Unit Cohesion

MitigateRemove Unnecessary Stressors

Ensure Adequate Sleep and Rest

Conduct After-Action Review (AAR) in Small Groups

Identify

Know Crew Stress Load

Recognize Reactions, Injuries and Illness

TreatSelf

“Buddy Aid” (Peers)

Chain of Command

Chaplain

Medical

ReintegrateKeep with Unit if at all Possible

Expect Return to Full Duty

Don’t Allow Retribution or Harassment

Communicate with Treating Professionals (Both Ways)

(US Navy NTTP 1-15M and US Marine Corps MCRP 6-11C, 2010)

Building Resilience in the Navy

Treatment PreventionAdvancements in health care Readiness

Total Sailor Fitness

www.nccosc.navy.mil

Social Physical Environmental Medical Spiritual Nutritional Psychological Behavioral

OSCPRP, CFLNOFFS Safety

Health Promotion

Community Outreach

Initiatives- PIE, Project Handclasp

NOFFS OSCSAPR,

NADAP, CMEO, FAP

SHARPCREWS

into Shape ORM PDHA, PHA CRPCREWS

into ShapeFOCUS

Suicide Awareness

& First Responder

CSADD TRIPS SHARP MWR m-NEAT SHARP

MWR SHIPSHAPE CREDO CSADD

Life Skills

Resilience

Assessment Training

CPROEvaluation

Resilience Program Components

Low Resilience High

Stress

High

Low

Leader effort

Individual effort

Mild distress

Moderate distress

Severe distress

Optimal functioning

Resilience Continuum

Factors That Contribute To Resilience

Behavior Control

Control and Confidence

Optimism

Positive Coping

Flexible Thinking

Values

Resilience

Resilience Skills Development

• The Cognitive-Behavioral Model is used to illustrate the interconnection of thoughts, feelings and behaviors

• Learning to change thoughts behind negative behaviors and feelings is the key to positive behavior changes and building resilience

Thoughts

Behavior Feelings

www.nccosc.navy.mil

Initiatives in Wellness and Optimal Performance

• Evaluate and compare effectiveness of stress regulation skills– Coherence Training (emWave) Vs. PMR– 8 of 10 cohorts enrolled (4 coherence & 4 PMR)

• N = 146 IDC students• Classes assigned to Coherence Training or PMR• Assessments at baseline, 3 mo, 6 mo, 1 year

• Stress, anxiety, sleep, PTSD, unit support, performance & attrition

www.nccosc.navy.mil

Coherence Training Study

• Evaluate the effectiveness of stress regulation skills– SRTS Vs. PMR (both iPad based systems)– N = 200 service members in training environments– Random assignment: SRTS, PMR or waitlist control– All participants receive an iPad for 2 months– Assessments at baseline, 2 and 4months

• Stress, resilience, coping, anxiety, sleep, PTSD, unit support, performance & attrition

www.nccosc.navy.mil

Stress Resilience Training System

• Military services are evaluating and developing programs addressing fitness of mind, body, spirit and social fitness.

• Collaboration of operational, scientific and educational communities regarding evidence based resilience and wellness initiatives.

• Provide our service members and families the tools needed for growth and to endure the challenges of military service and help preserve the skills and talents they bring to the fight.

www.nccosc.navy.mil

Summary

Thank You!

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