Military Health Provider Training and Evaluation of a Problem-Solving Intervention to Reduce Distress and Enhance Readiness Among Service Members.

Abstract:

INTRODUCTION:Department of Defense (DoD) has identified problem-solving training (PST) as a promising prevention/early intervention for mental health disorders. PST is a four-session group intervention that emphasizes building problem-solving and coping skills to mitigate emotional dysregulation and the adverse effects of stressful events. It was adapted from problem-solving therapy, which is an evidence-based, cognitive-behavioral approach that has shown effectiveness with treating depression and managing suicide risk. The current evaluation examined a pilot program that: (1) trained DoD providers in the delivery of PST, (2) conducted PST intervention groups with active duty personnel, and (3) developed PST master trainers to train other providers. MATERIALS AND METHODS:Clinical (e.g., psychologists) and non-clinical (e.g., chaplains) providers attended a 2.5-day workshop of didactic coursework and experiential training on conducting PST, with a subset of providers selected to attend an additional workshop to become master trainers in PST. Providers (n = 82) who attended a PST Facilitator Workshop completed pre- and post-workshop assessments of self-efficacy in PST skills. Eight providers evaluated a Master Trainer Workshop. After completing workshop training, providers conducted PST intervention groups with service members (n = 435), who were experiencing distress, with or without a mental health diagnosis, and whose needs were appropriate for a prevention/resiliency-based skills group. Service members completed the following pre- and post-PST group outcome measures: (a) Outcome Questionnaire-30 (OQ-30) and Patient Health Questionnaire-9 (PHQ-9) as measures of distress; and (b) Brief Resilience Scale (BRS) to assess resilience, which contributes to readiness. They also completed the Social Problem Solving Inventory-Revised: Short Form (SPSI-R:S), as a process measure for the intervention. The SPSI-R:S, which assesses how individuals cope when faced with problems, includes the following subscales: (1) positive problem orientation, (2) negative problem orientation, (3) rational problem-solving, (4) impulsivity/carelessness style, and (5) avoidance style. Service members also completed a post-group evaluation of PST. Data were analyzed with descriptive statistics, paired sample t-tests, and correlational analyses. RESULTS:Providers showed pre- to post-facilitator workshop increases in self-efficacy of PST skills (all p < 0.001) and those selected as master trainers evaluated their workshop training favorably, particularly the role-playing exercises. Analyses of pre- vs. post-PST group intervention measures among service members indicated that OQ-30 and PHQ-9 scores declined, while BRS and SPSI-R:S total scores increased (all p < 0.001). In addition, correlational analyses of change scores showed that the SPSI-R:S subscales negative problem orientation and avoidance style were negatively correlated with BRS and positively correlated with OQ-30 and PHQ-9 (all p < 0.001). Service members gave positive post-group evaluations of PST effectiveness and program materials. CONCLUSION:DoD providers reported increased self-efficacy in skills required for the delivery of a four-session PST group intervention after participating in a pilot program of training workshops. The pilot of the PST group intervention showed an association with improvements on service members' self-reported measures related to distress, readiness, and coping. In addition, changes in problem-solving measures were associated with changes in outcome measures. Follow-on research is needed to further investigate if PST is effective in preventing more severe forms of distress.

journal_name

Mil Med

journal_title

Military medicine

authors

Cooper DC,Bates MJ

doi

10.1093/milmed/usy229

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

e303-e311

issue

5-6

eissn

0026-4075

issn

1930-613X

pii

5106692

journal_volume

184

pub_type

杂志文章
  • Prevalence and Clinical Correlation of Superficial Fungal Foot Infection in Thai Naval Rating Cadets.

    abstract:BACKGROUND:Superficial fungal foot infection is one of the most important dermatological diseases currently affecting military personnel. Many Thai naval rating cadets are found to suffer from superficial fungal foot infections and their sequels. OBJECTIVE:To investigate prevalence, potent risk factors, responding pat...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.1093/milmed/usx187

    authors: Ongsri P,Bunyaratavej S,Leeyaphan C,Pattanaprichakul P,Ongmahutmongkol P,Komoltri C,Kulthanan K

