Mike Grill MS, NREMT-P South Denver EMS Team Littleton, Colorado First Response Resiliency A Research Project on the Efficacy of a Student-Centered Learning Model for Improving Resiliency for First Responders Mike Grill MS, NREMT-P South Denver EMS Team Littleton, Colorado © 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries. The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

What Do We Know About the Emergency Response Community? Mental Health Issues Addiction Physical Health Family Relationships ----- Meeting Notes (12/16/12 13:39) ----- 0:30 to 4:14

15/2 Rule

--Rachel Naomi Remen, M.D. The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet. --Rachel Naomi Remen, M.D. ----- Meeting Notes (12/16/12 13:39) ----- 0:30 to 4:14

My Beautiful Obsession….

Resiliency is the ability to bounce back from adversity and the development of the skills needed to manage stress in an optimal way.

Supportive Education for Returning Veterans (SERV)

Definitions Stress to be the opposite of relaxation or the physiological and psychological responses to situations or events that disturb the equilibrium of an organism. Post Traumatic Stress Disorder (PTSD) can be considered an extreme stress “disorder.” Post Traumatic Growth (PTG) refers to the positive behaviors, attitudes and skills developed by individuals in response to traumatic situations .

Victim Or Survivor?

First Response Resiliency History 2009 – Idea for Fire/EMS from SERV curriculum at University of Arizona 2009 – Sierra Vista (AZ) Fire Dept 2 day curriculum – 13 Skills 2010 – University of Arizona PD 2011 – Glendale (AZ) FD and Mesa (AZ) FD

First Response Resiliency History 2012 Colorado initiative with CDPHE Office of Preparedness and Response 2 Day Resiliency – 13 Skills Taught South Metro Fire Rescue, Littleton FR, Upper Pine River FPD 2013 – 1 Day Resiliency – 12 Skills 7 Skills Taught Aurora Theatre Shooting Responders 2014 – 1 Day Resiliency and 1 Day Train-the Trainer Rifle, Frederick and Larkspur

12 Skills of Resiliency Goal Setting Eat Right Exercise Might Relaxation Chill Out Sleep Tight Perspective Self-Defeating Thoughts ABC’s Point Out Empathy Wins and Losses Reaching Out Social Support

SOCIAL SUPPORT IS THE MOST CRITICAL SKILL

Resiliency Skill Drill 1. Review Prior Skills (0-5 minutes) 2. Introduction of the Skill (10 -12 minutes) 3. Internalize the Skill (5-10 minutes) 4. Externalize the Skill (5-10 minutes) 5. Review the Skill (5 minutes) 6. How to Effectively Remember this Skill (5 minutes) 7. Additional: Externalize to a Community (5 minutes) 8. Summarize the Skill (5 minutes) Total Time per Skill ~ 45 to 55 minutes

Questions Posed In Study Can Individuals make significant resiliency improvements within the span of several hours of intense instruction? And, if change does occur, can this change be sustained Do participants perceive training will provide them with the ability to be more resilient? In effect, is this program perceived to be beneficial in dealing with stressful events?

12 Skills of Resiliency Goal Setting Eat Right Exercise Might Relaxation Chill Out Sleep Tight Perspective Self-Defeating Thoughts ABC’s Point Out Empathy Wins and Losses Reaching Out Social Support

Aurora Theatre Shooting Responders Results From 1 Day Resiliency Training Pretest Mean = 70.5, [SD] = 10.4, 95% CI; p<0.05 Post-Test Mean = 77.2, [SD] = 8; 95% CI; p<0.05

Post-Test Mean = 81.3, [SD] = 13.1 95% CI; p<0.05 Aurora Theatre Shooting Responders Results From 1 Day Resiliency Training Convenience Sample Pretest Mean = 74.9, [SD] = 4.0 95% CI; p<0.05 Post-Test Mean = 81.3, [SD] = 13.1 95% CI; p<0.05

Questions Posed In Study Can Individuals make significant resiliency improvements within the span of several hours of intense instruction? And, if change does occur, can this change be sustained A: This study suggests resiliency characteristics can be taught effectively using compressed, one-day problem-based learning. Further, it appears within a 6 week period effects were sustained.

Questions Posed In Study Q: Do participants perceive training will provide them with the ability to be more resilient? In effect, is this program perceived to be beneficial in dealing with stressful events? A: Six-weeks post training, 14 of 15 participants responded affirmatively. Participants were unanimous in recommending the training to others.

Results have been duplicated in… Tucson, AZ with LEO Mesa, AZ with Fire Recruits Casa Grande (AZ) FD Gilbert (AZ) FD Tempe (AZ) FD Peoria (AZ) FD Rifle, CO Frederick, CO Larkspur, CO Numerous Veteran Cohorts

Journal of Emergency Medical Services (JEMS) March, 2014

Moving Forward: Train the Trainer Resilient First Responders Resilient Spouses AND Families RESILIENT COMMUNITY

For more information on providing Resiliency training in your community Mike Grill mtgrill@mindspring.com