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Police Department Personnel Stress Resilience Training: An Institutional Case Study

Police Department Personnel Stress Resilience Training: An Institutional Case Study GLOBAL ADVANCES IN HEALTH AND MEDICINE CASE REPORt Police department Personnel Stress Resilience training: An Institutional Case Study Gershon Weltman, PhD, United States; Jonathan Lamon, United States; Elan Freedy, United States; Donald Chartrand, United States Author Affiliations ABStRACt Perceptronics Solutions, The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and Inc, Sherman Oaks, resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The California (Dr Weltman, Mr Lamon, Mr Freedy); Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a Ease Interactive, Inc, San series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV- Diego, California controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and (Mr Chartrand). effective stress resilience training programs is becoming better understood, as it has been in the military. Law enforce- Correspondence ment and military service share many stress-related features including psychological stressors connected with the mis- Gershon Weltman, PhD sion, extended duty cycles, and exposure to horrific scenes of death and injury. San Diego (California) Police Department gweltman@ personnel who participated in the study were 12 sworn officers and 2 dispatchers, 10 men and 4 women. The SRTS speakeasy.net intervention comprised an introductory 2-hour training session, 6 weeks of individualized learning and practice with Citation the SRTS app, and four 1-hour telephone mentoring sessions by experienced HeartMath mentors spread over a four Global Adv Health Med. week period. Outcome measures were the Personal and Organizational Quality Assessment (POQA) survey, the mentors’ 2014;3(2):72-79. DOI: reports of their observations, and records of participants’ comments from the mentoring sessions. The POQA results 10.7453/gahmj.2014.015 were overwhelmingly positive: All four main scales showed improvement; Emotional Vitality improved by 25% (P=.05) Key Words and Physical Stress improved by 24% (P=.01). Eight of the nine subscales showed improvement, with the Stress subscale, Stress, resilience, perhaps the key measure of the study, improving by approximately 40% (P=.06). Participant responses were also uni- heart rate variability, formly positive and enthusiastic. Individual participants praised the program and related improvements in both on-the- HRV, coherence advantage, mentoring, job performance and personal and familial situations. The results support the efficacy of the program to achieve its goal law enforcement, of building stress resilience and improving officer wellness by providing practical self-regulation skills for better man- apps, HeartMath agement of emotional energy. We conclude that the SRTS program for building resilience and improving psychological disclosures wellness can be as effective for law enforcement as it is for military personnel. The authors completed the ICMJE Form for Disclosure of Potential INtROdUCtION training can help duplicate this process, with studies Conflicts of Interest and The stressful nature of police work is well estab- showing that experienced personnel are able to control disclosed the funding described in the lished, and the need for meaningful and effective stress and even use stress productively. An important part of Acknowledgments resilience training programs is becoming better under- what experienced personnel learn is self-awareness of section of this article. stood, as it has been in the military. Police work and their stress state and self-regulation of stress energy. No other potential conflicts were disclosed. military service share many stress-related features: Accordingly, the current Department of Defense defini- Psychological stressors connected with the mission, tion of resilience is “the ability to withstand, recover, such as extended duty cycles and exposure to horrific and grow in the face of stressors and changing scenes of death and injury, are common to both cases. demands.” The Stress Resilience Training System Anger-management issues, family relationship issues, (SRTS) is completely consistent with this definition of and substance abuse as the results of stress are also resilience and its associated objectives. common to both military and police. And suicides in The Stress Resilience Training System (SRTS) was both the police and military now exceed deaths in the developed by a team at Perceptronics Solutions, Inc line of duty. Dr Daniel Goldfarb, a respected psycholo- (Sherman Oaks, California), including Ease Interactive, gist specializing in police stress, states that a failure to Inc (San Diego, California), and the Institute of get help is a major contributor to police suicide and HeartMath (Boulder Valley, California), as a Small other stress effects. Business Innovative Research (SBIR) project sponsored The US military today recognizes that unregulated by the Defense Advanced Research Projects Agency response to stress can not only result in decreased opera- (DARPA) and the Office of Naval Research (ONR). The tional performance, but can also increase risk for a wide goal was to meet the need for a self-contained, mobile, range of adverse health outcomes, psychological and comprehensive stress resilience training program that emotional injury, and family breakdown. As a result, all can be used by both military and civilian populations. branches of the US military have moved to include self- Usability evaluation at George Mason University regulation and resilience trainings in their operations. (Fairfax County, Virginia) and initial evaluations of It has long been accepted that people in risky situ- the SRTS by US Navy, Air Force, and Army groups have ations, parachutists as well as soldiers, adapt to situa- been highly positive. Consequently, we believed US tional stress after the first few experiences, and that police forces would be likewise amenable to a low-cost, 72 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING validated program that could bring stress resilience Organizational Stress, Emotional Stress, and Physical training to their personnel in an easy-to-use format that Stress—and above average or substantially above aver- is both engaging and overcomes the still-existing stig- age on all but one of the subscales. Accordingly, our case ma of visits to a clinician, therapist, or counselor. study group could be characterized as mature, emotion- A key premise of our SRTS development has been ally stable representatives of police personnel. that in addition to reducing the adverse effects of stress, Nevertheless, when this group was asked at the introduc- a scientifically based self-regulation and resilience build- tory training session what stressed them, their responses ing program can actually enhance service members reflected virtually every factor mentioned in the litera- health and performance. A study conducted by Institute ture: problems with management, on-the-job dangers, of HeartMath researchers showed that this can be true in lack of public appreciation, non-understanding family police and correctional officers as well. The San Diego members, etc. It was obvious from their answers and Police Department (SDPD), including its newly formed their participation in the study that even these relatively Wellness Unit headed by Captain Sarah Creighton, well adjusted people desired help in dealing with stress. agreed to a multi-participant case study with 14 police personnel representing a wide range of departments. tIMELINE With the chief’s approval, we obtained the cooperation We launched the case study in May 2013 with an of the Wellness Unit in performing the case study initial 2-hour workshop training session at SDPD head- reported here, including recruiting participants, arrang- quarters. The initial training included an overview of ing for training facilities, and assisting in data collection. the overall program and its objectives, the neurophysi- ological basis of the self-regulation techniques taught in CLINICAL FINdINgS: PARtICIPANt dEMOgRAPHICS the Coherence Advantage, the application of the learned ANd INItIAL EMOtIONAL LEVELS tools to some real-life situations, and the features and Participants were 10 male and 4 female SDPD per- operation of the SRTS app itself. The participants sonnel from several police specialties; 12 were police retained the SRTS app and iPads (Apple Inc, Cupertino, officers and 2 were police dispatchers. The participants California) for 6 weeks, after which they were collected appeared highly motivated and interested in the gen- and the post-trial POQA administered. For the first 4 eral implications of the study as well as in the potential weeks, 1 hour of telephone mentoring in the resilience- benefits of the program on their health as well as pro- building skills was made available to each participant. fessional and personal life. All 14 participants completed the pre-study 52-item ASSESSMENt Personal and Organizational Quality Assessment (POQA) POqA Survey questionnaire; of these, 11 completed the post-study sur- The POQA is a 52-item validated questionnaire vey; and of the 11 post-study surveys, 10 could be reliably that factors into four major