No abstract

Operational stress injuries (OSIs) are an increasing concern for military personnel, particularly those returning from conflict zones. Over the last decade, the Canadian Armed Forces (CAF) has seen a sharp increase in the number of soldiers returning from Afghanistan who are reporting OSIs. Efforts have been made by the CAF and other agencies to help this population get the help they need through specialized programming. However, some are still not seeking treatment, in part due to the perceived stigma associated with mental illness. One novel approach to improving mental well-being is the Outward Bound Canada Veterans (OBCV) program. These adventure-based wilderness education courses are shown to have a positive impact on well-being among the veteran population. This study explores how the Outward Bound program facilitates a stigmafree environment which allows participants to more fully benefit from the therapeutic wilderness setting. This exploratory mixed-methods study used a pre-, post-, concurrentnested mixed-methods design. This small-scale study evaluated the experience of participants (n = 20) in the 2016 program. The Endorsed and Anticipated Stigma Inventory was administered at three times followed by a single semi-structured interview (n = 6) covering themes related to the OBCV program and perceptions of self-stigma and public stigma. This study found that the process of the OBCV program facilitated an environment that was perceived by participants to be stigma-free. Evidence from interviews suggests aspects of self-stigma, such as gaining a sense of personal empowerment, may be positively influenced by participation in wilderness or adventure programs.

LAY SUMMARY This study looked at the use of dialectical behaviour therapy (DBT) skills group training with military personnel. DBT skills group training teaches coping skills to manage emotions; it has been well researched and used effectively with civilians and Veterans, but less is known about its use with military personnel. The General Mental Health (GMH) clinic receives a large volume of referrals for military personnel who have difficulty with coping skills and managing emotions. On the basis of previous research, a modified DBT skills group therapy program was developed for the clinic to offer an efficient, effective treatment program for these clients in this busy clinic. Military personnel may be a particularly good fit for this type of group-based treatment because they are familiar with working in small group settings. This treatment can also allow for a timelier return to work, minimizing interruptions to military deployments and operations. Study results showed that program participants had lower levels of depression and a greater ability to manage emotions and cope more effectively after the program. Treatment gains were largely maintained at 6-month follow-up. This research suggests that DBT skills group training may be an effective treatment for military personnel.