An Assessment of the Army's Tactical Human Optimization, Rapid Rehabilitation and Reconditioning Program
RAND Health Quarterly, 2013; 3(2):8
RAND Health Quarterly, 2013; 3(2):8
RAND Health Quarterly is an online-only journal dedicated to showcasing the breadth of health research and policy analysis conducted RAND-wide.
More in this issueIn 2009, U.S. Special Operations Command provided U.S. Army Special Operations Command with funds to establish the Tactical Human Optimization, Rapid Rehabilitation and Reconditioning (THOR3) program, an investment reflecting “truth number 1” of special operations forces: “Humans are more important than hardware.” The goals of THOR3 are to increase the physical and mental capabilities of Army special forces, help these soldiers recover more rapidly from injuries sustained in combat or training, and help them stay healthy and able to contribute longer. The program differs from other Army fitness programs in several important ways, including its holistic approach to improving physical and mental performance, its focus on individual and unit needs, and its reliance on a professional staff of program coordinators, strength and conditioning coaches, physical therapists, dietitians, and cognitive enhancement specialists to deliver training and rehabilitation services that are on par with those provided to professional sports teams. U.S. Army Special Operations Command asked RAND Arroyo Center to determine whether THOR3 is effectively utilizing the resources provided and to identify opportunities for improvement in the program's planning and implementation, staffing (including hiring and retention), leader development and education, facility and equipment requirements, and ability to support participating personnel.
Special operations forces (SOF) are among the most capable in the U.S. Department of Defense (DoD) in terms of both their skills and their physical abilities. To maximize these abilities, help prevent injuries, and increase the length of time these soldiers spend in the force, in 2009, U.S. Special Operations Command (USSOCOM) provided U.S. Army Special Operations Command (USASOC) with funds to establish the Tactical Human Optimization, Rapid Rehabilitation and Reconditioning (THOR3) program. The program aims to increase the physical and mental capabilities of SOF soldiers, help them more rapidly recover from injuries sustained in combat or in training, and help them stay healthy and able to contribute longer.
The THOR3 program was implemented in 2010, and there are plans to expand it to all USASOC commands. The program currently has a small headquarters office under the USASOC Deputy Chief of Staff, Surgeon, and unit-level programs in the special forces groups (SFGs), the Ranger Regiment, the 160th Special Operations Aviation Regiment (SOAR), the U.S. Army John F. Kennedy Special Warfare Course and School (SWCS), and battalions of these operational units that are stationed in other locations. Each unit-level program consists of a human performance program coordinator and a given number of strength and conditioning coaches, physical therapists, dietitians, and cognitive enhancement specialists.*
In anticipation of the program's expansion, USASOC asked RAND Arroyo Center to determine whether THOR3 is effectively utilizing the resources provided, with a particular emphasis on military, Army civilian, and contractor staffing. RAND was also asked to identify options for improving the program across the domains of doctrine, organization, training, materiel, leadership and education, personnel, facilities, and policy (DOTMLPF-P).
This study involved extensive interviews with THOR3 staff and consumers, site visits to several USASOC locations and collegiate sports and U.S. Olympic training facilities, and a review of subject-matter expertise in the fields examined.
The following findings and recommendations are of general importance to USASOC, and they concern all elements of the THOR3 program.
The decision about who participates in THOR3 is a command-level issue and affects funding for personnel, facilities, and equipment. There is a difference between how USSOCOM views the decision about which soldiers and units should participate in THOR3 and how that decision is viewed by USASOC leadership and staff. According to USASOC staff, USSOCOM has indicated that the program should be limited to “18-series” soldiers who are in special forces groups, soldiers in Ranger units, and selected personnel from the 160th SOAR. Restricting participation to this level would have a significant effect on personnel and facilities funding in particular. USASOC leaders feel that THOR3 should be open to all USASOC soldiers, and they have prepared personnel requests that reflect this.
The degree of decentralization of THOR3 program execution will affect both staffing and how the program operates. Currently, the program operates in an almost completely decentralized manner. This is appropriate for some functions (e.g., strength and conditioning), but it is less than ideal in other areas (e.g., cognitive enhancement)—at least in the short term. The ability to provide oversight and support, collect and disseminate best practices, develop funding requests for expensive items (such as cognitive enhancement equipment), and conduct assessments will be directly affected by USASOC leadership preferences for how the program is run. Our findings indicate that there are benefits to a decentralized approach if it can be adopted without significant loss of technical functionality. However, the development of program coordinators, oversight of cognitive enhancement (until it is a mature part of THOR3 and accepted by the USASOC community), and, possibly, the performance of certain administrative functions (e.g., best practices and assessments) will require leadership and real capability at the THOR3 headquarters office because USASOC is unlikely to be able to hire fully developed program coordinators.
The current THOR3 headquarters staff will be adequate only if its role is very modest—if it focuses on performing routine administrative tasks and coordinating the program. The headquarters office is not staffed to allow it to perform a substantive oversight role or to provide cross-USASOC management in any significant way (e.g., assessment of unit-level programs, advice or direction on technical matters). USASOC's request for staff includes a THOR3 headquarters office of six: a program manager; subject-matter experts in strength and conditioning, physical therapy, and dietetics; and an administrative specialist (all roles to be filled by Army civilians), as well as a data manager (contractor). This structure is likely adequate, with the possible exception of oversight for cognitive enhancement.
Finally, we note that one important element of USASOC is not included in THOR3 or this analysis: the reserve component. To the extent that reserve SOF soldiers are part of future operational plans, there should be a way to provide them with best practices and lessons learned from THOR3, if not full access to training and facilities.