constructs that directly matched with their pre-study counterparts. Accordingly, affect health and job performance; each major scale we conducted two types of analysis: one used the entire has been subdivided into subscales, using the same pre and post participant data, which was used to calculate statistical techniques, to provide a finer-grained pic- group means for the scales and subscales; the second used ture of the components. The four POQA scales and the matched pairs in a paired t-test analysis of the scales their subscales are as follows: and subscales. The matched-pairs analysis shows that our case study group had the following characteristics: 1. Emotional Vitality scale: the positive emotional energy that enriches life experience and enhances 1. Marital Status, well distributed among single, health and well-being. This scale is an overall mea- married, and divorced sure of the degree to which employees feel a posi- 2. Age Range, from early 20s to late 40s, with 50% tive and emotional energy, enabling an optimistic in the 31-to-40-year age range and fulfilling life experience. Low scores on this 3. Employment Status, 86% were working officers, scale suggest employees may have limited emo- and 14% were dispatchers tional energy available to invest. Subscales are 4. Education, 80% reported “some college” or bach- Emotional Buoyancy and Emotional Contentment. elor’s degrees, and 20% had master’s degrees 2. Organizational Stress scale: organizational imped- 5. Hours Worked Per Week, 60% reported 41 to iments and relational discord that impair work per- 50, with about 40% working 51 to 59 or more formance, reduce job satisfaction, and increase 6. Years at Organization, 20% reported 2 to 5, 30% employee turnover. This scale is an overall measure reported 5 to 10, and 50% reported 10 to 20 of the degree to which employees feel negatively 7. Years at Current Job, almost evenly distributed pressured by stressors and conflicts at work and in from 0 to 6 months to 10+ years their personal lives that not only detract them from work performance but may also lead them to want In addition, the initial POQA data showed that as a to quit their job. High scores on this scale signify group, these police personnel were above average in all likely stressors and tensions employees feel they are four of the main scales—Emotional Vitality, experiencing that impede work performance and Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 73 GLOBAL ADVANCES IN HEALTH AND MEDICINE 7,8 may also signal an intention to quit. Subscales are ience-building skills. The current version of the SRTS Pressures of Life, Relational Tension, and Stress. app has a Navy orientation because the Navy’s Operational 3. Emotional Stress scale: emotional discord that Stress Control (OSC) Program has been the major transi- reduces the quality of life experience and jeopar- tion and evaluation partner. But the program’s objectives dizes health and well-being. This scale is an over- and approach are equally applicable to any highly stressed all measure of the degree to which employees personnel such as first responders and individuals work- report negative emotions that they have difficulty ing in institutional and corporate environments. controlling and that they feel impair the quality The key features that differentiate the program and effectiveness of their life experience. High from other resilience building and stress control scores on this scale indicate it is likely that the approaches are as follows: employees are feeling emotionally stressed, over- whelmed, and/or frustrated by the present circum- • adopting portable technology in a scientifically stances of their lives. Subscales are Anxiety/ validated stress resilience training approach that Depression and Anger/Resentment. incorporates both cognitive learning and HRV 4. Physical Stress scale: physical symptoms of fatigue coherence biofeedback; and poor health that reflect the overall stress an • minimizing the adverse effects of stress and employee is experiencing. This scale is an overall enhancing its productive effects to help improve measure of the level of physical symptoms of stress immediate performance as well as prevent the among employees. High scores on this scale indicate occurrence of psychological injuries; the employees may have low levels of physical and • using a state-of-the art mobile device such as the emotional energy and may also be experiencing pre- iPad or other tablet to greatly enhance training cursors of significant health issues and problems. effectiveness by enabling refreshment training Subscales are Fatigue and Health Symptoms. and practice during and after deployment; and • embedding the training methods in a set of casual We administered the POQA survey at the beginning and serious games to provide a framework for of the introductory training session and again 6 weeks learning to control and use stress productively in a later, after the participants had practiced using the SRTS form acceptable to today’s young military popula- and had completed the personal mentoring sessions. tion and other age groups as well. Mentor Reports The iPad app provides access to four main compo- In addition to the POQA results, assessment of the nents, as shown in Figure 1. case study efficacy was based on the observations of the mentors who provided individualized assistance to the − KNOW HOW. Provides the user with neces- participants in achieving the program’s goals. The men- sary knowledge in the form of an Introduction tors tracked the length and number of completed men- and specific information on Resilience; Stress; toring sessions, the participants’ statements about their Putting Stress in Perspective; and Preparing for, main stressors or challenges, which of the techniques and practices taught in the program were most helpful, and how they helped them in various situations both at work and in their home lives. The mentors also rated how engaged the participants were in using the SRTS and the self-regulation techniques in daily life. The lat- ter reports included quotations of relevant responses from the individual participants. INtERVENtION PROgRAM Stress Resilience training System (SRtS) The intervention in this case study was centered on participants’ use of the SRTS to learn about resilience and its effects and the HeartMath self-regulation techniques and to practice sustaining a physiologically coherent state. The SRTS is a self-contained, mobile training course— presently available as an iPad app—that combines (1) information about the physiology of stress and resilience, (2) engaging training in a series of evidence-based energy self-regulation techniques, and (3) the use of heart rate variability (HRV) coherence biofeedback to control a series of progressively more challenging games that are designed to increase the use and sustainment of the resil- Figure 1 iPad displaying the app’s four main components. 74 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING Incoherence: Impairs Performance—Amplifies Energy Drains Inhibits Brain Function 70 (incoherence) 1 50 100 150 200 Time (seconds) Coherence: Promotes Optimal Performance—Builds Resilience Facilitates Brain Function (coherence) 1 50 100 150 200 Time (seconds) Figure 2 The heart rate variability associated with incoherence (top) and coherence (bottom). Performing in, and Recovering from operations. more even HRV pattern associated with coherence, − TECHNIQUES. Teaches the HeartMath HRV when the sympathetic and parasympathetic nervous Coherence Advantage technique including self- systems are in synch. It represents the neurophysiology regulation of HRV and shifting from negative to of optimal function, when everything seems easy and positive emotions. cognitive performance is enhanced. − GAMES. Provides a set of entertaining games To our knowledge, SRTS is unique in its compre- during which the user can practice maintaining hensive delivery of generalized stress knowledge, evi- HRV coherence while playing in increasingly dence-based HRVC feedback, and game-based practice challenging environments in an adaptable eLearning framework supported on a − REVIEW. Allows the user to review his or her mobile tablet. It provides a new capability for broad progress in learning and Coherence skills. delivery and on-site sustainment training. Each component has been human factored for ease Personal Resilience Mentoring of use and professionally designed and produced to Following the initial training session and during high iPad app standards. his or her use of the SRTS app, each participant had four An essential part of the SRTS app is Coherence 1-hour telephone sessions with one of two HeartMath- Advantage training using techniques and processes certified Personal Resilience mentors. The mentoring developed and validated by the Institute of portion of the program has several unique aspects: 6,10 HeartMath. Coherence Advantage incorporates the use of HRV coherence (HRVC) biofeedback to facili- 1. Mentoring has significant potential to increase the tate skill acquisition of the self-regulation techniques sustainability of the techniques taught in the SRTS that allow users to recognize and shift the mental and app, which have been shown to reduce a wide range emotional responses associated with counterproduc- of stress-related symptoms such as a feeling of being tive stress reactions. The iPad SRTS employs an ear overwhelmed, fatigue, sleep issues, emotional sensor to detect the pulse, which is used to determine drama, and the incidence of more serious conditions; heart rate, and HRV coherence measurement algo- 2. The phone-based delivery mechanism rithms developed by HeartMath for iOS platforms. − Is easily replicable and scalable, up or down; The top graph of Figure 2 shows the edgy, jerky − Eliminated concerns related to stigmatization; and HRV pattern associated with incoherence. Incoherence − Eliminated most travel and logistic issues as the means the higher brain systems and the sympathetic phone appointments were scheduled to accom- and parasympathetic nervous systems are out of synch; modate the schedules of the participants. it represents the neurophysiology of poor mental and 3. The approach has been proven to be cost-effective, physical performance. The bottom graph shows the and to lower health care costs. Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 75 75 Heart rate Heart rate GLOBAL ADVANCES IN HEALTH AND MEDICINE The mentors focused on understanding the unique utes as it was difficult to set aside a full hour when their and specific challenges of each participant and encour- schedules are already full, although others appreciated aged them to use appropriate self-regulation and coher- the longer sessions. The mentors felt that shortening ence-building skills to build and sustain their own the sessions would not materially decrease the effec- health and resilience. tiveness of the mentoring and that they could always go longer if needed. At times the mentors did shorter RESULtS sessions because they had covered what needed to be POqA Primary Scales covered at that stage of learning and practice. Figure 3 (top) shows the officers’ scores on the The mentors recognized that this was a mature Primary Scales as assessments against a normative data group, with many of them having years of experience base and as changes from pre- to post-intervention. The either in law enforcement or previously in the military. statistical results are from the matched-pairs analysis The mentors heard from each person in the group the and shown in the Table. love they have for the work they do as public servants. As The distribution of scores on each scale for the nor- seasoned officers and dispatchers, they are all very aware mative sample has been rescaled to a statistical scale of the array of challenges they face each day and of the with a maximum value of 100. Scores of 25 and below are long-term toll that these can take. With that, they are also considered low. For example, if an organization has a well aware of the psychological needs currently not being score of 23, this means that that score is lower than 23% met that the SRTS program was able to effectively address. of the individuals in the normative sample. Conversely, scores of 75 and above are considered high. Thus, if an Participant Comments organization has a score of 79, then that score is higher The comments as reported by the mentors were than 79% of the individuals in the normative sample. universally positive. Participants reported that they In addition, the Organizational, Emotional, and were able to learn the Coherence Advantage technique Physical Stress scales have been “reverse coded” so that and to progress in the games from the simpler to the decreases in stress are shown as increases on the dia- more challenging. More important, they were able to gram, ie, moving toward the “Commendable” 100% top apply the technique in real-life situations, including of the scale. Finally, scales that show a statistically sig- one actual confrontation with a suspect. They related nificant improvement from pre- to post-trial (ie, improvements in both on-the-job performance and Probability ≤.05) have been marked with an asterisk. personal and familial situations and generally praised Stress is measured on a different scale than the the program. The following presents several typical other items and so is not shown in Figure 3, but the comments under five response topics. Stress measure moved from a low-average score of 17 to an extremely low score of 5. As seen, several of the sub- 1. General Response to the SRTS Intervention scales in addition to Stress also achieve significance, I absolutely love it! The content is relevant and either based on the conventional value of a ≥0.05 proba- the videos are very well produced. They are engag- bility or based on probabilities below or near 0.10, a ing and have a very high production quality. I level that is frequently accepted as significant for small think it’s important that they are short for most samples such as this. people’s attention spans. I have enjoyed using the games . . . except the slingshot game, which makes Mentor Reports me dizzy when the car goes into space! So I use the Participants reported that they found the initial asteroid game and have had good success with it. training helpful in setting the stage for working with the This training went fabulously well! I first SRTS app. Many reported that it was beneficial to learn started using the program during slow times at about the physiology of coherence and optimal func- work when I wasn’t dispatching, and found that tioning, which supported their understanding of resil- my coherence level went to 100% after about 3 ience and the program as an energy management, self- breaths. Then I started a basic training segment regulation approach. All participants reported that the while dispatching and noticed that my coherence mentoring helped to deepen their understanding of how level dropped significantly to 50% or less. Now I to use their newly gained skills in everyday situations, use techniques I learned in SRTS to self-regulate making it a more practical and effective overall program. during stressful calls, and I’m leaving work feel- In turn, the mentors felt that every officer was ing much less stressed. I have been sharing the genuine in the feedback he or she gave throughout the program with the other people in my department, mentoring process. The mentors also appreciated the and they all want it. effort the participants put into the mentoring sessions As a leader, I’ve been through many different and in practicing on-the-go what they had learned. The psychology-based stress relief programs, but I’ve mentors said that it was a pleasure and a privilege found this one to be far more effective. I use it in working with each of them. my job every day because the physiology basis of Some participants suggested that it would be help- the techniques took it out of the realm of ideas and ful if the mentoring sessions were limited to 30 min- made it tangible. 76 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING 100% Commendable Substantially above average Pre Post 75% Above average Average 50% Below average 25% Substantially below average Poor 0% Emotional †Organizational †Emotional †Physical vitality stress stress stress Emotional †Organizational †Emotional †Physical vitality stress stress stress 100% Commendable Substantially above average 75% Above average Average 50% Below average 25% Substantially below average Poor 0% †Reverse coded to show the degree of improvement over time. Paried t test significance; *P<.05. Figure 3 Personal and Organizational Quality Assessment matched-pair results for scales (top) and subscales (bottom). Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 77 Emotional buoyancy Emotional contentment †Pressures of life †Relational tension †Intention to quit †Anxiety and depression †Anger and resentment †Fatigue †Health symptoms GLOBAL ADVANCES IN HEALTH AND MEDICINE table Personal and Organizational Quality Assessment Scores and Results Pre (N=10) Post (N=10) Paired differences Lower Upper Mean Sd SEM Mean Sd SEM Mean Sd SEM 95% CI 95% CI t df P < Organizational stress 3.38 1.55 0.49 2.97 1.18 0.37 –0.41 0.96 0.30 –1.10 0.27 –1.36 9 NS Pressures of life 2.88 1.70 0.54 2.30 1.04 0.33 –0.58 1.08 0.34 –1.35 0.19 –1.70 9 NS Relational tension 4.47 2.12 0.67 4.53 1.94 0.61 0.07 1.83 0.58 –1.24 1.38 0.12 9 NS Stress 6.00 3.32 1.11 3.67 1.73 0.58 –2.33 3.16 1.05 –4.76 0.10 –2.21 8 NS Emotional vitality 5.29 1.21 0.38 5.66 0.93 0.29 0.37 0.51 0.16 0.01 0.74 2.30 9 .05 Emotional buoyancy 5.41 1.23 0.39 5.75 0.87 0.28 0.34 0.60 0.19 –0.09 0.77 1.78 9 NS Emotional contentment 5.13 1.27 0.40 5.55 1.17 0.37 0.42 0.53 0.17 0.04 0.79 2.49 9 .05 Emotional stress 1.90 0.62 0.20 1.67 0.34 0.11 –0.23 0.66 0.21 –0.71 0.24 –1.12 9 NS Anxiety and depression 1.74 0.74 0.23 1.61 0.39 0.12 –0.13 0.64 0.20 –0.58 0.33 –0.64 9 NS Anger and resentment 2.04 0.76 0.24 1.71 0.42 0.13 –0.33 0.85 0.27 –0.93 0.28 –1.21 9 NS Physical stress 2.79 0.78 0.25 2.11 0.59 0.19 –0.68 0.69 0.22 –1.18 –0.19 –3.12 9 .05 Fatigue 3.10 1.37 0.43 2.28 0.71 0.23 –0.83 1.27 0.40 –1.73 0.08 –2.05 9 NS Health symptoms 2.58 0.70 0.22 1.98 0.68 0.21 –0.60 0.62 0.20 –1.05 –0.16 –3.06 9 .05 Intention to quit 2.15 1.89 0.60 1.50 0.94 0.30 –0.65 1.20 0.38 –1.51 0.21 –1.71 9 NS Paired Samples Test Primary scale. Sub-scale. Abbreviations: CI, confidence interval; df, degrees of freedom; NS, not significant; SD, standard deviation; SEM, standard error of the mean. 2. Work-related Implications and Effects 4. Psychological and Physical Effects Last week