The U.S. Department of Defense has implemented many programs to support service members experiencing difficulties handling stress, mental health problems, or deficits caused by a traumatic brain injury. This report describes RAND's assessment of one such program, Airman Resilience Training (ART), an Air Force psychoeducational program designed to improve airmen's reactions to stress during and after deployment.
An Evaluation of the Implementation and Perceived Utility of the Airman Resilience Training Program
- Is the targeted population receiving the briefing?
- Is the briefing appropriate for enabling comprehension and impact of the material?
- Is delivery of the briefing consistent with provided guidelines?
- How useful do deploying and reintegrating airmen find the briefing material?
- After receiving the briefing, do deploying airmen perceive they are now prepared to cope with stress in theater?
- How do reintegrating airmen compare Airman Resilience Training with resilience training programs received prior to deployment?
- To what extent did reintegrating airmen report utilizing skills and coping mechanisms while in theater discussed in resilience training programs prior to deployment?
Since 2001, the U.S. military has been functioning at an operational tempo that is historically high for the all-volunteer force in which service members are deploying for extended periods on a repeated basis. Even with the drawdown of troops from Iraq in 2011, some service members are returning from deployment experiencing difficulties handling stress, mental health problems, or deficits caused by a traumatic brain injury (TBI). In response to these challenges, the U.S. Department of Defense (DoD) has implemented numerous programs to support service members and their families in these areas. In 2009, the Assistant Secretary of Defense for Health Affairs asked the RAND National Defense Research Institute to develop a comprehensive catalog of existing programs sponsored or funded by DoD to support psychological health and care for TBI, to create tools to support ongoing assessment and evaluation of the DoD portfolio of programs, and to conduct evaluations of a subset of these programs. This report describes RAND's assessment of an Air Force program, Airman Resilience Training (ART), a psychoeducational program designed to improve airmen's reactions to stress during and after deployment and to increase the use of mental health services when needed. ART was initiated in November 2010, replacing a previous program named Landing Gear, which had been in place since April 2008. The RAND study took place from August 2011 through November 2011. This report will be of particular interest to officials within the Air Force who are responsible for the psychological health and well-being of airmen, as well as to others within the military who are developing programs for service members to help them cope with stress while in combat situations and after returning from deployment.
Airman Resilience Training (ART) may not be meeting its intended goals of promoting the resilience of deploying airmen and supporting the reintegration of returning airmen for two reasons:
1: Implementation of ART Varied Due to Logistics Constraints Placed on Briefers and Briefers' Oral Presentation Skills or Deployment Experience
- Briefers had limited time to convey the content in ART. Some briefers followed the slides closely or exemplified content with relevant statistics or anecdotes, as recommended in the training manual. However, no ART briefings included participant discussion, no airmen ever asked any questions, and most airmen appeared disengaged with the briefings, as exemplified by distracted behaviors.
2: Perceived Usefulness of ART Was Generally Low
- The ART briefing was delivered to airmen in tandem with a long list of required briefings, many of which occurred on the same date as ART. Therefore, many respondents felt they were inundated with information on the same day and reported "tuning out" to ART.
- Teaching resilience skills through a set of briefing slides did not seem to encourage active learning of concrete coping skills, but rather the passive absorption of information and discouraged active participation by audience members.
- ART was presented to all audience members in each session in the same way, without recognition that each audience included airmen with different deployment experiences, missions, or combat experience.
- Informants reported that the information provided within the slides was often vague, and the specific behavioral coping skills and topic areas they view as important were not covered.
RAND recommended that the Air Force conduct assessments to identify the best goals, structure, and content of ART to ensure that it is provided in an effective and efficient manner. One assessment should determine the range of resilience training needs of airmen. Another assessment should determined which resilience training needs are already being met through other training programs and which need to be a part of ART. If leadership determines to retain ART in its current format, RAND recommended improving the content and delivery of ART in the following ways:
- Design the content to meet the needs of specific intended audiences.
- Allow airmen more choice in the resilience training they receive.
- Focus on skills training in ART.
- Incorporate engaging anecdotes and examples in a standardized way.
- Work to obtain buy-in from Air Force personnel who are involved with implementation and delivery.
- Recalibrate the scope of material covered or the timing allowed.
- Minimize the extent to which the resilience training takes staff resources away from treatment activities.
- Institute criteria for who should brief ART.
- Ensure that briefers receive clear guidance and training on how to deliver ART and what content to cover.
- Reconsider solely using Power Point slides as the primary medium for delivering resilience information.
- Track implementation.
Table of Contents
Findings from the Site Visits: Delivery of ART
Findings from the Site Visits: Perceived Usefulness of ART's Content
Key Findings and Suggestions for Improvement
Airmen Resilience Training PowerPoint Slides and Manual
Structured Observation Tool
Protocol for Discussion Sessions with Deploying and Reintegrating Airmen
Protocol for Interviews with Chief Mental Health Officers and Their Staff