The impact of the Community Resiliency Model (CRM) on the mental well-being of youth at risk for violence: A study protocol.

PURPOSE: Assess the effect of a brief, somatic awareness resiliency training, the Community Resiliency Model (CRM)®, on the mental well-being of incarcerated youth. SPECIFIC AIM 1: Explore the relationship between youth demographics and justice history to baseline well-being scores and response to treatment. Q1: How do personal variables, including length of time in juvenile justice, relate to baseline mental health scores and response to the wellness skills intervention? SPECIFIC AIM 2: Examine the mental health scores over time to determine effectiveness of participating in CRM training while incarcerated. Hypothesis 1: Well-being scores will increase after CRM training. Hypothesis 2: Emotional distress will decrease after participating in a CRM training. Hypothesis 3: Pro-social feelings and behaviors will increase after participating in a CRM training.

The Community Resiliency Model, an interoceptive awareness tool to support population mental wellness.

The objective of this article is to describe the Community Resiliency Model (CRM)®, a sensory-focused, self-care modality for mental well-being in diverse communities, and CRM's emerging evidence base and neurobiological underpinnings as a task-sharing intervention. Frieden's Health Impact Pyramid (HIP) is used as a lens for mental healthcare interventions and their public health impact, with CRM examples. CRM, a sensory awareness model for self-care and mental well-being in acute and chronic stress states, is supported by neurobiological theory and a growing evidence base. CRM can address mental wellness needs at multiple levels of the HIP and matches the task-sharing concept to increase access to mental health resources globally. CRM has the potential for making a significant population mental health impact as an easily disseminated, mental health, self-care modality; it may be taught by trained professionals, lay persons, and community members. CRM carries task-sharing to a new level: scalable and sustainable, those who learn CRM can share the wellness skills informally with persons in their social networks. CRM may alleviate mental distress and reduce stigma, as well as serve a preventive function for populations facing environmental, political, and social threats.

Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support.

OBJECTIVE: To introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic. DESIGN: Randomised controlled trial with a no treatment control group. SETTING: Two large urban health systems in the Southern United States between October 2020 and June 2021. PARTICIPANTS: Eligible participants were currently employed as healthcare workers within the participating healthcare systems. 275 employees registered and consented electronically in response to email invitations. 253 participants completed the baseline survey necessary to be randomised and included in analyses. INTERVENTION: Participants were assigned 1:1 to the control or intervention group at the time of registration. Intervention participants were then invited to 1-hour virtual CRM class teaching skills to increase somatic awareness in the context of self and other care. MAIN OUTCOME MEASURES: Self-reported data were collected rating somatic awareness, well-being, symptoms of stress, work engagement and interprofessional teamwork. RESULTS: Baseline data on the total sample of 275 (53% nurses) revealed higher symptoms of stress and lower well-being than the general population. The intervention participants who attended a CRM class (56) provided follow-up survey data at 1 week (44) and 3 months (36). Significant improvement for the intervention group at 3 months was reported for the well-being measures (WHO-5, p<0.0087, d=0.66; Warwick-Edinburgh Mental Well-Being Scale, p<0.0004, d=0.66), teamwork measure (p≤0.0002, d=0.41) and stress (Secondary Traumatic Stress Scale, p=0.0058, d=46). CONCLUSION: Baseline results indicate mental health is a concern for healthcare workers. Post intervention findings suggest that CRM is a practical approach to support well-being for healthcare workers during a crisis such as this pandemic. The simple tools that comprise the model can serve as a starting point for or complement self-care strategies to enhance individual resilience and buffer the effects of working in an increasingly stressful work environment.

A Nurse-Led, Well-Being Promotion Using the Community Resiliency Model, Atlanta, 2020-2021.

The wrath of COVID-19 includes a co-occurring global mental health pandemic, raising the urgency for our health care sector to implement strategies supporting public mental health. In Georgia, a successful nurse-led response to this crisis capitalized on statewide organizations' existing efforts to bolster well-being and reduce trauma. Partnerships were formed and joint aims identified to disseminate a self-care modality, the Community Resiliency Model, to organizations and communities throughout the state. (Am J Public Health. 2022;112(S3):S271-S274. https://doi.org/10.2105/AJPH.2022.306821).

An approach to trauma-informed education in prelicensure nursing curricula.

