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Before operational stress: Evaluating novel psychosocial interventions for public safety personnel (PSP) and their families

Keywords: BOS program, Families, Operational Stress, Public Safety Personnel

Summary

Public Safety Personal (PSP) experience heightened operational stressors. The list is exhaustive, but includes shift work, exposure to traumatic events, threats to personal safety, witnessing current or past accidents, homicides, assaults, and suicide. Operational stress injury (OSI) is a term that has come to describe the acute and cumulative effects of these operational stressor, and prevalence rates for OSI’s, including posttraumatic stress disorders (PTSD), depression, and anxiety disorders, range from 8% to 44% within Canadian PSP populations. Our study will focus on three PSP professions – firefighters, police, and paramedics – but sadly, the high percentages are also reflected in other PSP roles and service areas.

These volatile estimates of OSI prevalence and its effects are magnified by the reality that many PSP are spouses and family members who experience and vicariously transmit the effects of operational stress in the home. In particular, PSP are likely to turn to family members (especially spouses) as a first option when in need of support, and we know that PSP who have support from their families are less likely to experience heightened symptoms or risk for diagnosis of a mental disorder. Leveraging the strengths of the family to provide this support and reduce risk is our primary goal.

Existing support systems for PSP generally neglect including family members, and our study is energized by the expressed need of PSP family members for a program to address how operational stress impacts families – relationships, identity, resiliency – and how they can learn to respond in healthy ways. Thus, the current study will address this need by designing, piloting, and evaluating the effectiveness of a psychoeducation and support program for PSP family members aimed to support and strengthen the functioning of the family and of the PSP member.

Interview with the team

Are there any additional questions or challenges that your research might help to address?

An important element of our study is the implementation of new methods of data collection and measurement. First, all family participants in our program will complete pre-, mid, and post-assessment of relational, familial, individual, and social functioning. We recognize that family systems are complex, and thus we endeavor to explore if, where, and how significantly our program is reflected in changes in self-reported functioning. Second, we have team members with expertise in biomedical measurement of physiological assisting in the use of wearable technology (e.g., Garmin). All participants will have the option to voluntarily contribute this data to our study.

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

There is no more humbling experience that partnering with local, provincial, and national PSP organizations to engage in this important work. Since receiving the CIHR/CIPSRT grant, we have been privileged to meet with organizational leaders, frontline PSP members, fellow researchers, and, particularly, family members to discuss the challenges and the strengths of being in a first responder family. It is our intent that our study will not only translate into helping PSP family members better understand the family system, their relationships, and the impact of operational stress, but that it will also indirectly and positively change the trajectory of attitudes, behaviour, and physical health of PSP members themselves.

As a research team with expertise in health, physiology, clinical and social psychology, and social work, we are being cautious about promoting gains and advances for PSP and family members that we can’t predict and measure. We are emboldened by the knowledge that we are building a family-based program with families rather than to families, and this gives us confidence that our participants will leave our program with both new understandings and new strategies for strengthening their family system. By extension, we hope all national fire, police, and paramedic organizations will find that they can confidently recommend this evidence-informed PSP-Family program to their members and their families.

 

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

We have been privileged to share some preliminary results from our online survey and focus groups at various professional and academic conferences in 2020 and 2021. We have several manuscripts in preparation, and we will be piloting the content for our PSP Spouse program in February, 2022. Preliminary results from our pilot study will be shared in early Spring, 2022.

Where can PSP go to learn more about your study or, if applicable, to participate? For example, do you have a website?  

We welcome PSP and their families to visit our study website (https://www.buildingonstrengths.ca/) to learn more about our study and to reach out to us if you are interested in participating.

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

Critical to developing a program for families is ensuring their voices are heard at every phase of its design, piloting, and implementation. Early in the process (December, 2020), we surveyed hundreds of PSP members and family members on the daily challenges they face, but we also as asked about the strengths that they inherently see in their families. We then invited (February, 2021) a smaller number to join focus groups and tell us their own words about lived experiences in PSP families, and to guide us on what form (i.e., in-person, online, hybrid) of program would serve them best. Hearing and learning from PSP family members is critical to keeping us as researchers focused on what must come first: families.

Researchers

Dr. Kelly Dean Schwartz is an Associate Professor in the School and Applied Child Psychology program, Werklund School of Education, at the University of Calgary. Dr. Schwartz has been engaged in the study of children, youth, and their families for over 20 years, most notably focusing on the development assets and family strengths contributing to healthy development and thriving.

Allan McLuckie is an Associate Professor at the Faculty of Social Work, University of Calgary. His area of research includes mental health, parenting/family stress and family-based interventions. He also has extensive experience engaging in nationally funded knowledge-translation initiatives within research projects and pertaining to research-policy-practice translations for health/mental health initiatives.

Dr. Carly McMorris is an early-career investigator and Assistant Professor at the University of Calgary. As a Child Clinical Psychologist, she has extensive experience in assessing and treating children and adolescents with mental health problems, including depression and anxiety, and neurodevelopmental disorders (e.g., autism spectrum disorder). Her expertise is in examining bio-psycho-social mechanisms for the development of mental health issues in youth with ASD.

Dr. Andrea Stelnicki is a postdoctoral fellow in the Department of Psychology at the University of Regina. Stelnicki is currently heading several projects evaluating programs for PSP, including the BOS program evaluation project and tracking the mental health of PSP peer supporters.

Dr. Linda Duffett-Leger is an Associate Professor Faculty of Nursing, University of Calgary and is a registered nurse and certified user experience designer, with expertise in using user-centred design approaches in the development of technologies to optimize health and educational outcomes. Her research focuses on using participatory design methods in the co-design of wearable technology solutions to solve real-world clinical problems.

Dr. Reed Ferber is a Professor in the Faculties of Kinesiology, Nursing, and Medicine at the University of Calgary. He is a clinician-scientist with post-doctoral training in biomedical engineering and has published97papers in his career, 25 in the last two years, and attracted nearly$5M in peer-reviewed research funding.

Dr. Megan McElheran is a Clinical Psychologist with WGM Psychological Services, a community-based psychology practice headquartered in Calgary, AB.  Dr. McElheran is creator of the Before Operational Stress (BOS) program and is National Clinical Director for WGM Psychology Ltd. Dr. McElheran began working with uniformed service personnel in 2004, at which time she had the opportunity to train extensively within the National Center for PTSD, a branch of the United States Veterans Affairs Administration.

Dr. Joanne Park completed her Ph.D. in Clinical Psychology at the University of British Columbia. She completed her pre-doctoral residency in the Child and Adolescent Clinical Psychology Track at IWK Health in Halifax, where she received specialized training in Dialectical Behaviour Therapy with adolescents, and neuropsychological and psycho-educational assessments for children and adolescents.

Dr. Milena Spasojevic is a Clinical Psychologist serving as the Director of Clinical Operations of Eastern Canada in the Toronto, ON location of WGM Psychological Services. In this role, Spasojevic provides assessment and treatment to PSP and their families. Her doctoral research examined psychological variables in post-war Serbia, and she currently serves active duty military and veterans in her practice.

Presentation Video

 

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