ChaplainsoftheCanadianForcesProfessionalDevelopmentProgram-Outline

The purpose of this outline is to further illustrate the intended training model, as described in the project proposal, to be delivered to Chaplains of the Canadian Armed Forces. Rational: Learning in A Culture of Traditional Masculinity Research has shown that many men don’t express health concerns, seek medical help or access psychological services despite physiological and/or psychological stress (O’Brien, Hunt, & Hart., 2005). And yet, there are significant benefits to men if they commit to and follow through in getting psychological help. While endorsement of “traditional” masculine ideals (e.g., altruism, solving other people’s problems, thinking logically and calmly, and valuing traits such as loyalty, self-reliance, and identifying themselves through their bodies) has many positive aspects, it is also associated with a host of problematic issues, such as poor self-esteem, reduced interpersonal intimacy, depression, and anxiety (Mahalik, Good, & Englar-Carlson, 2003). Men are often left in a double bind in which, if they successfully ascribe to these unrealistic and contradictory masculine ideologies, they may limit their coping repertoires (e.g., by resisting help). On the other hand, if they deviate from masculine norms, they may expect to be harshly judged or socially ostracized (Englar-Carlson, 2006). Pleck (1981) theorized that when these gender role violations occur, the resulting strain is so unpleasant that men compensate by ascribing even more rigidly to traditional definitions of masculinity. This is problematic because a growing body of research suggests a strong connection between the degree to which men endorse traditional or dominant masculine ideologies and poor health behaviours. This includes avoiding therapy, which often involves disclosing weaknesses or problems – which for many men is threatening to their masculine identity and to be avoided (Courtenay, 2000). Military veterans are a subgroup of men that, to a large extent, suffer the negative outcomes listed above. These men tend to endorse even higher levels of male gender role socialization related to military disciplinary culture (Hinojosa, 2010) – a factor that exacerbates how they experience stigma (Hoge, Castro, Messer, McGurk, Cotting, & Koffman., 2004). Further,

military trauma is associated with posttraumatic stress disorder (PTSD), major depression, and an elevated risk of suicide (Braswell & Kushner., 2012). Taken together, this subgroup of men may experience high levels of mental disorder coupled with low help seeking and low therapeutic engagement – a process complicated by gender role based shame reactions to feelings of weakness or social rejection (Englar-Carlson., 2006). Training/ Learning Model The VTP is a 10-day residential based program (100 hours) that utilizes a small-group format (6-10 participants) and is offered in three phases. In phase 1, the focus of the program is on developing a cohesive working group, learning strategic communication skills, and understanding and learning how to manage post-traumatic stress responses. In addition, the men participate in a guided autobiography life review. Phase 2, through the use of “Therapeutic Enactment”, focuses on the processing and integrating of critical traumatic events that contribute to the stress injury – this stage is referred to by the men as “dropping the baggage”. Phase 3 involves the consolidation of the personal learning that occurred in phases 1 & 2 and shifts the focus on transitioning into the future by developing specific individual, family and career goals that are reinforced by ongoing support from peers in the group. Finally, post-group referral plans are developed on an individual basis as needed. Considering the immense challenges of engaging military men in help services, it is remarkable that the VTP has demonstrated high levels of engagement, near-zero dropout rates, reduced stigma among participants, and substantially decreased depression for the participants (Weswtood, Cox, Hoover, Chan, Kivari, Dadson, & Zumbo., 2016). While veterans are just one grouping of men, the principles and approach used by the VTP may also help reduce stigma and enhance engagement within other military subgroups experiencing depression and suicidal ideation. A key reason for this is that the program works with, instead of against, male socialization processes. Male altruism, action-orientation, and self-reliance are

