Resilience Programs Have Mushroomed in Military, But Do They Work?

by U.S. Medicine

October 4, 2011

WASHINGTON — The U.S. military has implemented programs and strategies to promote psychological resilience among troops as stress from the current conflicts in Iraq and Afghanistan has taken a toll.

Little is known, however, about the effectiveness of those programs, according to a recent study which suggested there is a need to evaluate the performance of resilience programs at the  DoD.

“Because relatively few of the programs have conducted formal evaluations in military populations, there is limited evidence available as to how well the programs are working or would work if they were implemented in the military,” the study stated.

The report, “Promoting Psychological Resilience in the U.S. Military,” was commissioned by DCoE and conducted by the RAND Corporation. The report examined 23 military and civilian programs that address psychological resilience and provided recommendations on how these programs can be improved.

Other findings of the report included the need for a common definition of resilience.

“Senior commanders and policymakers should carefully formulate a definition of resilience that reflects both the literature and the military culture as a necessary first step in building any existing programs,” the researchers wrote in the report summary.

USPHS Cdr. George Durgin, DCoE resilience division chief for DCoE’s Resilience and Prevention Directorate, said the report’s findings provided validation of the issues that DoD knows about and already is tackling. A common definition of resilience was expected to be released by the end of September, he said.

Resilience Program Review

For the study, researchers conducted a systematic review of 270 scientific publications on psychological resilience. They then identified 20-evidence informed factors associated with resilience and sought to determine the extent to which these factors were reflected in 23 resilience programs for troops and their families.

Most programs did emphasize some of the resilience factors, the researchers found. However, when it came to measuring effectiveness, “programs showed considerable variation in their definitions of resilience and the measures they used to gauge program effectiveness,” and few had a process for reviewing results.

“We found that only five of the 23 programs had conducted formal assessments of their effectiveness. Because of this, there is limited evidence available as to how well the programs are working or would work if they were implemented in the military,” the report summary stated.

The report also stated there was a need to develop standardized resilience measures to enable program comparisons.

“Such an effort would move the field toward consensus about what factors comprise resilience, which measure is most valid and reliable for assessing resilience, and their relevance for military populations,” the researchers wrote.

Recommendations in the report included defining resilience, conducting more rigorous program evaluations, standardizing resilience measures to enable program comparison and integrating evidence-based resilience factors into new resilience programs.

Resilience Programs Have Mushroomed in Military, But Do They Work? Cont.

Durgin said the need for more rigorous program evaluation is an issue that DCoE had also recognized.

“There are multiple resilience programs, and they are very well intentioned, and some are anecdotally believed to be great programs, but the issue was how do we validate or what are the metrics that you have a good program?” he told U.S Medicine. “I think that is what the RAND program provides us, this piece that you don’t have metrics, and we knew that.”

He said that Army’s Comprehensive Soldier Fitness already has metrics and has been collecting data. The Air Force is developing an Air Force-wide resilience program and is working to make sure it has tools to validate what it is doing, he said, adding that the Navy’s Operational Stress Control and Marine Corps’ Combat Operational Stress Control are engaging in a similar process.

Resilience programs were not as common in the past, but with prolonged combat engagements since 9/11, the need for them was recognized by DoD leaders and policymakers, Durgin said. with significant funding for these types programs coming from Congress three years ago.

“As a result of prolonged combat engagements, we have recognized the need for robust resilience and prevention programs,” he said in a written statement. “As the services have moved forward with a variety of programs, it was to provide immediate support, and there may have not been a process for validation for these new programs.  Now we know we need to validate.”  

The key to strengthening programs must be an “ongoing collaborative effort between the Defense Department and the service,” he explained.  Continual evaluation and refinement of existing programs and processes will continue to help the Defense Department identify the best-of-breed programs and initiatives across the force.” DCoE has taken a multi-pronged approach to identifying research-supported best practices for resilience programs, according to Durgin.

“Our approach includes directly assisting promising resilience programs with their program evaluation efforts, conducting site-visit evaluations for red-cell-funded programs, developing program effectiveness toolkits to disseminate with programs and advising DoD workgroups and agencies conducting research and program evaluations.”

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