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The Journal of Positive Psychology
Dedicated to furthering research and promoting good practice
Volume 16, 2021 - Issue 5
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Articles

Can resilience training improve well-being for people in high-risk occupations? A systematic review through a multidimensional lens

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Pages 573-592 | Received 31 Jan 2020, Accepted 13 Mar 2020, Published online: 27 Apr 2020
 

ABSTRACT

Background: Psychological resilience may be central to Positive Psychology as one way to face the dark side of life. But is resilience training universally effective? This paper initiates a systematic review of primary research on resilience training in high-risk occupations.

Methods: Examined resilience training outcomes and conducted analysis from a multidimensional perspective.

Results: Thirty-three papers totalling 10,741 participants, 12 occupations, and eight countries. Although 81% (n = 118) of Principal Outcomes reaching statistical significance showed improved well-being, resilience training was less effective in populations with prior trauma exposure or already experiencing the negative sequelae of trauma.

Conclusion: Given the moral imperative to adequately prepare people in high-risk occupations for exposure to adverse stressors, further research is recommended into improving the effectiveness of resilience training for those already with primary or vicarious trauma exposure; and whether such training should also be offered to close family and co-workers of people in high-risk occupations.

Acknowledgments

Thank you to Ian Hesketh, Alan Card, Summer Thompson, Siobhan O’Neill, Nick Brown, and Giselle Perez for sharing your research (for free) and your enthusiasm for this subject.

Thank you to Lieutenant Colonel Karl Frankland RLC for the genesis of this research idea. May the psychological protective qualities of resilience training be made available to all who serve so selflessly unpicking old and new bombs, wherever and why-ever the world needs you to do it.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. Figures from the US Department of Defense dated October 2015 https://www.npr.org/2015/10/28/451146230/missed-treatment-soldiers-with-mental-health-issues-dismissed-for-misconduct in (Zwerdling & De Yoanna, Citation2015).

2. The emergence of the movement ‘drop the D’ reflects a recent shift away from psychiatric classification of mental illness towards a more sensitive ethnographic descriptor through the experiences of people acquiring mental illness after experiencing traumatic events such as combat (Smith & Whooley, Citation2015); however, many of the studies in this current paper have used the term PTSD, and so the term PTS and PTSD have been used interchangeably.

3. Transgenerational Trauma: when the psychological consequences of parental trauma detrimentally impact their interaction with their children (Hanna et al., 2012 in Fitzgerald et al., Citation2017) to the extent that the children inadvertently hold trauma-related beliefs or display symptoms of trauma without being aware of its origin (Banyard et al., Citation2001; Cherepanov, Citation2016), a phenomenon supported by the research into Developmental Childhood Trauma (Stevens, Citation2013; Van der Kolk, Citation2014, Citation2017).

4. Though adult employment rights and rules apply in the UK at age 18, some high-risk occupations such as the British Army allow people aged 16 years to join as junior soldiers and to apply for the Regular Army at 17 years and 9 months. Basic training commences, but soldiers cannot deploy on operations until they are 18 (MOD, Citation2018). Worldwide, 37 countries also recruit from the age of 17 (ForcesWatch, Citation2011). Basic training is a time when some resilience training may be delivered, and this study wishes to be able to capture such data, if relevant by setting the lower age parameter at 17.

5. Accordingly, studies on elite sportspeople were considered with one on elite high-altitude climbers (Crust et al., Citation2016) excluded as no training was delivered; and one on elite young cricketers (Bell et al., Citation2013) included as participants were in training for GB national professional cricket careers.

6. With the exception of the elite GB cricketers study (Bell et al., Citation2013) mentioned above.

7. NOTE – the categorising of Principal Outcomes into these LIFE quadrants required a subjective assessment by the researcher, as this model is designed to be ‘content free: rather than advocating theories in a given area, extant theories and research from that area can be situated within the quadrants’ (Lomas et al., Citation2014, p.11). Transparency note-keeping on the spreadsheet and self-reflection were used to mitigate against this potential source of bias during categorising.

8. Most studies do multiple measures of a number of outcomes, so this column represents the number of studies measuring the Outcomes listed.

9. Groups exhibited partial rebound decline in scores at 6–12 months but then recovered. ‘Evidence of rebound in general is not unexpected as PTSD, depression, and anxiety are often more chronic than acute conditions. (Roy et al., Citation2017, p. 475).

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