Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review.
BACKGROUND
Employers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations.


METHODS
A search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted.


RESULTS
Two surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs.


CONCLUSIONS
Given the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables.
Mulligan
K
K
Academic Centre for Defence Mental Health (ACDMH), King's College London, UK. kathleen.mulligan@kcl.ac.uk
Fear
N T
NT
Jones
N
N
Wessely
S
S
Greenberg
N
N
D000437:Alcoholism / Q000517:prevention & control* / Q000523:psychology; D003130:Combat Disorders / Q000517:prevention & control* / Q000523:psychology; D003419:Crisis Intervention; D006801:Humans; D001523:Mental Disorders / Q000517:prevention & control* / Q000523:psychology; D008889:Military Personnel / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control* / Q000523:psychology; D016896:Treatment Outcome