    更新日期:2018-09-01 00:00:00

  • Descriptive analysis of patients undergoing shoulder surgery at a tertiary care military medical center.

    abstract::Shoulder pain is a common musculoskeletal complaint. Patients with shoulder pain who are seeking care in a military tertiary setting in the United States have not been previously described. This study describes the clinical features of 55 patients (47 men, 8 women) undergoing shoulder surgery at a tertiary care milita...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-01-3607

    authors: Walsworth MK,Doukas WC,Murphy KP,Bimson W,Mielcarek BJ,Michener LA

    更新日期:2009-06-01 00:00:00

  • Daily insufficient sleep and active duty status.

    abstract:OBJECTIVE:We assessed the relationship between active duty status and daily insufficient sleep in a telephone survey. METHODS:U.S. military service status (recent defined as past 12 months and past defined as >12 months ago) and daily insufficient sleep in the past 30 days were assessed among 566,861 adults aged 18 to...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-14-00158

    authors: Chapman DP,Liu Y,McKnight-Eily LR,Croft JB,Holt JB,Balkin TJ,Giles WH

    更新日期:2015-01-01 00:00:00

  • Dietary supplements in the Department of Defense: possible solutions to optimizing force readiness.

    abstract::Dietary supplement use is common among military service members; approximately 17 to 20% report using high-risk weight-loss, performance-enhancing, and bodybuilding supplements. To date, no overarching policy or program has been approved or implemented to inform service members or educate health care providers on the ...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-12-00249

    authors: Gonsalves S,Stavinoha T,Hite L,Costa J,Dilly G,Deuster PA

    更新日期:2012-12-01 00:00:00

  • When Exception to Policy Is Exceptional Policy: How Booking Physical Therapy Appointments Too Far in the Future May Adversely Impact Access to Care, Business Optimization, and Readiness.

    abstract:INTRODUCTION:Physical therapy (PT) is a high-volume service that treats musculoskeletal injury and improves return-to-duty rates. Our experience suggests that no-show (NS) and patient cancellation (PC) rates increase the further appointment that is booked in the future, impede access to care, and increase the healthcar...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.1093/milmed/usz287

    authors: Baker SE,Silvernail J,Scoville C,Kushner S,Mabry L,Konitzer L,Easley S,Iveson B,Sims C,Stoeker S,Gudorf G

    更新日期:2020-01-07 00:00:00

  • Paraganglioma of the vagus nerve masquerading as a carotid body tumor.

    abstract::A case of paraganglioma of the vagus nerve in a 69-year-old woman presented as a pulsatile neck mass of 20 years duration. Angiogram showed it to be a vascular tumor and suggested the diagnosis of carotid body tumor. At operation, the tumor was found to involve the vagus nerve, which needed to be resected. The relevan...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Deshmukh N,Horbowyj R

    更新日期:1994-02-01 00:00:00

  • The association between childhood physical and sexual abuse and functioning and psychiatric symptoms in a sample of U.S. Army soldiers.

    abstract:OBJECTIVE:We examined associations between abusive childhood experiences and functioning and psychiatric symptoms in an active duty sample of U.S. Army soldiers. METHODS:Cross-sectional survey of 204 soldiers stationed at a southern U.S. Army facility. RESULTS:Forty-six percent of individuals reported childhood physi...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-10-00038

    authors: Seifert AE,Polusny MA,Murdoch M

    更新日期:2011-02-01 00:00:00

  • Use of Bibliometric Analysis to Assess the Scientific Productivity and Impact of the Global Emerging Infections Surveillance and Response System Program, 2006-2012.

    abstract:BACKGROUND:Scientific publication in academic literature is a key venue in which the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System (GEIS) program disseminates infectious disease surveillance data. Bibliometric analyses are tools to evaluate scientific productivity and impact o...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-16-00276

    authors: Reaves EJ,Valle R,Chandrasekera RM,Soto G,Burke RL,Cummings JF,Bausch DG,Kasper MR

    更新日期:2017-05-01 00:00:00

  • Tactical medicine -- the Israeli revised protocol.

    abstract::Limited conflicts and the war against terrorism, in particular, have changed the emphasis in the present trend from preparing to cope with full-scale wars to the need to combat in limited conflicts. This shift has affected significantly medical units' preparations. Law enforcement organizations have come together with...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-11-00245

    authors: Waldman M,Richman A,Shapira SC

    更新日期:2012-01-01 00:00:00

  • The 274th Forward Surgical Team experience during Operation Enduring Freedom.

    abstract::The 274th Forward Surgical Team (FST) was deployed in support of Operation Enduring Freedom from October 14, 2001 to May 8, 2002. During this period, the FST was asked to perform many nondoctrinal missions. The FST was tasked with functioning as a mini-combat support hospital during the earlier phases of Operation End...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed.170.6.451

    authors: Peoples GE,Gerlinger T,Craig R,Burlingame B

    更新日期:2005-06-01 00:00:00

  • Vascularized plantar myocutaneous free flap transfer for amputee stump preparation: a proof of concept cadaver study.

    abstract::Lower extremity amputee stump ulceration, irritation, and pain have been a deterrent to consistent long-term or continuous use of lower extremity prosthetics. This study is the first in a series that hypothesizes that these complications can be minimized through the insetting of a vascularized plantar free flap (VPFF)...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-12-00298

    authors: Smith LN,Richards WT,Mozingo DW,Lottenberg L

    更新日期:2013-02-01 00:00:00

  • Functional Capacity Evaluation-Military: Program Description and Case Series.

    abstract::A functional capacity evaluation (FCE) evaluates the ability of an individual to perform activities related to employment. There is no FCE specific to the military population; therefore, a FCE for the military population (FCE-M) was developed to evaluate an injured service member's (SM) ability to return to duty. The ...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-16-00072

    authors: Cancio JM,Oliver RA,Yancosek KE

    更新日期:2017-01-01 00:00:00

  • Elbow arthrodesis after war injuries.

    abstract::Arthrodesis is a surgical procedure that results in fusion of the joint and bony ankylosis. With this operation, we can achieve satisfactory function of the limb in cases in which options for different treatments no longer exist. Severe joint destruction, joint infections, and nonunions, as well as complex war injurie...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Bilic R,Kolundzic R,Bicanic G,Korzinek K

    更新日期:2005-02-01 00:00:00

  • Evaluation of intraosseous delivery of factor VIIa during hemorraghic shock in the pig.

    abstract::The purpose of this investigation is to determine if intraosseous infusion (IO) is a suitable method for the delivery of recombinant human factor VIIa (rFVIIa) during hemorrhagic shock. The measures that were used to evaluate IO delivery suitability included: (1) determination of clinically significant local or system...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-58-7608

    authors: Wright JK,Christy RJ,Tharp RV,Kalns JE

    更新日期:2009-02-01 00:00:00

  • A new model of blast injury from a spherical explosive and its special wound in the maxillofacial region.

    abstract:OBJECTIVE:The goal of this study was to establish an efficient explosive model with spherical explosives for the study of blast injury and its wound characteristics in the maxillofacial region. METHODS:Different spherical explosives were used to produce blast waves and to establish the wound model. Fresh sheep heads a...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Wang Z,Liu Y,Lei D,Bai Z,Zhou S

    更新日期:2003-04-01 00:00:00

  • Fluticasone as Treatment for Cluster Headaches in a Navy Aircrew Member.