I was in a situation in which a person I’m very happy with this training because I squared off on me and started reaching in his jacket. I believe it is helping me with anxiety and stress. I went to my breath and activated coherence and don’t know if it would have the same impact on never felt anything but calm. As I noticed the sirens of me 5 years ago. Today I have a family, bills, job my backup arriving, I realized my heart was beating stresses, and the list goes on and on. Thank you slowly. Every other time that has happened, I basical- for selecting me, but more importantly It is help- ly screamed for backup and it took me a whole day to ing me with job performance and everyday life. calm down. When my Captain got there, he said he thought I was kidding when I put out the call because dISCUSSION ANd CONCLUSIONS I sounded so calm on the radio. He asked what I’d The results of this case study were overwhelmingly been doing differently. This stuff is for real. positive: All four main scales within the POQA instru- My mentor helped me when I changed jobs ment showed improvement; Emotional Vitality within the Department. When I went for the inter- improved by 25% (P=.05) and Physical Stress improved view, I used a technique to activate coherence and felt by 24% (P=.01). Eight of the nine subscales showed myself calming down. I nailed the interview and got improvement, with the Stress subscale, perhaps the key the job—they said it was because I was confident measure of the study, improving approximately 40% and didn’t seem nervous. (P=.06). Participants’ responses were also uniformly posi- tive and enthusiastic. Participants were able to learn the 3. Personal and Familial Implications and Effects Coherence Advantage technique and progress in the I completed all the learning sections, the tests, games; they praised the SRTS program overall and related and the games and I have to say I’m impressed! I improvements in both on-the-job performance and per- am using the techniques at work and home and am sonal and familial relations. Most important, they were very happy with this training because it is helping able to actually apply the technique in real-life situations. me with anxiety and stress. I have a family, bills, The SRTS resilience training program evaluated by job stresses, and the list goes on and on. SRTS is SDPD, which included classroom training and was sus- helping me with job performance and everyday life. tained by telephone mentoring, is one of two similar Thank you for selecting me. programs we have conducted in 2013 with law enforce- Things have been excellent. I am more aware as ment personnel. The other one involved Air Force to how I add to family drama, and I have made an Security Forces personnel, and while the duty require- effort to use Freeze Frame more and be more ments are not identical, there is enough similarity to accountable for my words and actions. learn from the results and draw some conclusions about 78 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING the effectiveness of SRTS programs in law enforcement tary personnel. A key objective of such training is to populations. In both cases, the participants’ responses as improve awareness and appropriate responses during recorded by the mentors were enthusiastically positive. intense situations, up to and including combat—and Both groups found the SRTS program to be highly also in the instances of intense social interactions that worthwhile, well designed, and engaging; and they both comprise a law enforcement officer’s daily routine. felt that the expert telephone mentoring added signifi- The SDPD case study results underscored the Acknowledgments Research, development cantly to the program. Even for the relatively short time importance of mentor support and group interactions. and evaluation of SRTS they had with the SRTS iPads, participants saw positive The mentor interactions personalized the training to by Perceptronics effects in their on-the-job performance and in their each participant, focusing on the issues that cause the Solutions, Inc (Sherman Oaks, California) has home life and relationships. Finally, both police officers most distress in each individual’s life and applying the been helped by team and Air Force Security Personnel said that SRTS should resilience-building techniques to those issues. This members Ease be part of essential training. Personnel in both groups approach minimizes the negative effects of professional Interactive, Inc recommended initiating self-regulation training at the disturbances on the home, and the negative effects of (San Diego, California) and Institute of boot camp or Academy level. domestic disturbances on the job. Mentors also build on HeartMath (Boulder A vital perspective of stress resilience, which is a foundation of issues that rejuvenate and build energy, Valley, California) and strongly taught throughout SRTS program, is that the which leads to improved communication and perfor- funded by the Defense Advanced Research key to building and sustaining stress resilience is mance. Likewise, an environment in which discussing Projects Agency (DARPA) improving one’s ability to self-regulate with regard to the techniques and their application are both acceptable through Small Business energy-draining emotions. Despite a relatively short and encouraged is critical to improving the resilience of Innovation Research exposure period, the SDPD study results clearly support a unit or a department. These aspects of resilience train- (SBIR) Phase Contract N10PC20058 and Phase II the ability of the SRTS program to achieve its major goal ing are so significant that we are adjusting the new Contract D11PC20125. of building stress resilience through the self-regulation Web-based iteration of SRTS to emphasize the personal- The Perceptronics of emotional energy. izing role of the mentor and the supportive impact of Solutions team’s support In police work, energy-draining emotional respons- the group. We are confident that these adjustments will of an efficacy evaluation at the Naval Center for es to challenges, as well as actual fatigue, are what build on the improvements shown in the SDPD case and Combat and Operational deplete both energy and self-regulatory capacity—and will result in an SRTS program that is highly suitable for Stress Control (NCCOSC) thus resilience. From both comments in the mentor general law enforcement as well as for numerous other has been funded by ONR BAA contracts reports and the POQA survey results, we see that after civilian applications. N0001412M0198 and using SRTS to learn about resilience and practice the REFERENCES N0001412M0408. self-regulation techniques including HRV coherence, 1. Balko R. Rise of the warrior cop. The Wall Street Journal. July 19, 2013. We acknowledge the 2. Goldfarb D. The effect of stress on police officers. The Police News, Police the SDPD officers report that they have more energy, are outstanding help of the News Publishing Co, LLC; 2012. http://www.thepolicenews.net/default.aspx/ following HeartMath less fatigued, have more emotional buoyancy, and have act/newsletter.aspx/newsletterid/12743/category/News+1-2/MenuGroup/ personnel: Jackie increased their ability to self-regulate as reflected in Home.htm. Accessed February 24, 2014. Waterman for her 3. Fenz WD, Jones GB. Individual differences in physiologic arousal and perfor- reduced anger, anxiety, stress, and physical symptoms rigorous statistical mance in sport parachutists. Psychosom Med. 1972 Jan-Feb;34(1):1-8. analysis of the POQA of stress, such as sleep problems. All of these effects indi- 4. Smith MA, Woo HJ, Parker JP, et al. Using iterative design and testing survey results; the cate an increase in stress resilience. towards the development of SRTS: a mobile, game-based stress resilience mentoring group for training system. In: Proceedings of the Human Factors and Ergonomics The stress and resilience improvements in this their dedicated and Society 2013 Annual Meeting, September 30-October 4, 2013. study were achieved despite the facts that: (1) the SRTS effective work; and 5. Cohn JV, Morrison T, Weltman G, et al. Stress resilience training system Dr Rollin McCraty for his app was oriented to the Navy environment in its look (SRTS). In: Proceedings of the 2013 Human-Computer Interaction guidance during the International Conference. Las Vegas, NV, July 22-26, 2013. and feel and in the content of its learning modules and case study and in the 6. McCraty R, Atkinson M, Tomasino D, Sundram, F. Impact of the HeartMath self tests; (2) the volunteer SDPD police sample was at preparation of this paper. self-management skills program on physiological and psychological stress an above-average level of psychological and emotional in police officers. Boulder Creek, CA: Heartmath Research Center, Institute of Finally, we most HeartMath; 1999. Publication No. 99-075. gratefully acknowledge health to begin with; and (3) the exposure to the SRTS 7. Weltman G, Cohen M, Freedy E, McDonough J, Ratwani R, Freedy A. Stress and thank the San Diego app was relatively short. Accordingly, the results of the resilience training system (SRTS) for inoculating the warfighter. In: SBIR Police Department for its Phase I Final Report, DARPA Contract No. N10PC20058, I. Sherman Oaks, SDPD case study indicate strongly that the SRTS cooperation and support, CA: Perceptronics Solutions; 2010. and in particular Captain approach to building stress resilience is as appropriate 8. Weltman G, Freedy A, Freedy E, Ratwani R, Chartrand D, McCraty R. Stress Sarah Leighton and her for law enforcement personnel as it is for military per- resilience training system (SRTS) for inoculating the warfighter, in SBIR colleagues in the Phase II First Quarterly Report, DARPA Contract No. D11PC20125, I. sonnel, its original target. Wellness Unit. Sherman Oaks, CA: Perceptronics Solutions; 2011. It is worthwhile to note that the distinction 9. Fletcher JD, Tobias S. Using computer games and simulations for instruc- between law enforcement and military operational tion: a research review. In: Proceedings of the Society for Applied Learning Technology (SALT) Meeting. Orlando, FL; February 18-20, 2006. environments may be getting smaller. Radley Balko, in 10. McCraty R, Atkinson M, Tomasino D, Bradley RT. The coherent heart: heart- his recent article “Rise of the Warrior Cop,” points out brain interactions, psychophysiological coherence, and the emergence of that “in response to a range of perceived threats, law system-wide order. Integral Rev. 2009;5(2):10-115. 