Printer-friendly versionA. Specific Aims
The initial objective will be to build the infrastructure necessary to implement the SR® process systemically across several parameters and locations worldwide. This will permanently put in place all the support staff within the Military to continue to administer and supervise the SR® process and its ability to effectively intervene in the US Military PTSD crisis, curtail and eradicate combat warrior suicide, and intervene in numerous other depressive disorders experienced by US Military warriors and their families. There will be three steps involved in implementing the SR® process and building the initial infrastructure. Within four weeks after implementation, we will have the initial infrastructure to begin warrior and family data collection in three locations. Additional locations will be designated by the Military .
Step 1- Administer SR® Certifications to selected US Military personnel systemically:
- Applicable Medical Service psychiatrists, doctors, PAs, psychologists, nurses, and mental health personnel
- Applicable Support/Service Center Counselors and staff
- Chaplains and staff
- Retention/separation counselors
- Other US Military-designated personnel
Implementation
SR® Certifications will happen over a five day period, as follows:
Monday and Tuesday Certification - 5.5 hours per day, with the core of the Burris SR® program presented.
Wednesday and Thursday Workshops – Workshops will be conducted with identified PTSD/suicidal US Military warriors , along with the Certification group, to observe how a Workshop is conducted. These Workshops will be two to three hours per day with data collection, preceded with a structured workshop program outline, and followed by a clinical debrief of the workshop, led by SR® Institute staff.
Friday Follow-Up Workshop – Friday will be an all-day, follow-up workshop involving all US Military command SR® Certified personnel and SR® Institute staff, discussing the SR® methodology, the Wednesday and Thursday workshops with PTSD/suicidal-identified personnel, and future command implementation of the SR® Program. We will concentrate on the data reduction from the pre and post Emotional Checklists, Behavior Control Checklists, Relationship Satisfaction Surveys, and certification satisfaction/success surveys.
All personal Certified in the SR® process will be licensed to print as many of the Workbooks for Warriors, Adults and ages 7-17 as they need. This will allow effective implementation of the SR® process with groups or individuals, live or online.
Step 2 – US Military Command Certified SR® personnel and SR® Institute staff administer the SR® Program to selected US Military Combat and Noncombat-experienced Personnel as follows:
- Identified PTSD/suicidal US Military combat-exposed warriors and their spouses and children(7-17 year old children and young adults living at home)
- Returning From Combat Zone warriors and their spouses and children (7-17 year old children and young adults living at home) (PTS and PTSD SR® counseling)
- Pre-deployment to Combat Zone warriors and their spouses and children (7-17 year old children and young adults living at home) (preventive SR® counseling)
- Alert personnel and crews
- Local trauma incident victims/personnel
- Military/air Police
- Stockade/Article 15 NJP confines/detainees
- Spouse/child abuse perpetrators and victims
- Alcohol and chemical abuse identified personnel and their spouses
- Military dependents with identified mental health issues/problems
- Military instructors
- Overseas military schoolteachers (elementary through high school)
Implementation
SR® Program Workshops (and ongoing SR® treatment) will be conducted by US Military Command SR® Certified personnel and SR® Institute staff over a two day period, as follows (Ongoing SR® treatment will be administered by US Military Certified SR® personnel only):
US Military warriors identified or diagnosed as “at risk” for PTSD/suicide, and their families, will receive an intensive two day workshop with an immediate third day follow-up intended to stem and stop the most serious outcomes involving these “at risk” conditions, with provision for a fourth and fifth day, if deemed necessary. Data collection will take place before each workshop, at the completion of the SR® process and at every follow-up. This Workshop will be conducted by the joint US Military Certified SR® personnel and SR® Institute staff. Following this intensive SR® Workshop, Warriors and families will be scheduled to receive ongoing weekly (or more frequent suicide-prevention) 1-2 hour treatment administered by US Military SR® Certified personnel. This ongoing weekly treatment frequency will continue for at least a six month period, with monthly visits during months 7-12, and release to annual visits by Certified US Military SR® staff. All frequency of treatment intervals will be pragmatic, and determined by our data collection process in the warriors/family recovery from PTSD and suicidal risk.
Returning from Combat Zone warriors not identified or diagnosed with PTSD or suicide symptoms, and their spouses and applicable children will receive an intensive two day Burris SR® Workshop conducted by US Military command SR® Certified staff assisted by SR® Institute staff. Identified warriors and family members in need of additional SR® treatment as described above, will continue to receive SR® treatment.
Pre-deployment to Combat Zone Warriors and their spouses and children (7-17 year old children and young adults living at home) will receive an intensive two day SR® Workshop administered jointly by certified US Military personnel and SR® Institute staff. Identified warriors and family members in need of additional SR® treatment as described above, will continue to receive SR® treatment.
Alert personnel and crews, and their spouses and children (7-17 year old children and young adults living at home) will receive an intensive two day SR® Workshop administered jointly by certified US Military personnel and SR® Institute staff. Identified warriors and family members in need of additional SR® treatment as described above, will continue to receive SR® treatment.
