Abstract
Law enforcement officers are regularly exposed directly and indirectly to a wide variety of traumatic stressors, which take place against a backdrop of high levels of organizational stressors. Consequently, this group is at elevated risk for posttraumatic stress disorder (PTSD) and other negative physical and mental health outcomes, yet there are few empirically supported interventions to proactively mitigate the effects of occupational stress for this population. Recent studies suggest that training in mindfulness meditation may reduce perceived stress and improve related physical and mental health outcomes in this group. We sought to demonstrate feasibility, acceptability, and adherence for an 8-week mindfulness training program in 30 officers from a mid-sized, Midwestern US police department, replicate findings of improved stress-related health outcomes, and provide novel evidence for reduced PTSD symptoms. All 30 officers completed the training, with high rates of class attendance, substantial out-of-class practice time, and good acceptability of the training and teachers. We replicated findings of reduced post-training perceived stress, sleep disturbances, anxiety, and burnout. We also identified novel evidence for reduced PTSD symptoms that persisted at a 5-month follow-up assessment. These results indicate key targets for future investigation in larger, mechanistic, randomized controlled trials of mindfulness training in police officers.
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Acknowledgments
The authors thank Robin Goldman, John Koger, Mara Beebe, DK Jang, Cara Knoeppel, and the staff of the UW Hospital Clinical Research Unit for contributing to study design and data collection; Lori Gustafson for conducting focus groups; Sophia Diamantis for conducting interviews; Mike Christopher, Lt. Rich Goerling, and Brant Rodgers for providing consultation on the intervention; and members of the Madison Police Department for contributing to this project, including Ofc. Sue Carnell (ret.), Chief Kristen Roman (University of Wisconsin-Madison Police Department), Capt. Tim Patton, Capt. Tom Snyder (ret.), Capt. Mary Schauf (ret.), Capt. Brian Austin, Ofc. Dan Frei, Chief Mike Koval (ret.), and all of the study participants.
Funding
This project was supported by the NIH (CTSA at UW-Madison grant UL1TR000427; NIMH grant K01MH117222) and by the University of Wisconsin-Madison School of Medicine and Public Health’s Wisconsin Partnership Program, WPP-ICTR grant #3086.
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Dr. Richard J. Davidson is the founder and president of, and serves on the board of directors for, the non-profit organization, Healthy Minds Innovations, Inc. The other authors report no conflicts of interest.
Ethical Approval
All procedures performed in this study were in accordance with the ethical standards of the institutional research committee (University of Wisconsin-Madison Health Sciences IRB #2016-0675) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Appendix
Appendix
Intervention Summary: First Responder Resilience and Mindfulness training
Overview of 8-week curriculum developed between July 2016 and June 2017. This curriculum was inspired by the Mindfulness-Based Resilience Training curriculum created by Mike Christopher, Rich Goerling, and Brant Rogers at Pacific University. We are deeply grateful to them for sharing their wisdom and experience with us.
Week 1: Introduction to resilience and mindfulness.
Content: Introduction of course/instructors/volunteer/participants. Definition of mindfulness, neuroplasticity and how we can foster greater resilience. Creation of community agreements and discussion of culture. Movement and body scan practices. Debriefing of session 1 practices.
Homework: Explanation of practice log. Formal practice: 9-min movement/9-min body scan 6 out of 7 days. Informal practice: “Dropping in” and 3 good breaths.
Week 2: Settling into resilience and mindfulness.
Content: Normalizing mind wandering and addressing other (mis)conceptions about doing the practices “correctly.” Movement, body scan, and debrief. Introduce walking practice.
Homework: Practice log. Formal practice: alternate 9-min movement/9-min body scan 6 out of 7 days. 5 min of walking practice 3 times. Informal practice: “Dropping in” and 3 good breaths.
Week 3: Meeting our experiences through resilience and mindfulness.
Content: Movement, exploration of physical posture, introduction to breath awareness practice, and debrief. Reading/video to reconnect to inspiration/motivation.
Homework: Practice log. Formal practice: alternate 9 min of movement/5 min of awareness of breath practice 6 out of 7 days a week. Informal practice: pleasant events calendar, integrated walking practice, and 3 good breaths.
Week 4: Meeting stress with resilience and mindfulness.
Content: Movement, breath awareness practice and debrief. Introduction of mindful eating.
Homework: Practice log. Formal practice: alternate 15 min of movement with 15 min of a breath awareness practice. Informal practice: integrated walking practice, unpleasant events calendar, and 3 good breaths.
Week 5: Reactivity, resilience, and mindfulness.
Content: Movement, breath awareness, and debrief. Reflection of practice and course at halfway point and resetting of intentions for the remaining 4 weeks. Introduction to compassion practice.
Homework: Practice log. Alternate movement/breath awareness practice with compassion practice 6 days out of 7. Informal practice: walking practice (1× per week) and 3 good breaths.
Week 6: Response, resilience, and mindfulness.
Content: Movement, awareness of breath practice, compassion practices, and debriefing.
Discussion and preparation for the day of extended practice.
Homework: Practice log. Alternate between 15 min of awareness of breath and compassion practice. Informal practice: walking practice (1× per week), and 3 good breaths.
Week 7: Extended practice session (4 h).
Content: This session includes all of the previous practices of mMBRT along with mountain meditation and a period of silence.
Homework: Practice log. Participant decides his/her practice.
Week 8: Resilience and mindfulness: beginning again.
Content: Movement, breath awareness practice, and debriefing. Debriefing about course.
Implementation exercise. Review of resources and support for participants.
Homework: Practice log. Participant decides her/his practice.
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Grupe, D.W., McGehee, C., Smith, C. et al. Mindfulness Training Reduces PTSD Symptoms and Improves Stress-Related Health Outcomes in Police Officers. J Police Crim Psych 36, 72–85 (2021). https://doi.org/10.1007/s11896-019-09351-4
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DOI: https://doi.org/10.1007/s11896-019-09351-4