Why was the study done?
Public safety personnel (PSP) are at a high risk of developing mental health problems or occupational stress injuries (OSI) as a result of the stressful, and sometimes traumatic, nature of their work. A number of proactive programs have been designed to help with OSI. These programs are often short and only offered as a one-time course. The limited research on these programs has shown that a single session may not be enough to impact behavioural changes or help-seeking in PSP.
The Before Operational Stress (BOS) program is a 16-hour program offered by a trained clinical professional over eight consecutive weeks; the initial program is followed by 10 monthly sessions. The program includes psychoeducation and training in basic elements of cognitive behavioural therapy. Unlike other programs, the BOS also offers an interactive format, a cohort group that builds support, promotion of positive mental health habits, and the technique of functional disconnection and reconnection (click to learn more).
The purpose of this study was to:
- determine if there are changes after the BOS program in mental health symptoms reported by PSP;
- determine if there are changes after the BOS program in participant emotion regulation, shame, guilt, resilience, social support, and stigma.
What was done in the study?
Participants in the BOS program where offered the option to participate in an evaluation of the program. They were asked to complete a survey that included measures of anxiety, depression, stress, PTSD, alcohol use, emotion regulation, shame, guilt, resilience, social support, and stigma. The current study results are a comparison between pre-BOS measurements and four months post-BOS (six months after pre-BOS measurement).
In addition to the measures, participants were also asked five open-ended questions about their experience with the program. These answers were evaluated to look for themes.
What did we learn?
- There were improvements in symptoms of PTSD, depression, and stress, with the changes in PTSD symptoms being significant.
- There was an improvement in emotion regulation.
- There were decreases in shame and mental health stigma.
- Participants showed improvement in emotion regulation, social support, quality of life, and resilience. The improvement in social support is significant.
- The responses to the open-ended questions indicated that participants’ views of the BOS program were primarily positive.
- Many participants referenced an increased ability to understand and recognize feelings and mental state.
- The increased recognition of feelings and mental state caused difficulties for some who felt it brought up unresolved feelings, which sometimes had to be dealt with via the help of a professional.
- Many participants reported that the course made them feel normal/not alone.
- Some participants felt that disclosing mental health concerns in a group setting was a challenge.
Where do we go from here?
This study begins to build an evidence base for the effectiveness of the BOS program. As with many longitudinal studies, there was a drop-off in participants between time periods, which limits the researchers’ ability to generalize results. However, this early evidence supports the effectiveness of the BOS program. Continued study will be needed to explore effectiveness with a large group and determine how long the improvements last. The participants involved suggested that this type of training should be offered as early in a PSP’s career as possible.
The original wording of the study was changed and condensed for the current research summary.
Stelnicki, A.M., Jamshidi, L., Fletcher, A.J., & Carleton, R.N. (2021). Evaluation of Before Operational Stress: A program to support mental health and proactive psychological protection in public safety personnel. Frontiers in Psychology, 12:511755 https://doi.org/10.3389/fpsyg.2021.511755
Summary prepared by Kossick, E. Edited & reviewed by Barootes, B. & Stelnicki, A.