    abstract::Cluster headaches (CHs) are one of the most debilitating of all the identified headache syndromes. Their pathogenesis is poorly understood, which has made their treatment challenging. Various medicines and modalities have been put forth in an effort to minimize the symptoms, but none have proven to be consistently rel...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-14-00713

    authors: Andicochea CT,Blalack PM,Fulkerson JA,Kidd GA,Taylor BM

    更新日期:2015-10-01 00:00:00

  • The Tripler Tobacco-Cessation Program: predictors for success and improved efficacy.

    abstract::This study analyzed differences in baseline, course of treatment, and post-quit variables of participants in a tobacco-cessation program to identify factors predictive of outcome that could be used as a focus for intervention. The program offered a 10-week course of transdermal nicotine replacement combined with educa...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Faue M,Folen RA,James LC,Needels T

    更新日期:1997-07-01 00:00:00

  • Refractive error distribution and incidence among U.S. Army aviators.

    abstract::Spectacle incompatibility has been a major problem in the fielding of advanced Army avionic and electro-optical systems. As a result, routine contact lens wear may be instituted as an option to spectacles. Refractive error data were extracted from the Aviation Epidemiological Data Registry, a computer-accessible repos...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Lattimore MR Jr,Schrimsher RH

    更新日期:1993-08-01 00:00:00

  • Case study illustrating risks of garrison unit watch for soldiers at risk of suicide.

    abstract::Unit watch over suicidal patients by nonmedical soldiers is often necessary in a deployed environment, but this strategy's risks may outweigh its benefits in a garrison environment. This case study illustrates risks of unit watches that are difficult for medical personnel to effectively mitigate. The suicidal soldier ...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-14-00519

    authors: Brown CS,Sheridan RJ Jr

    更新日期:2015-06-01 00:00:00

  • Outcomes of community-acquired, methicillin-resistant Staphylococcus aureus, soft tissue infections treated with antibiotics other than vancomycin.

    abstract::Community-acquired, methicillin-resistant Staphylococcus aureus (cMRSA), soft tissue infections are becoming increasingly prevalent in the outpatient setting. Few studies have been specifically designed to examine the efficacy of oral antibiotic therapy for these infections. We performed an observational study to dete...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed.171.6.504

    authors: Barnes EV 2nd,Dooley DP,Hepburn MJ,Baum SE

    更新日期:2006-06-01 00:00:00

  • Pacific Partnership 2008: the surgical mission, surgical screening process, and the anesthetic management of uncontrolled, untreated hypertensive patients.

    abstract::United States Armed Forces and nongovernmental agencies on board the USNS Mercy provided humanitarian and civic assistance to over 68,000 patients in five southeastern Asian nations during Pacific Partnership 2008. A commitment to improving the health and well-being of the citizens of these countries along with streng...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed-d-09-00063

    authors: King HC,Baker W

    更新日期:2010-01-01 00:00:00

  • Suicidal Ideation is Associated With All-Cause Mortality.

    abstract::Suicidal ideation may be associated with all-cause mortality. Available research shows that treatment of depression reduces the risk of all-cause mortality in patients with suicidal ideation. However, this finding has not been replicated in a clinical population, where patients have various mental health conditions. W...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-15-00496

    authors: Shiner B,Riblet N,Westgate CL,Young-Xu Y,Watts BV

    更新日期:2016-09-01 00:00:00

  • Exploring Theta Burst Stimulation for Post-traumatic Stress Disorder in Australian Veterans-A Pilot Study.

    abstract:INTRODUCTION:Post-traumatic stress disorder (PTSD) is a severe and debilitating condition affecting a significant proportion of the veteran community. A substantial number of veterans with PTSD fail to benefit from trauma-focused psychological therapies or pharmacotherapy or are left with residual symptoms, and therefo...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.1093/milmed/usaa149

    authors: Nursey J,Sbisa A,Knight H,Ralph N,Cowlishaw S,Forbes D,O'Donnell M,Hinton M,Cooper J,Hopwood M,McFarlane A,Herring S,Fitzgerald P

