Research in Trauma: Shocks, Shrinks and Statistics Crisis Intervention & Management, Australasia 1st December 2015 John Durkin PhD

Introduction Observation Hypothesis Test Results Interpretation

Write your shoe size on… A Blue Post-it if you’re a man A Yellow Post-it if you’re a woman

Stick it on the wall Round up half sizes Women right (Yellow) - men left (Blue) 7 8 9 10 11

Stick it on the wall Round up half sizes Women right (Yellow) - men left (Blue) 7 8 9 10 11

Stick it on the wall 7 8 9 10 11

Is there a difference? 7 8 9 10 11

Is there a difference? 7.7 9.0 7 8 9 10 11

Who changed? 12.5 29.5 0 5 10 15 20 25 30 35 40

Who changed? 12.5 29.5 0 5 10 15 20 25 30 35 40

Who changed? 0 5 10 15 20 25 30 35 40

Background Notts F&RS supported Dr John Durkin during his PhD at the University of Nottingham FF Paul Meakin trained in TIR, February 2014 Trained counsellor with a long interest in psychological stress Committed to the wellbeing of colleagues

Proposal Implement a peer-support programme within Nottinghamshire Fire and Rescue Service Train key individuals in Traumatic Incident Reduction (TIR) - an evidence-based approach to trauma Run a 3-month pilot project with FF Paul Meakin delivering sessions to volunteer staff 12 staff: Nine completed questionnaires

Introduction Information placed on intranet from early-2015 Nine volunteers - operational and non-operational Posttraumatic stress (incident) = 5/5 Life stress (e.g., bereavement, conflict) = 8/9 Measured: Posttraumatic stress Symptoms of depression

Posttraumatic Stress Impact of Event Scale (IES) 0 - 75: Higher scores indicate higher distress Cut-off for PTSD = 35

Depression/Happiness Short Depression-Happiness Scale 0 - 18: Lower scores indicate more depression Cut-off for depression/happiness ≈ 9

Findings Posttraumatic stress (IES cutoff for PTSD = 35) Four staff reported single incidents Pre-session = 49.8 Post-session = 24.0 Depression/Happiness (SDHS cutoff ≈ 9.0) Five staff reported unwanted problems Pre-session = 9.0 Post-session = 11.6

Findings IES SDHS Cutoff 18 15 12 9 6 3 70 60 50 40 35 30 20 10 18 15 12 9 6 3 Posttraumatic stress reduced (5/5) Depression improved (8/9) Cutoff Before After Before After

Findings IES SDHS 70 60 50 40 35 30 20 10 18 15 12 9 6 3 Before After Before After

Findings IES SDHS 70 60 50 40 35 30 20 10 18 15 12 9 6 3 Before After Before After

“Rate how these affect your life…” Additional Data All voluntary Nine meetings: all-single session 11 to 27 days from session to follow-up Average ≈ 17.5 days Individual Impact Scale 1 - 10 “Rate how these affect your life…” 1 = not affected 10 = hugely affected

Individual Impact Scale Pre-session Post-session Sleeping 7 Sleeping 1 At Work 10 At Work 2 Bereavement 10 Bereavement 6 Sleeping 9 Sleeping 2 Relationships 7 Relationships 1

Individual Impact Scale (one person) Pre-session Post-session Trust 8 Trust 2 Anger 10 Anger 7 Sleeping 8 Sleeping 1 Alcohol 8 Alcohol 2 Medication 8 Medication 0

Pilot Project: Peer Support and Traumatic Incident Reduction Nottinghamshire Fire and Rescue Service, UK June 2015

Comments: Using peers “Paul is the perfect person for this as he is a fire fighter and a trusted independent person. I cannot emphasize enough the difference he made.” “With all due respect to other professionals in this field I felt more at ease talking to a fellow firefighter about my problem.”

Comments: Using peers “Having seen psychotherapists through the NHS the fact Paul was a fire fighter made a massive difference, as I had confidence that he knew exactly what I was going through.” “It was better for me personally to be able to talk to somebody I know, trust, and relate to and know they in turn can relate to and appreciate the issue concerned.”

Comments: Effectiveness “I found the peer-support intervention a great help.” “This is a new approach and the benefits are immense. It is highly important for fire fighters to talk about their experiences, not only after recent trauma, but also for lasting trauma like PTSD.”

Comments: Effectiveness “..I felt I was better able to process my thoughts in a more positive manner and felt much better about the problem I was dealing with.” “What I can say is that all the issues that I spoke about do not actually have a thought in my head anymore it’s as though they have been cleansed and dealt with.”

Comments: Recommendations “There will be no hesitation on my part to advocate this to any of my colleagues.” “I certainly highly recommend your services to anyone that may require any further assistance from you…” “If it would help the project then I am happy for my name to be disclosed… Thanks mate.”

Conclusion Shocks, Shrinks and Statistics Does a scale really measure trauma? If you don’t measure it it doesn’t exist Group statistics mask individual changes Ask individuals to endorse (or challenge) the changes

Research in Trauma: Shocks, Shrinks and Statistics Crisis Intervention & Management, Australasia 1st December 2015 John Durkin PhD