Resilience first aid: Primary prevention through a strength-based peer support programme
Abstract
Orientation: Peer support and resilience are crucial for mental health, particularly in high-stress occupations such as healthcare and emergency services. Existing interventions primarily focus on reactive measures, leaving a gap in proactive mental health strategies. Research purpose: This study aimed to investigate the effectiveness of the Resilience First Aid (RFA) programme, incorporating the Predictive 6 Factor Resilience (PR6) model and the ALL Protocol, in enhancing resilience and peer support. Motivation for the study: There is a pressing need for primary prevention strategies to address the growing mental health challenges in high-stress professions. These challenges include burnout, post-traumatic stress disorder (PTSD), and suicide, among others. This study addresses the knowledge gap by exploring a strength-based, proactive approach to peer support. Research approach/design and method: A literature review was conducted to examine gaps in peer support and explore the theoretical framework of RFA. The study draws on neurobiological insights and integrates psychotherapeutic principles to develop a resilience-focused intervention. Main findings: Resilience First Aid training significantly improved participants’ personal resilience, peer support skills and ability to recognise suicide risk factors. The ALL Protocol facilitated emotional regulation and constructive problem-solving in peer support interactions, aligning with neuroscience-based insights. Implications for practice: Implementing RFA in high-stress environments could enhance workforce resilience and reduce the prevalence of acute mental health crises. The programme’s structured, proactive approach addresses current gaps in mental health support systems. Contribution/value-add: This study contributes by presenting a comprehensive, proactive model for peer support and resilience, offering a structured conversational tool (ALL Protocol) that can be applied across various professional settings.
Keywords: resilience; peer support; mental health; emergency services; healthcare; burnout; PTSD
Metadata Record
References 73
- Abramson, B., Boerma, J., & Tsyvinski, A. (2024). Macroeconomics of mental health. National Bureau of Economic Research. Retrieved from https://boazabramson.github.io/assets/macro_mental.pdf
- Agarwal, B., Brooks, S.K., & Greenberg, N. (2019). The role of peer support in managing occupational stress: A qualitative study of the sustaining resilience at work intervention. Workplace Health & Safety. https://doi.org/10.1177/2165079919873934
- AIHW. (2024, March 23). Deaths by suicide over time. Retrieved from https://www.aihw.gov.au/suicide-self-harm-monitoring/data/deaths-by-suicide-in-australia/suicide-deaths-over-time
- Arnsten, A.F. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience. https://doi.org/10.1038%2Fnrn2648
- Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2005). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2005.07.003
- Cassilhas, R., Lee, K., Fernandes, J., Oliveira, M., Tufik, S., Meeusen, R., & De Mello, M. (2012). Spatial memory is improved by aerobic and resistance exercise through divergent molecular mechanisms. Neuroscience. https://doi.org/10.1016/j.neuroscience.2011.11.029
- CDC. (2024, March 23). Fatal injury trends. Retrieved from https://www.cdc.gov/injury/wisqars/fatal/trends.html
- Champine, R.B., Hoffman, E.E., & Matlin, S.L. (2022). ‘What does it mean to be trauma-informed?’: A mixed-methods study of a trauma-informed community initiative. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-021-02195-9
- Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: A systematic review of its effectiveness and acceptability in clinical populations. Expert Review of Neurotherapeutics. https://doi.org/10.1080/14737175.2020.1746184
- De Meza, D., & Dawson, C. (2021). Neither an optimist nor a pessimist be: Mistaken expectations lower well-being. Personality and Social Psychology Bulletin. https://doi.org/10.1177/0146167220934577
