Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers
Condition: Stress, Psychological; Aggression
MeSH terms: Aggression; Stress, Psychological
Study type: Interventional

Summary: 
      Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk
      for aggression and excessive use of force, as well as mental health consequences, including
      post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. The
      proposed study will identify, optimize and refine best clinical and research practices across
      two sites to ensure success in a future multisite efficacy trial assessing preventative
      effects of Mindfulness-Based Resilience Training on physiological, behavioral, and
      psychological outcomes.
    

Detailed description: 
      Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk
      for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to
      devastating consequences for their community, including unjustified shootings, severe
      beatings, and fatal chokings. It can also lead to serious consequences for the LEOs,
      including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse,
      depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little
      evidence to demonstrate that such approaches are effective, highlighting the urgent need for
      preventive interventions targeting the stress inherent to policing. Mindfulness training is a
      promising approach with high-stress populations that has been shown effective in reducing
      stress and increasing resilience. In a recent pilot feasibility study (R21AT008854), the
      study team established initial feasibility, acceptability, and adherence to procedures in a
      single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive
      intervention designed to improve LEO mental health and resilience, and reduce aggression and
      excessive use of force. The R21 data suggest physiological mechanisms and potential clinical
      benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed
      improvements in stress reactivity, aggression, burnout, occupational stress, sleep
      disturbance, and psychological flexibility. Implemented at two sites, the proposed study is
      designed to establish optimal protocols and procedures for a future full-scale, multi-site
      trial assessing effects of MBRT versus an attention control (Stress Management Education) and
      a no-intervention control, on physiological, behavioral, and psychological outcomes. To
      prepare for this future clinical trial, this study will: a) enhance efficiency of
      recruitment, engagement and retention; b) optimize lab, assessment, and data management
      procedures; c) optimize intervention training and ensure fidelity to intervention protocols;
      and d) assess participant experience and optimize outcome measures across sites. The
      long-term objective of this line of research is to develop an intervention that will reduce
      violence and increase resilience among LEOs, as well as yield significant benefits for
      communities and residents they serve.
    

Intervention name(s): Mindfulness-Based Resilience Training; Stress Management Education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, CBT, and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.; SME was designed as an active control condition for other Mindfulness-Based Intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Individually-Randomized Group Treatment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention