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Autonomic modulation training: A biological approach to building resilience and wellness capacity among police exposed to posttraumatic stress injuries (PTSI)

Keywords: Autonomic Modulation Training, Police, Posttraumatic Stress Injury (PTSI)


Police officers are regularly exposed to potentially traumatic events (PTE). Accumulated stress results in physical and mental health conditions, of which post-traumatic-stress-injuries (PTSI) are central. Currently existing mental health interventions for public safety personnel (PSP) appear to have limited clinical effectiveness. The current methods focus on addressing cognitive, emotional, and behavioural components without addressing underlying neurological and physiological mechanisms.

Autonomic Modulation Training (AMT) is an eight-week intervention. Using real-time heart-rate-variability biofeedback (HRVB), physiological reflexes can be rewired while individuals process current psychological and physical symptoms. The research team will provide personalized training and education tailored for police officers.

The goals of the study are:

  1. To reduce mental health symptoms of PTSI through a biopsychological intervention;
  2. To build wellness capacity; and,
  3. to examine how sex and gender are related to baseline biological differences in PTSI symptoms and effects of AMT.

Future directions

AMT training is compatible with learning management systems and, if effective, can be distributed to police services across Canada.

Interview with the team

Are there other questions or challenges you research may help address?

By providing an established wellness program in a confidential online format, our research will also address barriers to seeking care (e.g., stigma, concerns about retribution) that prevent police and other PSP from seeking help for PTSI. This approach will also reach a broader PSP audience, including those that serve in remote communities where additional wellness training programs are unavailable.

What is exciting about your work for the PSP community? For example, how will your results help PSP frontline workers? PSP families? PSP leaders?

The results of our work will provide objective evidence on the physiological mechanisms underlying PTSI, as well as the physical and psychological factors that support wellness capacity building and sustainability. Using cutting-edge biofeedback technology, participating police officers will get a first-hand look at their real-time cardiorespiratory activity as they practice re-wiring physiological stress responses in tandem with positive coping and metacognitive skills.

When do you expect to have results to share with the PSP community?

Due to the Covid-19 pandemic, launching our AMT Intervention study has been delayed to the Fall of 2021. However, we hope to have preliminary results on the effectiveness of this online program by Summer 2022 following data collection from several cohorts of police officers from across Canada.

Where can PSP go to learn more about your study or, if applicable, to participate?

To learn more about our research, please visit, or contact the research Post-doctoral coordinator, Paula Di Nota (

Is there anything else you would like to share with the PSP community about your research?

We are committed to integrating the valuable insights and lived experiences of our police partners whenever possible, from formulating our research questions, adapting our experimental protocols to meet their operational norms and schedules, as well as informing the content of our training and research materials to ensure relevance and buy in. We also aim to publish our research findings and policy recommendations in a broad variety of sources (i.e., open access journal articles in policing, occupational health and medicine, practitioner periodicals) that can reach the audience we intend to benefit and serve with our work.


Principal Researchers

Judith Andersen, Associate Professor of Psychology at University of Toronto. Professor Andersen is a health psychologist who specializes in the psychophysiology of stress and stress-related mental and physical health issues. She has more than a decade of experience working with populations exposed to severe and chronic stress, including combat soldiers and police. Her ongoing research projects include the development of evidence-based, use of force training programs among police and special forces teams in Canada, the United States, and Europe. Further, she is working to customize evidence-based resilience programs for different sectors of first responders who are exposed to trauma.

Dr. Joseph Arpaia, MD, Clinical Interventionist. Central to the theoretical development of the AMT Intervention is Joseph Arpaia, MD.  Dr. Arpaia has been teaching mind/body strategies for over 25 years to help people deal with stress-related conditions, such as addiction, anxiety, PTSD, depression, and chronic pain.  He is the co-author of a book on meditation that received a foreword from the Dalai Lama. He spends his free time hanging out with his family, practicing martial arts, and plunking on the piano.

Dr. Paula Di Nota, postdoctoral research fellow. Paula’s expertise lies in understanding how brain networks are shaped by complex motor learning. Investigating Canadian and international samples of tactical and frontline police officers, Paula’s research seeks to identify how stress physiology impacts lethal force decision-making, situational awareness, memory, and mental health. Paula has published several peer-reviewed publications in top industry journals, including Frontiers in Psychology, Policing: An International Journal, Occupational Medicine, and Stress & Health.

Jennifer Chan, PhD Candidate. Jennifer’s research specialization is in psychoneuroimmunology. Specifically, her research uses biological measurements across neurological, cardiovascular, and endocrine disciplines to study how stress and trauma affect the physical and mental health of first responders.

Sarah Scott, incoming PhD candidate. Sarah has a keen interest in trauma neuroscience and the modulation of the stress response. She has performed research in a variety of fields, including decision neuroscience, clinical neuropsychology, behavioural neuroscience, trauma psychology and human biology. Sarah has assisted in the facilitation of police de-escalation training and police physiological modulation training. She is pursuing her career in psychology as a doctoral candidate at the University of Toronto, in the HART Lab.

Presentation Video

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