Military/air Police, Stockade/Article 15 NJP confines/detainees, and Military instructors will receive an intensive two day SR® Workshop administered jointly by certified US Military personnel and SR® Institute staff. Identified warriors and family members in need of additional SR® treatment as described above, will continue to receive SR® treatment.
Overseas military schoolteachers (elementary through high school), Local trauma incident victims/personnel, Spouse/child abuse perpetrators and victims, Alcohol and chemical abuse identified personnel and their spouses, Military dependents with identified mental health issues/problems, and other US Military-identified personnel will receive an intensive two day SR® Workshop administered jointly by certified US Military personnel and staff. Identified warriors and family members and other personnel in need of additional Burris SR® treatment as described above, will continue to receive SR® treatment.
Step 3 - Personnel to Receive Master Burris SR® Certification:
- 1-2 US Military Command staff personnel at each command/base
- 1-2 persons at each US Military medical facility
- 1-2 persons at each US Military Support/Service Center
- 1-2 Chaplains at each US Military base
- 1-2 military instructors at each US Military base
- 1-2 DOD schoolteachers at each applicable US Military school
Implementation
Master Certification of the SR® process will be accomplished by Master Certified SR® Counselors for 6-12 US Military command personnel identified above. These Master SR® Certified personnel will then be able to perpetuate the administration of the SR® Process on a continuing basis.
Each US Military Certified SR® person can receive Master Burris SR® Certification after accomplishing the following:
- Administer the SR® process to at least 10 groups or individuals with data collection
- Conduct a publishable quality research study of the SR® process with at least 20 persons participating. This study will include an administrator and third party for statistical analysis. When applicable, SR® Workshops described above can be utilized as a research study group.
- Receive approval from the SR® Institute for Master Certification in the SR® process.
Data Analytic Strategy
The SR® team will use direct data collection instruments that measure warrior, family and personnel Emotional Checklist, a Behavior Control Checklist to measure whether or not the person understood the SR® process, and a Relationship Satisfaction Scale. In addition, satisfaction/success surveys will be administered to all US Military command personnel for both formative and summative pragmatic changes to the administration of the SR® process. This data will be compared with all methods currently used to treat PTSD and suicidality in the Military, and will help to identify and profile future warrior/family PTSD/suicide “at risk” personnel.
Analysis of this data will be accomplished by data basing in Excel spreadsheets, with both descriptive and inferential statistical analyses performed. Changes in the emotional state and behavior of Certified Personnel, Warriors and families, and US Military staff from the initial SR® baselining data, will be tracked weekly through the administration of additional instruments. Paralleling this SR® data analysis will be the collection, analysis, and correlation of all available US Military performance and social/behavioral data. Complementing this data analysis will be a series of formative and summative subjective questionnaires administered to all study participants at agreed upon intervals. The numerical data analysis of these survey instruments will also be correlated, participant by participant, with both the SR® data and Military social/behavioral data.
Dissemination of Data
Dissemination of accumulated data will be made available to all authorized personnel via a password protected web site. This will provide communications, resource sharing and a scalable knowledgebase for all collaborative parties in a tiered permission structure.
Suicide Prevention and Counseling Research
The SR® Process addresses each parameter brought up by the research topics of military suicide prevention and counseling research. There are four categories (Prevention, Screening, Treatment, and Quality of Life) and 10 topic areas:
Prevention
1. Effective suicide prevention strategies that focus on tactical suicide prevention across the operational spectrum and DoD that use a broad based approach designed to, but not limited to:
a. Reduce risk factors and enhancing protective factors
b. Change social norms to eliminate stigma about seeking help
c. Improve understanding of mental health
d. improve buddy-aid
2. Evidence based counseling to prevent and/or reduce nurse stress and fatigue at military treatment facilities
3. Effective peer, leader, and first responder risk assessment and management training tools and products to detect and prevent suicide
Screening
4. Test ways to effectively detect and assess the psychological impact of first responders who work on the scene with suicide completers and their survived loved ones
5. Test ways to detect the antecedents, associations (to include, but not limited to family adversities, prescribed medications, other therapies, substance misuse, and mental disorders), and other risk factors effective at predicting suicidal behavior in field and clinical environments (i.e., primary care, behavioral health) across the military operational spectrum
6. Test ways to effectively detect the psychological impact, coping mechanisms, and psychological risks from loss to suicide among loved ones of the deceased
7. Evidence based suicide assessment scales effective at predicting suicidal behavior and evidence-based suicide assessment interventions for tactical (i.e., peer, leader, first responder) and clinical environments (i.e., primary care, behavioral health) across DoD and VA health care systems
Treatment
8. Evidence based treatment, crisis intervention, clinical post-intervention and case management for Service members identified with suicidality
9. Evidenced-based treatment of patients with co-occurring suicidality and mental and/or physical illness
Quality of Life
10. Investigations into the reactions, grief, and needs of loved ones and peers of suicide completers which lead to evidence based bereavement interventions to facilitate support and recovery from loss.
Future data collection and the integration of PET/MRI scans