- Domic-Siede, M., Irani, M., Valdés, J., Perrone-Bertolotti, M., & Ossandón, T. (2020). Theta activity from frontopolar cortex, mid-cingulate cortex and anterior cingulate cortex shows different roles in cognitive planning performance. NeuroImage. https://doi.org/10.1016/j.neuroimage.2020.117557
- Donovan, N. (2022). Peer support facilitates post-traumatic growth in first responders: A literature review. Trauma. https://doi.org/10.1177/14604086221079441
- Doulias, T., Thrikandiyur, A., Titus, N., Soundararasha, K., Coxon, A., Amarantidis, E., & Arulampalam, T. (2021). Junior doctors’ wellbeing at peak and post-peak pandemic: A repeated cross-sectional study. The Annals of The Royal College of Surgeons of England. https://doi.org/10.1308/rcsann.2021.0272
- Driven. (2022, September 7). Resilience first aid achieves full accreditation. Retrieved from https://home.hellodriven.com/articles/resilience-first-aid-achieves-full-accreditation/
- Fallon, P., Jaegers, L.A., Zhang, Y., Dugan, A.G., Cherniack, M., & Ghaziri, M.E. (2023). Peer support programs to reduce organizational stress and trauma for public safety workers: A scoping review. Workplace Health & Safety. https://doi.org/10.1177/21650799231194623
- Fazey, I. (2010). Resilience and higher order thinking. Ecology and Society. Retrieved from https://www.jstor.org/stable/26268183
- Feng, W., Wang, W., Liu, J., Wang, Z., Tian, L., & Fan, L. (2021). Neural correlates of causal inferences in discourse understanding and logical problem-solving: A meta-analysis study. Sec. Speech and Language. https://doi.org/10.3389/fnhum.2021.666179
- Feuer, B.S. (2021). First responder peer support: An evidence-informed approach. Journal of Police and Criminal Psychology. https://doi.org/10.1007/s11896-020-09420-z
- Frögéli, E., Rudman, A., Ljótsson, B., & Gustavsson, P. (2020). Preventing stress-related ill health among. Worldviews on Evidence-Based Nursing. https://doi.org/10.1111/wvn.12442
- Gangopadhyay, P., Chawla, M., Dal Monte, O., & Chang, S.W. (2021). Prefrontal-Amygdala circuits in social decision-making. Nature Neuroscience. https://doi.org/10.1038/s41593-020-00738-9
- Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment. https://doi.org/10.1192/apt.bp.107.005264
- Gilbert, P. (2015). Affiliative and prosocial motives and emotions in mental health. Dialogues in Clinical Neuroscience. https://doi.org/10.31887%2FDCNS.2015.17.4%2Fpgilbert
- Girotti, M., Adler, S., Bulin, S., Fucich, E., Paredes, D., & Morilak, D. (2018). Prefrontal cortex executive processes affected by stress in health and disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry. https://doi.org/10.1016/j.pnpbp.2017.07.004
- Godfrey, K., & Scott, S.D. (2020). At the heart of the pandemic: Nursing peer support. Nurse Leader. https://doi.org/10.1016/j.mnl.2020.09.006
- Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
- Hettema, J., Steele, J., & Miller, W.R. (2005). Motivational interviewing. Annual Review of Clinical Psychology. https://doi.org/10.1146/annurev.clinpsy.1.102803.143833
- Hofmann, S.G., & Hayes, S.C. (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science. https://doi.org/10.1177/2167702618772296
- Holz, N.E., Tost, H., & Meyer-Lindenberg, A. (2020). Resilience and the brain: A key role for regulatory circuits linked to social stress and support. Molecular Psychiatry. https://doi.org/10.1038/s41380-019-0551-9
- Iwakabe, S., Nakamura, K., & Thomas, N.C. (2023). Enhancing emotion regulation. Psychotherapy Research. https://doi.org/10.1080/10503307.2023.2183155
- Jonah, P.F., Wong, Y.J., & McDermott, R.C. (2021). Examining Nietzsche’s epigram: Having a why helps you bear almost any how? Journal of Humanistic Psychology. https://doi.org/10.1177/00221678211041828
- Juliyanto, E., Marwoto, P., Iswar, R.S., Wiyanto, Nugroho, S.E., & Mindyarto, B.N. (2021). Brain activity of problem solving proccess: A systematic literarure review. Journal of Physics: Conference Series. https://doi.org/10.1088/1742-6596/1918/5/052068
- Khanh-Dao Le, L., Esturas, A.C., Mihalopoulos, C., Chiotelis, O., Bucholc, J., Chatterton, M., & Engel, L. (2021). Cost-effectiveness evidence of mental health prevention and promotion interventions: A systematic review of economic evaluations. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1003606
