A cluster randomized controlled trial of a mind-body tactical resilience training in first responders

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First responders are regularly exposed to trauma and report high rates of PTSD, depression, and heavy drinking. Yet many are reluctant to engage in traditional mental health care when needed. A recent meta-analysis on first responder mental health found that one in three experience stigma regarding mental health, and one in eleven experience barriers to care. These findings suggest that reactive strategies are not reaching those in help, and more preventative approaches are needed. Studies on first responders suggest that they have a preference for behavioural interventions that emphasize fitness and well-being over more stigmatized psychological ill-health concepts. Research from military studies – another high-risk and trauma exposed population – found evidence for customised behavioural programs such as mind-body training and attention-bias modification training in reducing anxiety and PTSD symptoms respectively (Stoller et al 2012; Wald et al 2016). There is also emerging evidence to suggest that operational training, that is, job specific training, contributes to better psychological outcomes in trauma exposed workers. These preliminary findings suggest that employees who are better prepared and equipped with operational skills are less likely to develop mental health problems, including PTSD (Wessely et al., 2008; Brooks et al, 2018; Iversen et al., 2008). While still in its infancy, these recent developments suggest that further research is warranted to determine what type of resilience training is effective in increasing adaptive coping mechanisms as well as improving psychological outcomes, including post-traumatic stress symptoms in first responders. Our study aims to investigate the effectiveness of a novel mind-body tactical resilience training program for first responders that is job-specific and culturally informed, in improving mental health and physical symptoms as well as adaptive coping strategies, using a cluster randomized controlled trial study design. This existing training is widely implemented in many first responder organization in the U.S. however has yet to be evaluated as part of methodologically robust RCT. This research is essential because it will fill that gap in existing evidence-base of acceptable and novel preventative strategies, that has been previously identified in a recent review of psychosocial interventions for trauma-exposed first responders that prevent the development of trauma-related mental disorders. Findings from this pilot study will inform the content and method of delivering preventative strategies for trauma-related disorders amongst the first responder population

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