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Trauma Resilience in UK Policing

 

 

A feasibility study of post-incident trauma processing techniques (Randomised Controlled Trial design) was conducted between March 2018 - March 2019 with over 70 new recruits at Greater Manchester Police after the arena attack. Findings showed the techniques to be teachable and immediately effective in increasing sense of ease and safety around difficult incidents and recall. Results indicated that the trauma processing techniques:

  • Significantly improved ease of wellbeing about incidents to which they are applied (with large effect sizes), 
  • Improved recall (with over 65% remembering between one and ten new details about what happened),
  • Established a sense of safety and closure around incidents (with 99% of participants successfully recalling and applying ‘safety sues’ to their memory of the difficult incident) 
  • Are teachable and well-received, with high levels of advocacy (over 60% were likely to find it easy to apply the techniques to incidents in the future and over half expecting to share the techniques with peers, family and friends).

For more information about training in trauma processing, visit Police Care UK here.

With a call from the Police to improve post-incident support and the neuropsychological understanding of how this can be achieved, the Trauma Resilience in UK Policing project successfully conducted a 2-year trial of trauma-processing techniques in 2017. Results published in 2019 suggest the techniques to be immediately effective in improving a sense of ease and safety around traumatic scenarios and improves recall. The study shows the techniques to do no harm, proves the concepts that trauma processing techniques are a) teachable and b) that their application in operational policing is both feasible and well-received. The techniques are now being delivered through a ‘Train-the-Trainer’ modelled programme by Police Care UK. 

Why trauma processing techniques? 

In 2016, serving and former police officers across the UK called for more support after attending difficult or traumatic incidents on the job (2016 Injury on Duty Report by the Police Dependants’ Trust, now Police Care UK). In the same year, new evidence from neuropsychology suggested that trauma processing can be enhanced by stimulating hippocampal processing in the brain (see Miller et al., 2017 for a review). 

Amid the wave of terror attacks in 2017 and in particular in the wake of the Manchester arena attack in 2017, the need to understand what can be done to enhance and protect trauma resilience in policing became a pressing public issue. 

In 2018, the University of Cambridge and Police Care UK engaged with over 18000 to ask important questions about trauma management and wellbeing in forces, and in doing so established the first UK police PTSD prevalence rate (1 in 5) and the first-ever Complex-PTSD prevalence rate (12%) in a working population (Brewin, Miller, Soffia et al., 2019 in press). The survey 'Policing: The Job & The Life' revealed that over 2/3 of officers and staff on the front line had 'insufficient opportunity to make sense of traumatic incidents' before moving on to the next job and over half reported that trauma was 'not well managed' in their force.  

Providing officers and staff with quick, simple and effective techniques to apply post-incident to improve trauma resilience is a sensible solution to help minimise complex disorder emanating from a job like no other. 

What did we do?

Forty-six new recruits were taught and practised new trauma processing techniques over a period of three days in May 2018, then refreshed with a 2-hour session in August 2018. Twenty-six officers formed a control group who were trained in February 2019. The research team monitored the level of trauma impact on these 70+ participants every 4 weeks until April 2019.

The techniques involved testing specific forms (allocentric and egocentric) of spatial memory using drawing and mapping as well as episodic memory through the generation of extended timelines. Allocentric spatial processing is considered useful in trauma processing and has been used clinically for many years (Smith et al., 2015; Miller et al., 2017). The techniques have also been used in the forensic investigations and the Cognitive Interview to improve witness recall (Dando et al., 2008; Hope et al, 2013). The techniques are paper-based and materials comprised a participant workbook, Visual Assessment Scales on ease-of feeling and training presentations. 

What were the results?

The techniques significantly improved how “at ease” individuals felt about the difficult incidents, with a large effect size. Ninety-nine percent of participants were able to recall and use “safety cues” to reset the stress response. The techniques also improved recall with over 65% of participants remembering between one and ten new details about what happened.

Feedback on the accessibility of the training and how it is best put to operational use (as well as our data from the trial) all came together in our paper in Police Journal: Theory, Practice, Principles in July 2019. The paper is available from SAGE publications and we hope its findings will resonate with- and have implications for- policing beyond trauma resilience, including post-incident operational practice, force resilience programmes, therapeutic interventions and wider forensic investigation.

Access the full article published in the Police Journal through SAGE Publications, here.

What now?

The techniques training has been devloped using the data from the feasibility study, peer review and feedback from participants throughout the trial. A 'Train-the-Trainer’ course is being offered to police forces and networks across the UK with the capacity to train 4-5 trainers and 50+ officers at a time. Those trained will then be assessed delivering a 1 day (or half-day) course to 10-15 trainees to gain accreditation through Police Care UK. 

One-off one-day TIPT, TIPT Plus and Counter Terrorism training courses will also be hosted and delivered by Police Care UK periodically through 2020.

The courses will include a new animation explaining how the techniques work and a short film showing officers and inspectors applying the techniques on-the-job in real operational policing scenarios. The courses come complete with training presentation, workbooks for officers to keep, online feedback forms, competency assessments for Trainers and certificates of attendance and accreditation. 

Course content includes an introduction to police wellbeing, psychoeducation on the brain and trauma processing, techniques practice and a short session on atypical or secondary trauma processing for specialist roles such as Child Sexual Exploitation, 999 Call Handling, Firearms, Post-Incident Procedures, Family Liaison and Counter Terrorism.

The basic TIPT training takes 3 hours. TIPT-Plus takes an additional 2 hours. Train-The-Trainer training for those new to the techniques requires a full day. Train-The-Trainer training for those who have already attended a TIPT session only requires 2 hours. Accreditation requires 10-15 recruiting officers and staff from forces to be trained by the Trainer being assessed. Accreditation typically takes place in force. 

References

  • Brewin, C.B., Miller, J.K., Soffia, M., Peart, A., Burchell, B. (2019 in press). Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in U.K. Police Officers. Journal of Consulting and Clinical Psychology.
  • Dando C, Wilcock R and Milne R (2008) The cognitive interview: the efficacy of a modified mental reinstatement of context procedure for frontline police investigators. Applied Cognitive Psychology 23: 1. 
  • Hope L, Mullis R and Gabbert F (2013) Who? What? When? Using a timeline technique to facilitate recall of a complex event. Journal of Applied Research in Memory and Cognition 2: 20–24.
  • Miller J (2016) Navigating trauma: How PTSD affects spatial processing, Police Professional 532: 12–17. 
  • Miller JK, McDougall S, Thomas S, et al. (2017a) The impact of the brain-derived neurotrophic factor gene on trauma and spatial processing. Journal of Clinical Medicine 6: 108. 
  • Miller JK, McDougall S, Thomas S, et al. (2017b) Impairment in active navigation from trauma and post-traumatic stress disorder. Neurobiology of Learning and Memory 140: 114–123.

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