- Kunselman, A.R. (2024). A brief overview of pilot studies and their sample size justification. Fertility and Sterility. https://doi.org/10.1016/j.fertnstert.2024.01.040
- Leal, G., Afonso, P.M., Salazar, I.L., & Duarte, C.B. (2015). Regulation of hippocampal synaptic plasticity by BDNF. Brain Research. https://doi.org/10.1016/j.brainres.2014.10.019
- LeClaire, M., Poplau, S., Linzer, M., Brown, R., & Sinsky, C. (2022). Compromised integrity, burnout, and intent to leave the job in critical care nurses and physicians. Critical Care Explorations. https://doi.org/10.1097/CCE.0000000000000629
- Li, W., Yang, P., Ngetich, R.K., Zhang, J., Jin, Z., & Li, L. (2021). Differential involvement of frontoparietal network and insula cortex in emotion regulation. Neuropsychologia. https://doi.org/10.1016/j.neuropsychologia.2021.107991
- Ligibel, J.A., Goularte, N., & Berliner, J.I. (2023). Well-being parameters and intention to leave current institution among academic physicians. JAMA Netw Open. https://doi.org/10.1001/jamanetworkopen.2023.47894
- Luethi, M., Meier, B., & Sandi, C. (2008). Stress effects on working memory, explicit memory, and implicit memory for neutral and emotional stimuli in healthy men. Sec. Learning and Memory. https://doi.org/10.3389/neuro.08.005.2008
- Ma, Q., Gallo, J.J., Parisi, J.M., & Joo, J. (2022). Development of the Mental Health Peer Support Questionnaire in colleges and vocational schools in Singapore. International Journal of Mental Health Systems. https://doi.org/10.1186/s13033-022-00555-6
- Martínez, A., & Blanch, A. (2024). Are rescue workers still at risk? A meta-regression analysis of the worldwide prevalence of post-traumatic stress disorder and risk factors. Stress and Health. https://doi.org/10.1002/smi.3372
- Meade, A.W., & Craig, S.B. (2012). Identifying careless responses in survey data. Psychological Methods. https://doi.org/10.1037/a0028085
- Meisner, O.C., Nair, A., & Chang, S.W. (2022). Amygdala connectivity and implications for social cognition and disorders. Handbook of Clinical Neurology. https://doi.org/10.1016/B978-0-12-823493-8.00017-1
- Melissant, H.C., Hendriks, R.R., Bakker, E.J., Kox, J.H., Rietveld, N., Miedema, H.S., Roelofs, P.D.D.M., & Verhaegh, K.J. (2024). Interventions that support novice nurses’ transition into practice: A realist review. International Journal of Nursing Studies, 157, 104785. https://doi.org/10.1016/j.ijnurstu.2024.104785
- Mikulincer, M., & Shaver, P.R. (2010). Attachment in adulthood: Structure, dynamics, and change. Guilford Publications.
- NIH FY 2023 Budget. (2024). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/about/budget/fy-2023-budget-congressional-justification
- NIMH. (2024). Mental illness. Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness
- Oesch, N. (2024). Social brain perspectives on the social and evolutionary neuroscience of human language. Brain Science. https://doi.org/10.3390/brainsci14020166
- Peeples, A.D., Muralidharan, A., McCarthy, S., Goldberg, R., Kuykendall, L., Vineyard, N., & Chinman, M. (2023). Barriers and enablers to implementing peer specialists in veterans health administration primary care: A qualitative study. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-022-07782-0
- Peterson, C., Haileyesus, T., & Stone, D.M. (2024). Economic cost of US suicide and nonfatal self-harm. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2024.03.002
- Petrie, K., Crawford, J., Shand, F., & Harvey, S.B. (2020). Workplace stress, common mental disorder and suicidal ideation in junior doctors. Internal Medicine Journal. https://doi.org/10.1111/imj.15124
- Reidy, C. (2024). Peer support in chronic health conditions. BMJ. https://doi.org/10.1136/bmj-2022-070443
- Rossouw, J.G. (2023). National resilience index: USA & Australia 2023. Hello Driven. Retrieved from https://driv.ai/NRI2023
- Rossouw, J.G. (2024). Defining protective resilience: The 85% threshold for personality development and mental health risk reduction. Education & Training PsyArxiv. https://doi.org/10.31234/osf.io/jkmnf
- Rossouw, J.G., Erieau, C., & Beeson, E. (2019). Building resilience through a virtual coach called driven: Longitudinal pilot study and the neuroscience of small, frequent learning tasks. International Journal of Neuropsychotherapy. Retrieved from https://driv.ai/ijnpt-2019-023-041