11. Moor S. Military police mentor summary report. Perceptronics Solutions, enforcement agencies across the US, at every level of Inc, DARPA SBIR Phase II Technical Paper; Sherman Oaks, CA: Perceptronics government, have been blurring the line between police Solutions, Inc; 2013. officer and soldier.” Possible civic ramifications of this 12. Cloninger CR, Zohar AH, Hirschmann S, Dahan D. The psychological costs and benefits of being highly persistent: Personality profiles distinguish mood tendency aside, law enforcement personnel should have disorders from anxiety disorders. J Affect Disord. 2012 Feb;136(3):758-66. available to them the same training in stress resilience through self-regulation of emotional energy as do mili- Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 79 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Global Advances in Health and Medicine Pubmed Central

Police Department Personnel Stress Resilience Training: An Institutional Case Study

Weltman, Gershon; Lamon, Jonathan; Freedy, Elan; Chartrand, Donald
Global Advances in Health and Medicine , Volume 3 (2) – Mar 1, 2014
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2164-957X
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GLOBAL ADVANCES IN HEALTH AND MEDICINE CASE REPORt Police department Personnel Stress Resilience training: An Institutional Case Study Gershon Weltman, PhD, United States; Jonathan Lamon, United States; Elan Freedy, United States; Donald Chartrand, United States Author Affiliations ABStRACt Perceptronics Solutions, The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and Inc, Sherman Oaks, resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The California (Dr Weltman, Mr Lamon, Mr Freedy); Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a Ease Interactive, Inc, San series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV- Diego, California controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and (Mr Chartrand). effective stress resilience training programs is becoming better understood, as it has been in the military. Law enforce- Correspondence ment and military service share many stress-related features including psychological stressors connected with the mis- Gershon Weltman, PhD sion, extended duty cycles, and exposure to horrific scenes of death and injury. San Diego (California) Police Department gweltman@ personnel who participated in the study were 12 sworn officers and 2 dispatchers, 10 men and 4 women. The SRTS speakeasy.net intervention comprised an introductory 2-hour training session, 6 weeks of individualized learning and practice with Citation the SRTS app, and four 1-hour telephone mentoring sessions by experienced HeartMath mentors spread over a four Global Adv Health Med. week period. Outcome measures were the Personal and Organizational Quality Assessment (POQA) survey, the mentors’ 2014;3(2):72-79. DOI: reports of their observations, and records of participants’ comments from the mentoring sessions. The POQA results 10.7453/gahmj.2014.015 were overwhelmingly positive: All four main scales showed improvement; Emotional Vitality improved by 25% (P=.05) Key Words and Physical Stress improved by 24% (P=.01). Eight of the nine subscales showed improvement, with the Stress subscale, Stress, resilience, perhaps the key measure of the study, improving by approximately 40% (P=.06). Participant responses were also uni- heart rate variability, formly positive and enthusiastic. Individual participants praised the program and related improvements in both on-the- HRV, coherence advantage, mentoring, job performance and personal and familial situations. The results support the efficacy of the program to achieve its goal law enforcement, of building stress resilience and improving officer wellness by providing practical self-regulation skills for better man- apps, HeartMath agement of emotional energy. We conclude that the SRTS program for building resilience and improving psychological disclosures wellness can be as effective for law enforcement as it is for military personnel. The authors completed the ICMJE Form for Disclosure of Potential INtROdUCtION training can help duplicate this process, with studies Conflicts of Interest and The stressful nature of police work is well estab- showing that experienced personnel are able to control disclosed the funding described in the lished, and the need for meaningful and effective stress and even use stress productively. An important part of Acknowledgments resilience training programs is becoming better under- what experienced personnel learn is self-awareness of section of this article. stood, as it has been in the military. Police work and their stress state and self-regulation of stress energy. No other potential conflicts were disclosed. military service share many stress-related features: Accordingly, the current Department of Defense defini- Psychological stressors connected with the mission, tion of resilience is “the ability to withstand, recover, such as extended duty cycles and exposure to horrific and grow in the face of stressors and changing scenes of death and injury, are common to both cases. demands.” The Stress Resilience Training System Anger-management issues, family relationship issues, (SRTS) is completely consistent with this definition of and substance abuse as the results of stress are also resilience and its associated objectives. common to both military and police. And suicides in The Stress Resilience Training System (SRTS) was both the police and military now exceed deaths in the developed by a team at Perceptronics Solutions, Inc line of duty. Dr Daniel Goldfarb, a respected psycholo- (Sherman Oaks, California), including Ease Interactive, gist specializing in police stress, states that a failure to Inc (San Diego, California), and the Institute of get help is a major contributor to police suicide and HeartMath (Boulder Valley, California), as a Small other stress effects. Business Innovative Research (SBIR) project sponsored The US military today recognizes that unregulated by the Defense Advanced Research Projects Agency response to stress can not only result in decreased opera- (DARPA) and the Office of Naval Research (ONR). The tional performance, but can also increase risk for a wide goal was to meet the need for a self-contained, mobile, range of adverse health outcomes, psychological and comprehensive stress resilience training program that emotional injury, and family breakdown. As a result, all can be used by both military and civilian populations. branches of the US military have moved to include self- Usability evaluation at George Mason University regulation and resilience trainings in their operations. (Fairfax County, Virginia) and initial evaluations of It has long been accepted that people in risky situ- the SRTS by US Navy, Air Force, and Army groups have ations, parachutists as well as soldiers, adapt to situa- been highly positive. Consequently, we believed US tional stress after the first few experiences, and that police forces would be likewise amenable to a low-cost, 72 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING validated program that could bring stress resilience Organizational Stress, Emotional Stress, and Physical training to their personnel in an easy-to-use format that Stress—and above average or substantially above aver- is both engaging and overcomes the still-existing stig- age on all but one of the subscales. Accordingly, our case ma of visits to a clinician, therapist, or counselor. study group could be characterized as mature, emotion- A key premise of our SRTS development has been ally stable representatives of police personnel. that in addition to reducing the adverse effects of stress, Nevertheless, when this group was asked at the introduc- a scientifically based self-regulation and resilience build- tory training session what stressed them, their responses ing program can actually enhance service members reflected virtually every factor mentioned in the litera- health and performance. A study conducted by Institute ture: problems with management, on-the-job dangers, of