framed as strengths that fuel men’s willingness to help each other as they inevitably end up moving deeper into their own work. This ‘cutting edge’ approach to working with men contrasts with the deficit based approach of yesteryear that was thought to alienate men by making them feel emotionally inept or required them to change to meet the framework of mainstream helping programs (Kiselica & Englar-Carlson., 2010). In short, the ‘front-end’ presentation of men helping men is thought to foster familiarity and comfort that allow the men to feel safe in expressing more vulnerable aspects of themselves while maintaining a sense of strength and competence. Kivari’s preliminary master’s thesis findings suggest that once the front-end is addressed (i.e., men are allowed to be “men”) there is a strong value placed on the traditional aspects of therapeutic repair such as expressing caring and empathic understanding. This suggests that the VTP’s success in lowering stigma and enhancing engagement is in part due to how well it initially synergizes with male socialization. Building from the understanding that men helping men with important life transitions is a potentially useful model for serving other subgroups of military personal (Chaplains), the Chaplains Professional Development Program will pilot test a new Chaplains Development Program (based on the principles and strategies of the VTP) with Chaplains of the Canadian Armed Forces. Program Evaluation The Chaplains Development Program (CDP) will be piloted in British Columbia drawing from participants across Canada. Piloting the CDP with participants from across the country will enable us to determine whether the unique characteristics of the CDP, which have helped engage military men and reduce their burden of mental illness, can be used effectively with other sub-groups of the military. We will compare program outcomes by participant and place to distil the components that prevail as most beneficial across these units of analysis. Moreover, diversity and differences emerging within and across the participants and place will guide our future efforts toward targeting the CDP group intervention as an ongoing training component for Chaplains in the Canadian Armed Forces. Participant inclusion criteria will be based on readiness and motivation gathered from on one to one interviews conducted by the team lead. All participants will commit to attending the 6-day program, which will be delivered in 2 phases in a retreat setting. Phase 1 focuses on group building, teaching skills, goal identification, and preparation and presentation of life review stories. As well as a focus on therapeutic enactment that involves participants recreating, re-experiencing, and re-observing critical life events related to relational or other traumatic events. Phase 2 is a period of final integration, concrete skill consolidation, action planning, and prospective maintenance. Participants will complete demographic forms and be administered outcome measures at the beginning and end of the group, as well as at a three-month follow-up assessment. Participants will complete a) the Group

Engagement Measure (GEM), a measure that assesses the extent to which participants “buy in” to the process of group work – an important construct in the context of men overcoming the stigma-barrier, b) a para-professional skill acquisition assessment, and c) a learning assessment completed in the form of a one on one interview conducted at the end of the program, for which a content analysis method will be used to asses the participants level of learning (Macgowan, & Newman, 2005). Participants that demonstrate successful learning will be granted a certificate of completion from the University of British Columbia. It is anticipated that all sub-groups share a common core set of values and expectations related to receiving psychological assistance, yet sub-group variations of the common core set of values are anticipated depending on age, socioeconomic status, culture, physical well-being, and social context. Also within the final interviews will be a solicitation of the participants’ perceptions and their experiences of the program, including therapeutic approaches of the group leaders, the particular activities they were involved in, and the language that was used to describe challenges within their group. As part of the interview process, we will draw from the Enhanced Critical Incident Technique (ECIT) (Flanagan, 1954). This qualitative methodology explores which factors helped or hindered the success of a given domain, in this case men’s experiences of (a) overcoming stigmatizing attitudes regarding help-seeking and (b) becoming engaged in the therapeutic process. Within this mixed methods approach to the CDP, the subgroup (Military Chaplains) will be evaluated to ascertain outcome effectiveness, enhance KD, and improve means of delivery. Data analysis will involve describing the sample in terms of demographics, readiness to learn, and post-program levels of group engagement. Acquisition of knowledge and changes in skill will serve as the primary outcome measure. Qualitative data will be analyzed inductively by extracting incidents (i.e., instances of the program that helped or hindered their engagement and de-stigmatization) from transcribed participant interviews. These incidents will be organized into subsuming categories (e.g., “straightforwardness of group leaders”) to provide a framework for understanding each program’s effectiveness. Finally, a series of nine credibility checks, as listed by Butterfield et al., (2009) will be performed to ensure the trustworthiness of qualitative findings.

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