Psychological Fitness Defining Total Fitness for the 21

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Psychological Fitness Defining Total Fitness for the 21 st Century Conference Uniformed Services University

Psychological Fitness Defining Total Fitness for the 21 st Century Conference Uniformed Services University of the Health Sciences December 2009

Total Fitness Continuum Model FIT UNFIT RESILIENCE RECOVERY PERFORMANCE ENHANCEMENT Thriving Ready Reaction Injury

Total Fitness Continuum Model FIT UNFIT RESILIENCE RECOVERY PERFORMANCE ENHANCEMENT Thriving Ready Reaction Injury Illness Fitness for duty standard: minimum level of functioning for a person to work without risk to own or others’ health and safety (Cox, Edwards, & Palmer, 2000). Resilience: sum total of psychological processes to maintain or return to previous levels of well-being and functioning in response to adversity (Zamorski et al, 2008). Recovery: process of healing and transformation from an injury or illness … to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential (USDHHS & SAMHSA, 2004). Performance enhancement: Relatively precise, controlled and combined application of certain techniques, substances, or devices over the short and long-term to achieve optimization in a person or unit’s performance. Adapted from Human Performance Optimization (HPO; Russell, Buckley, & Grafton). 2

Analysis-Driven Theoretical Model Through development of Which are mobilized by Environmental resources • •

Analysis-Driven Theoretical Model Through development of Which are mobilized by Environmental resources • • Policy Leadership Units Families & Community • Programs & Services • Education & Training Personal resources • Job competence • Awareness • Executive Functions • Cognitive resources • Beliefs/ perceptions • Physical & emotional regulation • Social skills Which are achieved by influencing Key Mediators • Confidence in self • Engagement • Cognitive agility/ adaptability • Social support & cohesion Based in part on Conservation of resources theory. Ref: Hobfoll et al. “Fact or Artifact: The Relationship of Hope to a Caravan of Resources” Are supported by Targeted Outcomes Operational demands • Enhanced Performance • Resilience • Strong Morale • Unit cohesion • Focused energy and attention • Small force • High operational tempo • Repeated deployments • Harsh conditions • High physical and cognitive demands • Protracted conflicts 3

Execution: Modifying external resources can enhance mission-related outcomes via mediators Environmental resources Policy Leadership

Execution: Modifying external resources can enhance mission-related outcomes via mediators Environmental resources Policy Leadership Units Personal resources clear Job competence expectations sense of Awareness belonging opportunities to Executive Functions grow/advance Key Mediators Outcomes Confidence in self Resilient outcomes Engage- Engagement Cognitive agility/ adaptability Meaningfulness Families & Community Cognitive resources Education & Training Note: For efficiency, we are highlighting this path of action for just one of several mediators Beliefs/perce Beliefs/ ptions perceptions Physical & emotional regulation productivity Performance enhancement organizational commitment retention Social support & cohesion self-efficacy Programs & Services energy/ burnout sense of belonging Engagement: positive and fulfilling state of mind that is characterized by vigor, dedication, and absorption sense of purpose Social skills 4

Other Mediators: Definitions and components • Self confidence – aka self-efficacy – Composed of

Other Mediators: Definitions and components • Self confidence – aka self-efficacy – Composed of one's belief that one has the capability to complete a task and the belief that one will be successful (Bandura, 1994) • Cognitive agility – Ability to successfully navigate dynamic environments by changing decision frameworks or knowledge to meet the environmental needs (Haynie, 2005) – Also referred to as adaptability or the ability to change when necessary • Social support/cohesion – Interactions between people that functionally and meaningfully support them (Hobfoll, 1988). 5

Table of outcomes, variables, and metrics Outcome category Outcome variable Sample metrics Performance Team/organizational

Table of outcomes, variables, and metrics Outcome category Outcome variable Sample metrics Performance Team/organizational job performance Unit cohesion and morale Safety performance Organizations inspections (e. g. , compliance), unit surveys (e. g. , climate), Cohesion assessments (e. g. , MHAT) Performance Individual task performance Team task performance Resilience Health and functioning Resilience Enhanced recovery Scores on written and practical tests, 360 surveys, customer feedback Evaluation of team coordination and maneuvering in simulated performance scenarios PDHA, PDHRA, Shirom-Melamed Burnout measure, CES-D, PTSD Checklist-Military version Inpatient and outpatient healthcare utilization rates Resilience High risk behavior and antecedents Resilience Retention Measures of suicide and substance abuse risk/misuse. Alcohol related incidents, indiscipline rates Early separations, decision to re-enlist Resilience Family functioning Family maltreatment rates, divorce rates Performance and Resilience Performance Lost day rates, POV fatality rate, class ‘A’ mishaps 6

Bottom line for the Line • Promote strengths-based approach and constructive attitudes and beliefs

Bottom line for the Line • Promote strengths-based approach and constructive attitudes and beliefs (engagement) • Reinforce sense of belonging and contribution to team (engagement & social support) • Provide tough, realistic training (self-efficacy) • Cultivate effective problem solving skills, including both critical and creative thinking (cognitive agility) • Ensure regular periods of decompression and rest 7

 • Non-animated version of slide 3 follows 8

• Non-animated version of slide 3 follows 8

Execution: Modifying external resources can enhance mission-related outcomes via mediators Environmental resources Policy Leadership

Execution: Modifying external resources can enhance mission-related outcomes via mediators Environmental resources Policy Leadership Units clear expectations sense of belonging Personal resources Job competence Awareness opportunities to Executive grow/advance Functions Families & Community Cognitive resources Programs & Services Beliefs/perce ptions Education & Training Physical & Beliefs/ emotional perceptions regulation Note: For efficiency, we are highlighting this path of action for just one of several mediators Social skills Key Mediators Outcomes Confidence in self Resilient outcomes Engagement Cognitive agility/ adaptability Performance enhancement energy/ burnout productivity organizational commitment retention Social support & cohesion Meaningfulness self-efficacy Engagement: positive and fulfilling state of mind that is characterized by vigor, dedication, and absorption sense of belonging sense of purpose 9