Journal of the Royal Army Medical Corps
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This paper considers the manifestation and treatment of psychological trauma in the military. The article describes how military psychologists conceptualise psychological trauma within the culture of the Armed Forces (AF), which is reflected in the process of acquiring what has been referred to as cultural competency. Psychologists in this context acquire an understanding of the manner in which the psychological and organisational systems and culture of the military affect the presentation of psychological trauma, including post-traumatic stress disorder (PTSD). ⋯ Psychological care in the military is structured within an occupational mental health ethos, in which psychologists fulfil a range of clinical, organisational and leadership roles. These dynamics are explored with examples of care pathways and clarity on evidence-based interventions for trauma and PTSD in those experiencing military-related psychological injuries. Two vignettes are then offered to illustrate how some of these interventions can be used psychotherapeutically in addressing symptoms pertaining to hyperarousal, hypervigilance, guilt and shame.
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Psychological injury has been associated with military service, and this can result in a variety of mental health symptoms and disorders. A range of barriers to help-seeking have been identified in the military and mental health services have sought to address such factors through effective and efficient care and consultation. The use of eye movement desensitisation and reprocessing forms part of a repertoire of trauma-focused therapies within the UK's Armed Forces. This article will outline the application of this approach within the British military, along with the role of specialist clinical supervision in treating those affected by operational trauma.
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UK Ministry of Defence (MOD) policy and strategy recommend the use of a 'Defence MODified' version of the Health and Safety Executive Management Standards Indicator Tool to help managers identify risks of work-related stress among Defence personnel. The Defence MODified Tool ('Stress Indicator Survey') asks personnel to rate their perceptions of eight working conditions known to be significantly associated with work-related stress. MOD psychologists are developing a Defence norm group against which future survey scores can be compared. This article describes the use of the Stress Indicator Survey in MOD and gives an overview of findings from 2016 to 2018. ⋯ Possible explanations for the observed differences in risk of work-related stress are discussed, including the nature of military life and planned changes to Defence civilian headcount. Examples of managerial actions to improve working conditions based on individual survey findings are given.
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The Department of Communication and Applied Behavioural Science is one of the three departments in the academic faculty at the Royal Military Academy Sandhurst. The aim of the Department is to equip officer cadets with the skills, knowledge and personal qualities in order for them to develop their own potential, as both individuals and leaders in the British Army. The members of the Department have a range of backgrounds, with most having served in various capacities across UK Defence, both in uniformed and/or civilian crown servant contexts. ⋯ This paper provides a brief overview of the activities undertaken by the Department, with a specific focus on the psychology components of the academic and applied activities. Although mainly serving in academic teaching roles, this paper illustrates the work of the psychologists outside the classroom, such as via field exercises and deployments overseas. It also touches on the importance of the outreach undertaken by the psychologists in the Department, which supports their ongoing research.
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The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. ⋯ The identification of those skill sets required for deployment is in keeping with the General Medical Council's current drive towards credentialing consultants, by which a consultant surgeon's capabilities in particular practice areas would be defined. Limited opportunities currently exist for trainees and consultants to gain experience in the management of traumatic head, face, neck and eye injuries seen in a kinetic combat environment. Predeployment training requires that the surgical techniques described in this paper are covered and should form the curriculum of future military-specific surgical fellowships. Relevant continued professional development will be necessary to maintain required clinical competency.