Evaluates the structure, processes, and outcomes of the Air Force's Deployment Transition Center, which was established in 2010 to provide airmen returning from combat missions an opportunity to decompress and share lessons learned before returning to their home stations.
- What are the structure and processes of the Deployment Transition Center (DTC) program?
- Are DTC attendees satisfied with the program?
- Is participation in the DTC program associated with reduced posttraumatic stress disorder symptoms, depressive symptoms, binge drinking, or social conflicts with family and coworkers?
It is often accepted as common knowledge that military personnel benefit from decompression time between a war zone and the home station. To capitalize on the potential benefits of a decompression period paired with support services, the U.S. Air Force established the Deployment Transition Center (DTC) at Ramstein Air Base in Germany in July 2010. The DTC provides airmen returning from combat missions with an opportunity to decompress and share lessons learned before returning to their home stations.
The authors of this report evaluate the structure, processes, and outcomes of the DTC program. They find that, although a majority of participants found the DTC program worthwhile, a comparison of DTC participants and similar airmen who did not participate the program shows no evidence that the program helps reduce posttraumatic stress disorder symptoms, depressive symptoms, binge drinking, or social conflicts with family and coworkers. In addition, one of the DTC program elements appears to be similar to posttraumatic debriefing interventions, which several studies have found to be either ineffective or harmful. For these reasons, if the main goals of the DTC program are to improve behavioral health and social conflict outcomes, the authors recommend that the DTC program be discontinued or redesigned and Air Force resources invested in alternative programs. However, if the DTC program has other goals, such as providing rest and relaxation to airmen after a difficult deployment or capturing after-action information, then the authors recommend that these goals be documented and the DTC program be more specifically tailored to them.
Scientific Literature Supports Some Deployment Transition Center (DTC) Practices, but Others Are Contraindicated
- The DTC program consists of a rest and relaxation component, an after-action interview to provide feedback for leadership, a psychoeducational component on successful transitions from a deployment to home that is very similar to the Army's Battlemind program, and a component that is similar to several posttraumatic debriefing programs studied in civilian populations.
- The Army's Battlemind program has been shown to produce small reductions in posttraumatic stress disorder (PTSD) symptoms, depression symptoms, and sleep disturbance symptoms post-deployment among those with combat experiences; elements of the DTC program that borrow from Battlemind may be beneficial.
- Psychological debriefing programs — a primary prevention program involving groups of nondiagnosed individuals discussing and emotionally processing stressful incidents — have been well studied in a variety of populations and repeatedly been found to be either ineffective or harmful to participants. U.S. Department of Defense, U.S. Department of Veterans Affairs, and World Health Organization treatment guidelines for traumatized populations specifically recommend against these programs because of the lack of efficacy and potential for harm.
Most DTC Attendees Were Satisfied with the Program
- Eighty percent of DTC participants believed the program was a worthwhile experience, and 74 percent believed they were better prepared for reintegration after completing the program.
DTC Did Not Improve Measured Post-Deployment Outcomes
- A comparison of DTC attendees and a control group of airmen showed no evidence of significant reductions in PTSD symptoms, frequency of depression symptoms, binge drinking, or social conflicts attributable to DTC.
- If the main goals of the DTC program are improvements in psychological and social outcomes after reintegration, then the DTC program should be discontinued or redesigned, and resources directed to DTC should be invested in alternative programs or treatments that have been demonstrated to improve those outcomes.
- If the DTC has other goals and potential benefits, not assessed in this evaluation — such as providing airmen with well-deserved rest and relaxation following a difficult deployment, capturing after-action information that can feed into improved training and tasking, reducing stress during homecoming, or improving retention among airmen — then the program should be restructured around those alternative goals.
- Even if improving behavioral health is identified as a key program goal, remove the contraindicated program element of group processing of psychological trauma and develop policy to prevent its reintroduction.
Table of Contents
Evaluation Approach and Program Description
Review of Reintegration and PTSD Prevention Programs
Participant Satisfaction with the Deployment Transition Center
The Effects of DTC Attendance on Psychological Symptoms, Alcohol Use, and Social Conflict: A Propensity Score–Based Approach
Conclusions and Recommendations
Outcome Evaluation Using Propensity Score Matching with Synchronous Controls
Investigating the Differences Between the RAND and the Psychology Research Service Analytic Group's Analyses