HeartMath researchers showed that this can be true in lack of public appreciation, non-understanding family police and correctional officers as well. The San Diego members, etc. It was obvious from their answers and Police Department (SDPD), including its newly formed their participation in the study that even these relatively Wellness Unit headed by Captain Sarah Creighton, well adjusted people desired help in dealing with stress. agreed to a multi-participant case study with 14 police personnel representing a wide range of departments. tIMELINE With the chief’s approval, we obtained the cooperation We launched the case study in May 2013 with an of the Wellness Unit in performing the case study initial 2-hour workshop training session at SDPD head- reported here, including recruiting participants, arrang- quarters. The initial training included an overview of ing for training facilities, and assisting in data collection. the overall program and its objectives, the neurophysi- ological basis of the self-regulation techniques taught in CLINICAL FINdINgS: PARtICIPANt dEMOgRAPHICS the Coherence Advantage, the application of the learned ANd INItIAL EMOtIONAL LEVELS tools to some real-life situations, and the features and Participants were 10 male and 4 female SDPD per- operation of the SRTS app itself. The participants sonnel from several police specialties; 12 were police retained the SRTS app and iPads (Apple Inc, Cupertino, officers and 2 were police dispatchers. The participants California) for 6 weeks, after which they were collected appeared highly motivated and interested in the gen- and the post-trial POQA administered. For the first 4 eral implications of the study as well as in the potential weeks, 1 hour of telephone mentoring in the resilience- benefits of the program on their health as well as pro- building skills was made available to each participant. fessional and personal life. All 14 participants completed the pre-study 52-item ASSESSMENt Personal and Organizational Quality Assessment (POQA) POqA Survey questionnaire; of these, 11 completed the post-study sur- The POQA is a 52-item validated questionnaire vey; and of the 11 post-study surveys, 10 could be reliably that factors into four major constructs that directly matched with their pre-study counterparts. Accordingly, affect health and job performance; each major scale we conducted two types of analysis: one used the entire has been subdivided into subscales, using the same pre and post participant data, which was used to calculate statistical techniques, to provide a finer-grained pic- group means for the scales and subscales; the second used ture of the components. The four POQA scales and the matched pairs in a paired t-test analysis of the scales their subscales are as follows: and subscales. The matched-pairs analysis shows that our case study group had the following characteristics: 1. Emotional Vitality scale: the positive emotional energy that enriches life experience and enhances 1. Marital Status, well distributed among single, health and well-being. This scale is an overall mea- married, and divorced sure of the degree to which employees feel a posi- 2. Age Range, from early 20s to late 40s, with 50% tive and emotional energy, enabling an optimistic in the 31-to-40-year age range and fulfilling life experience. Low scores on this 3. Employment Status, 86% were working officers, scale suggest employees may have limited emo- and 14% were dispatchers tional energy available to invest. Subscales are 4. Education, 80% reported “some college” or bach- Emotional Buoyancy and Emotional Contentment. elor’s degrees, and 20% had master’s degrees 2. Organizational Stress scale: organizational imped- 5. Hours Worked Per Week, 60% reported 41 to iments and relational discord that impair work per- 50, with about 40% working 51 to 59 or more formance, reduce job satisfaction, and increase 6. Years at Organization, 20% reported 2 to 5, 30% employee turnover. This scale is an overall measure reported 5 to 10, and 50% reported 10 to 20 of the degree to which employees feel negatively 7. Years at Current Job, almost evenly distributed pressured by stressors and conflicts at work and in from 0 to 6 months to 10+ years their personal lives that not only detract them from work performance but may also lead them to want In addition, the initial POQA data showed that as a to quit their job. High scores on this scale signify group, these police personnel were above average in all likely stressors and tensions employees feel they are four of the main scales—Emotional Vitality, experiencing that impede work performance and Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 73 GLOBAL ADVANCES IN HEALTH AND MEDICINE 7,8 may also signal an intention to quit. Subscales are ience-building skills. The current version of the SRTS Pressures of Life, Relational Tension, and Stress. app has a Navy orientation because the Navy’s Operational 3. Emotional Stress scale: emotional discord that Stress Control (OSC) Program has been the major transi- reduces the quality of life experience and jeopar- tion and evaluation partner. But the program’s objectives dizes health and well-being. This scale is an over- and approach are equally applicable to any highly stressed all measure of the degree to which employees personnel such as first responders and individuals work- report negative emotions that they have difficulty ing in institutional and corporate environments. controlling and that they feel impair the quality The key features that differentiate the program and effectiveness of their life experience. High from other resilience building and stress control scores on this scale indicate it is likely that the approaches are as follows: employees are feeling emotionally stressed, over- whelmed, and/or frustrated by the present circum- • adopting portable technology in a scientifically stances of their lives. Subscales are Anxiety/ validated stress resilience training approach that Depression and Anger/Resentment. incorporates both cognitive learning and HRV 4. Physical Stress scale: physical symptoms of fatigue coherence biofeedback; and poor health that reflect the overall stress an • minimizing the adverse effects of stress and employee is experiencing. This scale is an overall enhancing its productive effects to help improve measure of the level of physical symptoms of stress immediate performance as well as prevent the among employees. High scores on this scale indicate occurrence of psychological injuries; the employees may have low levels of physical and • using a state-of-the art mobile device such as the emotional energy and may also be experiencing pre- iPad or other tablet to greatly enhance training cursors of significant health issues and problems. effectiveness by enabling refreshment training Subscales are Fatigue and Health Symptoms. and practice during and after deployment; and • embedding the training methods in a set of casual We administered the POQA survey at the beginning and serious games to provide a framework for of the introductory training session and again 6 weeks learning to control and use stress productively in a later, after the participants had practiced using the SRTS form acceptable to today’s young military popula- and had completed the personal mentoring sessions. tion and other age groups as well. Mentor Reports The iPad app provides access to four main compo- In addition to the POQA results, assessment of the nents, as shown in Figure 1. case study efficacy was based on the observations of the mentors who provided individualized assistance to the − KNOW HOW. Provides the user with neces- participants in achieving the program’s goals. The men- sary knowledge in the form of an Introduction tors tracked the length and number of completed men- and specific information on Resilience; Stress; toring sessions, the participants’ statements about their Putting Stress in Perspective; and Preparing for, main stressors or challenges, which of the techniques and practices taught in the program were most helpful, and how they helped them in various situations both at work and in their home lives. The mentors also rated how engaged the participants were in using the SRTS and the self-regulation techniques in daily life. The lat- ter reports included quotations of relevant responses from the individual participants. INtERVENtION PROgRAM Stress Resilience training System (SRtS) The intervention in this case study was centered on participants’ use of the SRTS to learn about resilience and its effects and the HeartMath self-regulation techniques and to practice sustaining a physiologically coherent state. The SRTS is a self-contained, mobile training course— presently available as an iPad app—that combines (1) information about the physiology of stress and resilience, (2) engaging training in a series of evidence-based energy self-regulation techniques, and (3) the use of heart rate variability (HRV) coherence biofeedback to control a series of progressively more challenging games that are designed to increase the use and sustainment of the resil- Figure 1 iPad displaying the app’s four main components. 