Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers

Pacific University

Status: Completed

Conditions: Aggression; Stress, Psychological

Treatments: Behavioral: Stress Management Education; Behavioral: Mindfulness-Based Resilience Training

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03784846

U01AT009841 (U.S. NIH Grant/Contract)

1295787-14

Details and patient eligibility

About

Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. The proposed study will identify, optimize and refine best clinical and research practices across two sites to ensure success in a future multisite efficacy trial assessing preventative effects of Mindfulness-Based Resilience Training on physiological, behavioral, and psychological outcomes.

Full description

Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to devastating consequences for their community, including unjustified shootings, severe beatings, and fatal chokings. It can also lead to serious consequences for the LEOs, including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little evidence to demonstrate that such approaches are effective, highlighting the urgent need for preventive interventions targeting the stress inherent to policing. Mindfulness training is a promising approach with high-stress populations that has been shown effective in reducing stress and increasing resilience. In a recent pilot feasibility study (R21AT008854), the study team established initial feasibility, acceptability, and adherence to procedures in a single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive intervention designed to improve LEO mental health and resilience, and reduce aggression and excessive use of force. The R21 data suggest physiological mechanisms and potential clinical benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed improvements in stress reactivity, aggression, burnout, occupational stress, sleep disturbance, and psychological flexibility. Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of MBRT versus an attention control (Stress Management Education) and a no-intervention control, on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, this study will: a) enhance efficiency of recruitment, engagement and retention; b) optimize lab, assessment, and data management procedures; c) optimize intervention training and ensure fidelity to intervention protocols; and d) assess participant experience and optimize outcome measures across sites. The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience among LEOs, as well as yield significant benefits for communities and residents they serve.

Enrollment: 109 patients

Sex: All

Ages: 21 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• be 21-65 years old (age limitations for both police departments),
• demonstrate English fluency,
• be a sworn, full-time, active status law enforcement officer,
• agree to random assignment to condition, and
• be willing to complete assessments at multiple time points and attend intervention groups

Exclusion criteria

• previous participation in MBSR, MBRT or a similar mindfulness course,
• score in the severe range on brief screening measures of depression, suicidal ideation, alcohol use, or PTSD, or
• unable or unwilling to give written informed consent.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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109 participants in 3 patient groups

Mindfulness-Based Resilience Training

Experimental group

Description:

MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, cognitive behavioral therapy (CBT), and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.

Treatment:

Behavioral: Mindfulness-Based Resilience Training

Stress Management Education

Active Comparator group

Description:

SME was designed as an active control condition for other mindfulness-based intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.

Treatment:

Behavioral: Stress Management Education

No Intervention Control

No Intervention group

Description:

No contact control condition (other than baseline, post, and follow-up assessments)