- Rossouw, J.G., Herlofson, J., Geldenhuys, D.J., & Erieau, C.L. (2024). High Adversity Resilience Training (HART): Development for emergency responders and defence. Journal of Applied Neurosciences. https://doi.org/10.4102/jan.v3i1.8 SEIPID
- Rossouw, J.G., Rossouw, P.J., Paynter, C., Ward, A., & Khnana, P. (2017). Predictive 6 factor resilience scale – Domains of resilience and their role as enablers of job satisfaction. International Journal of Neuropsychotherapy, 24–40. Retrieved from https://driv.ai/ijnpt-2017-1-0025-0040
- Rossouw, J.G., & Ruberto, M. (2024). Resilience first aid improves peer support and suicide prevention skills: Conceptual design and pilot evaluation. Researchgate Preprint. https://doi.org/10.13140/RG.2.2.26008.81920/1
- Rossouw, P.J., & Rossouw, J.G. (2016). The predictive 6-factor resilience scale: Neurobiological fundamentals and organizational application. International Journal of Neuropsychotherapy. Retrieved from https://driv.ai/ijnpt-2016-0031-0045
- Sher, L. (2019). Resilience as a focus of suicide research and prevention. Acta Psychiatrica Scandinavica. https://doi.org/10.1111/acps.13059
- Shin, L.M., Wright, C.I., Cannistraro, P.A., Wedig, M.M., McMullin, K., Martis, B., Macklin, M.L., Lasko, N.B., Cavanagh, S.R., Krangel, T.S., Orr, S.P., Pitman, R.K., Whalen, P.J., & Rauch, S.L. (2005). A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Archives of General Psychiatry, 62(3), 273–281. https://doi.org/10.1001/archpsyc.62.3.273
- Siegel, D.J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Publications.
- Simms, L., Ottman, K.E., Griffith, J.L., Knight, M.G., Norris, L., Karakcheyeva, V., & Kohrt, B.A. (2023). Psychosocial peer support to address mental health and burnout of health care workers affected by COVID-19: A qualitative evaluation. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph20054536
- Simon, D.H., & Masters, R.K. (2024). Institutional failures as structural determinants of suicide: The opioid epidemic and the Great Recession in the United States. Journal of Health and Social Behavior. https://doi.org/10.1177/00221465231223723
- Stacey, G., Cook, G., Aubeeluck, A., Stranks, B., Long, L., Krepa, M., & Lucre, K. (2020). The implementation of resilience based clinical supervision to support transition to practice in newly qualified healthcare professionals. Nurse Education Today. https://doi.org/10.1016/j.nedt.2020.104564
- Ungar, M., & Theron, L. (2020). Resilience and mental health: How multisystemic processes contribute to positive outcomes. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(19)30434-1
- Uusberg, A., Taxer, J.J., Yih, J., Uusberg, H., & Gross, J.J. (2019). Reappraising reappraisal. Emotion Review. https://doi.org/10.1177/1754073919862617
- Wheeler, M.S., Arnkoff, D.B., & Glass, C.R. (2017). The neuroscience of mindfulness: How mindfulness alters the brain and facilitates emotion regulation. Mindfulness. https://doi.org/10.1007/s12671-017-0742-x
- White, R., & Wild, J. (2016). ‘Why’ or ‘How’: The effect of concrete versus abstract processing on intrusive memories following analogue trauma. Behavioral Therapy. https://doi.org/10.1016/j.beth.2016.02.004
- Xinlu, W., Zhongqiu, L., & Chaoqun, D. (2022). Suicide resilience: A concept analysis. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2022.984922
- Yackle, K. (2023). Transformation of our understanding of breathing control by molecular tools. Annual Review of Physiology. https://doi.org/10.1146%2Fannurev-physiol-021522-094142
- Yates, S.W. (2020). Physician stress and burnout. The American Journal of Medicine. https://doi.org/10.1016/j.amjmed.2019.08.034
- Zimmermann, C., Strohmaier, S., Herkner, H., Niederkrotenthaler, T., & Schernhammer, E. (2024). Suicide rates among physicians compared with the general population in studies from 20 countries: Gender stratified systematic review and meta-analysis. BMJ. https://doi.org/10.1136/bmj-2023-078964
- Zumaeta, J. (2018). Lonely at the top: How do senior leaders navigate the need to belong? Journal of Leadership & Organizational Studies. https://doi.org/10.1177/1548051818774548