74 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING Incoherence: Impairs Performance—Amplifies Energy Drains Inhibits Brain Function 70 (incoherence) 1 50 100 150 200 Time (seconds) Coherence: Promotes Optimal Performance—Builds Resilience Facilitates Brain Function (coherence) 1 50 100 150 200 Time (seconds) Figure 2 The heart rate variability associated with incoherence (top) and coherence (bottom). Performing in, and Recovering from operations. more even HRV pattern associated with coherence, − TECHNIQUES. Teaches the HeartMath HRV when the sympathetic and parasympathetic nervous Coherence Advantage technique including self- systems are in synch. It represents the neurophysiology regulation of HRV and shifting from negative to of optimal function, when everything seems easy and positive emotions. cognitive performance is enhanced. − GAMES. Provides a set of entertaining games To our knowledge, SRTS is unique in its compre- during which the user can practice maintaining hensive delivery of generalized stress knowledge, evi- HRV coherence while playing in increasingly dence-based HRVC feedback, and game-based practice challenging environments in an adaptable eLearning framework supported on a − REVIEW. Allows the user to review his or her mobile tablet. It provides a new capability for broad progress in learning and Coherence skills. delivery and on-site sustainment training. Each component has been human factored for ease Personal Resilience Mentoring of use and professionally designed and produced to Following the initial training session and during high iPad app standards. his or her use of the SRTS app, each participant had four An essential part of the SRTS app is Coherence 1-hour telephone sessions with one of two HeartMath- Advantage training using techniques and processes certified Personal Resilience mentors. The mentoring developed and validated by the Institute of portion of the program has several unique aspects: 6,10 HeartMath. Coherence Advantage incorporates the use of HRV coherence (HRVC) biofeedback to facili- 1. Mentoring has significant potential to increase the tate skill acquisition of the self-regulation techniques sustainability of the techniques taught in the SRTS that allow users to recognize and shift the mental and app, which have been shown to reduce a wide range emotional responses associated with counterproduc- of stress-related symptoms such as a feeling of being tive stress reactions. The iPad SRTS employs an ear overwhelmed, fatigue, sleep issues, emotional sensor to detect the pulse, which is used to determine drama, and the incidence of more serious conditions; heart rate, and HRV coherence measurement algo- 2. The phone-based delivery mechanism rithms developed by HeartMath for iOS platforms. − Is easily replicable and scalable, up or down; The top graph of Figure 2 shows the edgy, jerky − Eliminated concerns related to stigmatization; and HRV pattern associated with incoherence. Incoherence − Eliminated most travel and logistic issues as the means the higher brain systems and the sympathetic phone appointments were scheduled to accom- and parasympathetic nervous systems are out of synch; modate the schedules of the participants. it represents the neurophysiology of poor mental and 3. The approach has been proven to be cost-effective, physical performance. The bottom graph shows the and to lower health care costs. Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 75 75 Heart rate Heart rate GLOBAL ADVANCES IN HEALTH AND MEDICINE The mentors focused on understanding the unique utes as it was difficult to set aside a full hour when their and specific challenges of each participant and encour- schedules are already full, although others appreciated aged them to use appropriate self-regulation and coher- the longer sessions. The mentors felt that shortening ence-building skills to build and sustain their own the sessions would not materially decrease the effec- health and resilience. tiveness of the mentoring and that they could always go longer if needed. At times the mentors did shorter RESULtS sessions because they had covered what needed to be POqA Primary Scales covered at that stage of learning and practice. Figure 3 (top) shows the officers’ scores on the The mentors recognized that this was a mature Primary Scales as assessments against a normative data group, with many of them having years of experience base and as changes from pre- to post-intervention. The either in law enforcement or previously in the military. statistical results are from the matched-pairs analysis The mentors heard from each person in the group the and shown in the Table. love they have for the work they do as public servants. As The distribution of scores on each scale for the nor- seasoned officers and dispatchers, they are all very aware mative sample has been rescaled to a statistical scale of the array of challenges they face each day and of the with a maximum value of 100. Scores of 25 and below are long-term toll that these can take. With that, they are also considered low. For example, if an organization has a well aware of the psychological needs currently not being score of 23, this means that that score is lower than 23% met that the SRTS program was able to effectively address. of the individuals in the normative sample. Conversely, scores of 75 and above are considered high. Thus, if an Participant Comments organization has a score of 79, then that score is higher The comments as reported by the mentors were than 79% of the individuals in the normative sample. universally positive. Participants reported that they In addition, the Organizational, Emotional, and were able to learn the Coherence Advantage technique Physical Stress scales have been “reverse coded” so that and to progress in the games from the simpler to the decreases in stress are shown as increases on the dia- more challenging. More important, they were able to gram, ie, moving toward the “Commendable” 100% top apply the technique in real-life situations, including of the scale. Finally, scales that show a statistically sig- one actual confrontation with a suspect. They related nificant improvement from pre- to post-trial (ie, improvements in both on-the-job performance and Probability ≤.05) have been marked with an asterisk. personal and familial situations and generally praised Stress is measured on a different scale than the the program. The following presents several typical other items and so is not shown in Figure 3, but the comments under five response topics. Stress measure moved from a low-average score of 17 to an extremely low score of 5. As seen, several of the sub- 1. General Response to the SRTS Intervention scales in addition to Stress also achieve significance, I absolutely love it! The content is relevant and either based on the conventional value of a ≥0.05 proba- the videos are very well produced. They are engag- bility or based on probabilities below or near 0.10, a ing and have a very high production quality. I level that is frequently accepted as significant for small think it’s important that they are short for most samples such as this. people’s attention spans. I have enjoyed using the games . . . except the slingshot game, which makes Mentor Reports me dizzy when the car goes into space! So I use the Participants reported that they found the initial asteroid game and have had good success with it. training helpful in setting the stage for working with the This training went fabulously well! I first SRTS app. Many reported that it was beneficial to learn started using the program during slow times at about the physiology of coherence and optimal func- work when I wasn’t dispatching, and found that tioning, which supported their understanding of resil- my coherence level went to 100% after about 3 ience and the program as an energy management, self- breaths. Then I started a basic training segment regulation approach. All participants reported that the while dispatching and noticed that my coherence mentoring helped to deepen their understanding of how level dropped significantly to 50% or less. Now I to use their newly gained skills in everyday situations, use techniques I learned in SRTS to self-regulate making it a more practical and effective overall program. during stressful calls, and I’m leaving work feel- In turn, the mentors felt that every officer was ing much less stressed. I have been sharing the genuine in the feedback he or she gave throughout the program with the other people in my department, mentoring process. The mentors also appreciated the and they all want it. effort the participants put into the mentoring sessions As a leader, I’ve been through many different and in practicing on-the-go what they had learned. The psychology-based stress relief programs, but I’ve mentors said that it was a pleasure and a privilege found this one to be far more effective. I use it in working with each of them. my job every day because the physiology basis of Some participants suggested that it would be help- the techniques took it out of the realm of ideas and ful if the mentoring sessions were limited to 30 min- made it tangible. 