The following findings and recommendations address each component across the range of the Army's DOTMLPF-P domains. They are presented in an order that reflects USASOC's primary concerns and the areas that are most important to the program, rather than in the traditional order.
Findings and recommendations regarding organization address both requirements for personnel of a certain type and the structure of the program. Together, these two components define the program and what it can do.
Properly articulated and validated requirements define the capabilities of the program, provide clear guidance on the roles of all players, help with hiring and retaining the right people, and provide needed information for the administration of the program. Interviews with ten THOR3 program staff in units at the O-6 and O-5 levels identified disconnects between the conceptual design of the program and its implementation. This finding may indicate a lack of knowledge of cognitive enhancement on the part of the unit-level human performance program coordinators. Some of these disconnects could be addressed by better statements of requirements.
Findings and recommendations that should help USASOC and the THOR3 headquarters office in this area are as follows:
Along with validated requirements, the structure of the program is critical to determining its capabilities. Key findings and recommendations in this area include the following:
Given an adequate structure, the next question is whether THOR3 can attract and retain the right people to run the program in the right numbers. This includes the ability to define positions in ways that will permit USASOC's human resource managers to attract high-quality applicants and screen out inadequate ones. Hiring human performance program coordinators (whose specialty is strength training and conditioning) has been problematic due, in part, to the lack of a specified job series for this specialty and inadequately defined job criteria. One option for solving the problem of inadequate job candidates being nominated for positions is direct hiring authority—that is, authority that would permit USASOC to hire personnel outside the typical practice in which the personnel system advertises a job, screens applicants based on specified criteria, and nominates the candidate who is “best qualified” for the job. Also important to USASOC is whether THOR3 personnel should be Army civilians or contractors. In our interviews, USASOC THOR3 personnel at the headquarters and program levels indicated a strong preference for Army civilians because they can be expected to stay with the units they support longer and may be more committed to those units. However, the experiences of similar programs indicate that contractors have also worked out well. Finally, all four of the specialties in THOR3 (strength and conditioning, physical therapy, performance dietetics, and cognitive enhancement) are expected to be in high demand nationally. THOR3 will have to compete to attract and retain these specialists in a competitive job market.
Our findings and recommendations in this area are as follows:
This research found some actual and potential gaps in the skills of program coordinators that the THOR3 program will need to address. In particular, current job descriptions do not indicate the need to manage moderately sized programs spread across multiple locations (in some cases), and our interviews found a lack of understanding of cognitive enhancement, generally. Furthermore, program coordinators must supervise staffs made up of medical and non-medical personnel.
The THOR3 program currently has no formal ability to develop its leaders or provide education for its staff. The responsibility is left to the individual staff member and the unit-level program coordinator to ensure that staff members stay technically proficient and develop appropriately. This is common practice for medical personnel who must keep current on their technical skills. However, it does not prepare program coordinators and other staff for supervisory positions.
Our specific findings and recommendations for leader development and education are as follows:
USSOCOM has determined (though not published) criteria for human performance program facilities. None of USASOC's facilities currently meet this standard, though the 1st Special Forces Group facility comes close. To address this shortfall, we offer the following findings and recommendations:
Of the areas examined in this research, materiel considerations pose the fewest problems for USASOC. The current decentralized approach, in which USASOC units purchase equipment out of their operating budgets, seems to work well. The one potential concern, due to its cost (approximately $400,000 per SFG), is cognitive enhancement equipment, which is not yet fielded at the unit level. The following findings and recommendations address the THOR3 program's materiel needs:
The USSOCOM initial capabilities document that stipulates the requirements for and goals of THOR3 articulates a target of 20-percent improvement in all aspects of human performance, rehabilitation, and recovery. According to the experts interviewed for this study, as well as USSOCOM staff responsible for overseeing THOR3 and similar programs in other USSOCOM commands, these expectations are unrealistic; because these soldiers already maintain a high level of fitness, such large improvements are impossible. Consequently, developing assessment protocols to demonstrate that THOR3 is meeting these expectations is not in the best interest of USASOC. Furthermore, there are no well-defined assessment tools for cognitive capability, which makes measurements in this field problematic. Our specific recommendations are as follows:
Little can be said about the doctrine or policies that THOR3 could affect. However, if it did have such an impact, it would most likely be in the way that the Army conducts physical fitness training overall. Good practices from THOR3 should be replicated throughout the Army to the extent that this can be done safely without a large, professional coaching staff to supervise physical training.
THOR3 is an innovative program that is intended to support the development and maintenance of USASOC's most important—and hard-to-create—asset: SOF soldiers. Despite the absence of adequate data to quantitatively demonstrate that its goals are being achieved, the logic behind the program's design appears sound. The Army should consider conducting further research into a THOR3-like program for reserve-component forces, along with longitudinal research and assessments of how such an initiative could be more useful to broader communities of interest (such as the military medical community and the U.S. Army in general).
Comprehensive Soldier Fitness-Performance and Resilience Enhancement Program, homepage, undated. As of November 1, 2012:
http://csfprep.army.mil
* Cognitive enhancement is a formal part of the Army's comprehensive soldier fitness program, which seeks to provide “a systematic way to build mental and emotional strength for Warriors, family members, and DA Civilians” (see Comprehensive Soldier Fitness-Performance and Resilience Enhancement Program, homepage, undated, for details). The THOR3 program has both adopted this approach and adapted it to the SOF mission and warrior.
The research described in this article was sponsored by the United States Army and conducted by the RAND Arroyo Center.
RAND Health Quarterly is produced by the RAND Corporation. ISSN 2162-8254.
Explore RAND Health Quarterly articles on PubMed