    更新日期:2020-09-18 00:00:00

  • Completion of a Veteran-Focused Civic Service Program Improves Health and Psychosocial Outcomes in Iraq and Afghanistan Veterans With a History of Traumatic Brain Injury.

    abstract:INTRODUCTION:Volunteering as a health promotion intervention is positively related to improved health and well-being in civilians and older adults. Yet, the impacts of participating in a community-based volunteering program on returning military veterans have not been studied, nor have the outcomes for veterans who hav...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-16-00150

    authors: Lawrence KA,Matthieu MM,Robertson-Blackmore E

    更新日期:2017-07-01 00:00:00

  • Differential impact of combat on postdeployment symptoms in female and male veterans of iraq and afghanistan.

    abstract:OBJECTIVES:We aimed to describe differences in combat experience for male and female veterans and characterize differential effects on postdeployment physical and mental health symptoms, including aggression. METHODS:Retrospective cross-sectional health screening data from 554 Operation Enduring Freedom and Operation ...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-14-00255

    authors: Afari N,Pittman J,Floto E,Owen L,Buttner M,Hossain N,Baker DG,Lindamer L,Lohr JB

    更新日期:2015-03-01 00:00:00

  • Two-Stage Osseointegrated Reconstruction of Post-traumatic Unilateral Transfemoral Amputees.

    abstract::A new technique called osseointegration was introduced recently by intimately connecting the artificial limb prosthesis to the residual bone, eliminating the problematic socket-residuum interface. The objective here is to describe the two-stage strategy for the osseointegrated reconstruction of amputated limbs and dis...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.1093/milmed/usx185

    authors: Muderis MA,Lu W,Glatt V,Tetsworth K

    更新日期:2018-03-01 00:00:00

  • Rubella outbreak, Fort Bragg, North Carolina, 1995: a clash of two preventive strategies.

    abstract::An outbreak of rubella occurred among visiting German troops involved in a combined military exercise at Fort Bragg, North Carolina, in April 1995. Public health and military operational concerns centered on the significant contact the German soldiers had had with host battalion dependents and the impact of the outbre...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Craig SC,Broughton G 2nd,Bean J,McKee KT Jr

    更新日期:1999-09-01 00:00:00

  • Did substance use change after September llth? An analysis of a military cohort.

    abstract::The purpose of this study was to assess changes in alcohol, tobacco, and other drug use after the terrorist attacks of September 11 among a cohort of young military personnel consisting of 661 active duty Navy personnel, including 164 women. Paired sample t tests were computed to assess mean differences in substance u...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/milmed.169.10.829

    authors: Moore RS,Cunradi CB,Ames GM

    更新日期:2004-10-01 00:00:00

  • Severe Systemic Lead Toxicity Resulting From Extra-Articular Retained Shrapnel Presenting as Jaundice and Hepatitis: A Case Report and Review of the Literature.

    abstract:INTRODUCTION:Despite greater than 60,000 nonfatal firearm injuries per year in the United States, retained shrapnel is a relatively rare cause of systemic lead toxicity with less than 100 cases reported in the medical literature since 1867. While intra-articular retained shrapnel as a cause of lead toxicity is well-des...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:10.7205/MILMED-D-16-00231

    authors: Grasso IA,Blattner MR,Short T,Downs JW

    更新日期:2017-03-01 00:00:00

  • Combined effects of Venezuelan equine encephalitis IIIA virus and gamma irradiation in mice.

    abstract::The combined effects of injury from exposure to ionizing radiation and the potential biological warfare agent Venezuelan equine encephalitis (VEE) virus remain largely unknown. To study these effects, 4- to 5-week-old B6D2F1/J female mice were given a sublethal whole-body 7 Gy dose of 60Co gamma-photon radiation follo...

    journal_title:Military medicine

    pub_type: 杂志文章

    doi:

    authors: Shoemaker MO,Tammariello R,Crise B,Bouhaouala SS,Knudson GB,Jackson WE 3rd,Ludwig GV,Smith JF

    更新日期:2001-12-01 00:00:00