76 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING 100% Commendable Substantially above average Pre Post 75% Above average Average 50% Below average 25% Substantially below average Poor 0% Emotional †Organizational †Emotional †Physical vitality stress stress stress Emotional †Organizational †Emotional †Physical vitality stress stress stress 100% Commendable Substantially above average 75% Above average Average 50% Below average 25% Substantially below average Poor 0% †Reverse coded to show the degree of improvement over time. Paried t test significance; *P<.05. Figure 3 Personal and Organizational Quality Assessment matched-pair results for scales (top) and subscales (bottom). Case Report www.gahmj.com • March 2014 • Volume 3, Number 2 77 Emotional buoyancy Emotional contentment †Pressures of life †Relational tension †Intention to quit †Anxiety and depression †Anger and resentment †Fatigue †Health symptoms GLOBAL ADVANCES IN HEALTH AND MEDICINE table Personal and Organizational Quality Assessment Scores and Results Pre (N=10) Post (N=10) Paired differences Lower Upper Mean Sd SEM Mean Sd SEM Mean Sd SEM 95% CI 95% CI t df P < Organizational stress 3.38 1.55 0.49 2.97 1.18 0.37 –0.41 0.96 0.30 –1.10 0.27 –1.36 9 NS Pressures of life 2.88 1.70 0.54 2.30 1.04 0.33 –0.58 1.08 0.34 –1.35 0.19 –1.70 9 NS Relational tension 4.47 2.12 0.67 4.53 1.94 0.61 0.07 1.83 0.58 –1.24 1.38 0.12 9 NS Stress 6.00 3.32 1.11 3.67 1.73 0.58 –2.33 3.16 1.05 –4.76 0.10 –2.21 8 NS Emotional vitality 5.29 1.21 0.38 5.66 0.93 0.29 0.37 0.51 0.16 0.01 0.74 2.30 9 .05 Emotional buoyancy 5.41 1.23 0.39 5.75 0.87 0.28 0.34 0.60 0.19 –0.09 0.77 1.78 9 NS Emotional contentment 5.13 1.27 0.40 5.55 1.17 0.37 0.42 0.53 0.17 0.04 0.79 2.49 9 .05 Emotional stress 1.90 0.62 0.20 1.67 0.34 0.11 –0.23 0.66 0.21 –0.71 0.24 –1.12 9 NS Anxiety and depression 1.74 0.74 0.23 1.61 0.39 0.12 –0.13 0.64 0.20 –0.58 0.33 –0.64 9 NS Anger and resentment 2.04 0.76 0.24 1.71 0.42 0.13 –0.33 0.85 0.27 –0.93 0.28 –1.21 9 NS Physical stress 2.79 0.78 0.25 2.11 0.59 0.19 –0.68 0.69 0.22 –1.18 –0.19 –3.12 9 .05 Fatigue 3.10 1.37 0.43 2.28 0.71 0.23 –0.83 1.27 0.40 –1.73 0.08 –2.05 9 NS Health symptoms 2.58 0.70 0.22 1.98 0.68 0.21 –0.60 0.62 0.20 –1.05 –0.16 –3.06 9 .05 Intention to quit 2.15 1.89 0.60 1.50 0.94 0.30 –0.65 1.20 0.38 –1.51 0.21 –1.71 9 NS Paired Samples Test Primary scale. Sub-scale. Abbreviations: CI, confidence interval; df, degrees of freedom; NS, not significant; SD, standard deviation; SEM, standard error of the mean. 2. Work-related Implications and Effects 4. Psychological and Physical Effects Last week I was in a situation in which a person I’m very happy with this training because I squared off on me and started reaching in his jacket. I believe it is helping me with anxiety and stress. I went to my breath and activated coherence and don’t know if it would have the same impact on never felt anything but calm. As I noticed the sirens of me 5 years ago. Today I have a family, bills, job my backup arriving, I realized my heart was beating stresses, and the list goes on and on. Thank you slowly. Every other time that has happened, I basical- for selecting me, but more importantly It is help- ly screamed for backup and it took me a whole day to ing me with job performance and everyday life. calm down. When my Captain got there, he said he thought I was kidding when I put out the call because dISCUSSION ANd CONCLUSIONS I sounded so calm on the radio. He asked what I’d The results of this case study were overwhelmingly been doing differently. This stuff is for real. positive: All four main scales within the POQA instru- My mentor helped me when I changed jobs ment showed improvement; Emotional Vitality within the Department. When I went for the inter- improved by 25% (P=.05) and Physical Stress improved view, I used a technique to activate coherence and felt by 24% (P=.01). Eight of the nine subscales showed myself calming down. I nailed the interview and got improvement, with the Stress subscale, perhaps the key the job—they said it was because I was confident measure of the study, improving approximately 40% and didn’t seem nervous. (P=.06). Participants’ responses were also uniformly posi- tive and enthusiastic. Participants were able to learn the 3. Personal and Familial Implications and Effects Coherence Advantage technique and progress in the I completed all the learning sections, the tests, games; they praised the SRTS program overall and related and the games and I have to say I’m impressed! I improvements in both on-the-job performance and per- am using the techniques at work and home and am sonal and familial relations. Most important, they were very happy with this training because it is helping able to actually apply the technique in real-life situations. me with anxiety and stress. I have a family, bills, The SRTS resilience training program evaluated by job stresses, and the list goes on and on. SRTS is SDPD, which included classroom training and was sus- helping me with job performance and everyday life. tained by telephone mentoring, is one of two similar Thank you for selecting me. programs we have conducted in 2013 with law enforce- Things have been excellent. I am more aware as ment personnel. The other one involved Air Force to how I add to family drama, and I have made an Security Forces personnel, and while the duty require- effort to use Freeze Frame more and be more ments are not identical, there is enough similarity to accountable for my words and actions. learn from the results and draw some conclusions about 78 Volume 3, Number 2 • March 2014 • www.gahmj.com Case Report POLICE DEPARTMENT PERSONNEL STRESS RESILIENCE TRAINING the effectiveness of SRTS programs in law enforcement tary personnel. A key objective of such training is to populations. In both cases, the participants’ responses as improve awareness and appropriate responses during recorded by the mentors were enthusiastically positive. intense situations, up to and including combat—and Both groups found the SRTS program to be highly also in the instances of intense social interactions that worthwhile, well designed, and engaging; and they both comprise a law enforcement officer’s daily routine. felt that the expert telephone mentoring added signifi- The SDPD case study results underscored the Acknowledgments Research, development cantly to the program. Even for the relatively short time importance of mentor support and group interactions. and evaluation of SRTS they had with the SRTS iPads, participants saw positive The mentor interactions personalized the training to by Perceptronics effects in their on-the-job performance and in their each participant, focusing on the issues that cause the Solutions, Inc (Sherman Oaks, California) has home life and relationships. Finally, both police officers most distress in each individual’s life and applying the been helped by team and Air Force Security Personnel said that SRTS should resilience-building techniques to those issues. This members Ease be part of essential training. Personnel in both groups approach minimizes the negative effects of professional Interactive, Inc recommended initiating self-regulation training at the disturbances on the home, and the negative effects of (San Diego, California) and Institute of boot camp or Academy level. domestic disturbances on the job. Mentors also build on HeartMath (Boulder A vital perspective of stress resilience, which is a foundation of issues that rejuvenate and build energy, Valley, California) and strongly taught throughout SRTS program, is that the which leads to improved communication and perfor- funded by the Defense Advanced Research key to building and sustaining stress resilience is mance. Likewise, an environment in which discussing Projects Agency (DARPA) improving one’s ability to self-regulate with regard to the techniques and their application are both acceptable through Small Business energy-draining emotions. Despite a relatively short and encouraged is critical to improving the resilience of Innovation Research exposure period, the SDPD study results clearly support a unit or a department. These aspects of resilience train- (SBIR) Phase Contract N10PC20058 and Phase II the ability of the SRTS program to achieve its major goal ing are so significant that we are adjusting the new Contract D11PC20125. of building stress resilience through the self-regulation Web-based iteration of SRTS to emphasize the personal- The Perceptronics of emotional energy. izing role of the mentor and the supportive impact of Solutions team’s support In police work, energy-draining emotional respons- the group. We are confident that these adjustments will of an efficacy evaluation at the Naval Center for es to challenges, as well as actual fatigue, are what build on the improvements shown in the SDPD case and Combat and Operational deplete both energy and self-regulatory capacity—and will result in an SRTS program that is highly suitable for Stress Control (NCCOSC) thus resilience. From both comments in the mentor general law enforcement as well as for numerous other has been funded by ONR BAA contracts reports and the POQA survey results, we see that after civilian applications. N0001412M0198 and using SRTS to learn about resilience and practice the REFERENCES N0001412M0408. self-regulation techniques including HRV coherence, 1. Balko R. Rise of the warrior cop. The Wall Street Journal. July 19, 2013. We acknowledge the 2. Goldfarb D. The effect of stress on police officers. 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Journal

Global Advances in Health and Medicine – Pubmed Central

Published: Mar 1, 2014

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