BACKGROUND: Trauma-informed care (TIC) is an evolving concept that acknowledges the prevalence and impacts of trauma on health; however, knowledge related to implementation for nursing students remains limited. PURPOSE: The purpose of this study is to understand the learning perspectives of nursing students and develop an innovative conceptual model to guide educators in implementing teaching and learning strategies related to TIC, consistent with the trauma and resiliency competencies for nurses. METHODS: Qualitative analysis of student responses after an online module to educate students on adverse childhood experiences (ACEs), trauma, and their impact on health through the lifespan. RESULTS: Three persistent themes emerged from the data: Growing in Self-Awareness, Filling Learning Needs, and Envisioning Future Roles. From these themes, we developed a framework for TIC content for nursing and other healthcare curricula. CONCLUSIONS: Our findings demonstrate a model to embed ACE education, TIC competencies, secondary traumatic stress awareness, and methods of self-care, including resiliency skills, into undergraduate nursing education.

Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model.

BACKGROUND: Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health. METHODS: Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8). RESULTS: Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves. CONCLUSIONS: After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

The Community Resiliency Model® to promote nurse well-being.

BACKGROUND: Rising rates of secondary traumatic stress and burnout among nurses signal a crisis in healthcare. There is a lack of evidence regarding effective interventions to improve nurse well-being and resiliency. PURPOSE: This study used a randomized controlled trial parallel design to test the effectiveness of a 3-hour Community Resiliency Model® (CRM) training, a novel set of sensory awareness techniques to improve emotional balance. METHODS: Registered nurses in two urban tertiary-care hospitals were invited to participate, which entailed attending a single 3-hour "Nurse Wellness and Well-being" class; 196 nurses consented and were randomized into the CRM intervention or nutrition education control group to determine if the CRM group would demonstrate improvement in well-being and resiliency, secondary traumatic stress, burnout, and physical symptoms. FINDINGS: Pre/post data were analyzed for 40 CRM and 37 nutrition group members. Moderate-to-large effect sizes were demonstrated in the CRM group for improved well-being, resiliency, secondary traumatic stress, and physical symptoms. Participants reported using CRM techniques for self-stabilization during stressful work events. DISCUSSION: CRM shows promise as a brief resiliency training for hospital-based nurses.

The Trauma Resiliency Model: A "Bottom-Up" Intervention for Trauma Psychotherapy.

BACKGROUND: The Trauma Resiliency Model (TRM) is an innovative therapeutic approach for trauma. This "bottom-up" somatic approach comprises nine skills that use sensory awareness for emotion regulation and integration. Body-based therapies may be more effective for trauma than currently used cognitive ('top-down") and exposure therapies. OBJECTIVE: The purpose of this article is to present TRM and current literature on the neuroscience of trauma and resiliency, and the rationale for body-based therapy. Two case examples illustrate the practical use of TRM therapy. DESIGN: The literature on the neuroscience of trauma, resiliency, and somatic approaches in therapy is reviewed. RESULTS: TRM teaches the biology of trauma responses and the practice of emotion regulation through biologically based skills. Neuroscience theory supports somatic awareness models; however, research on somatic therapies is limited. CONCLUSIONS: Chronic distress from trauma derails the ability to live life resiliently. TRM addresses trauma processing in a gentle and invitational manner and is a novel departure from existing therapies. Despite a paucity of research on body-based therapy, these therapies have strong neurophysiologic underpinnings.

Girlhood Betrayals of Women Childhood Trauma Survivors in Treatment for Addiction.

PURPOSE: This research explored the understanding of trauma from the perspective of women who had experienced abuse and neglect in childhood. The goal was to better conceptualize potential avenues or interventions for prevention and treatment. DESIGN: Qualitative description of the accounts of eight women who were childhood trauma survivors and in treatment for addiction. Open-ended interviews focused on key events or experiences during childhood and adolescence and the use of drugs and alcohol. FINDINGS: Four levels of betrayal fit the accounts the participants gave as the dominant theme in their narratives. "Primary betrayal" referred to the direct victimization by a perpetrator; "secondary betrayal" referred to the complicity, denial, or indifference of another adult to the child's victimization; "tertiary betrayal" referred to failures of responsible individuals in community settings to protect the child; and "quaternary betrayal" represented self-betrayals. Substance misuse was an adolescent self-betrayal that provided initial solace yet ultimately threatened the integrity of the girls. We found an almost complete lack of support in family and community settings for the participants. CONCLUSIONS: These findings on betrayal inform health care for trauma survivors and can be a framework for preventing violence against children. CLINICAL RELEVANCE: Interventions for child and adolescent trauma survivors are critical to prevent the life-long health sequelae of childhood trauma. Pivotal times to engage these survivors include periods when they may be accessed in school and healthcare settings.

Gardening for the mental well-being of homeless women.

PURPOSE: To explore the perceptions of homeless women regarding their experience in a shelter-based garden project to promote mental wellness. Participants planted and tended the vegetable garden and prepared and ate the fruits of their labor. DESIGN: A qualitative descriptive design with a conventional content analysis of narrative data. METHOD: Data were gathered in semistructured interviews. Participants were homeless daytime shelter guests who had participated in at least eight gardening sessions over 4 weeks. The project was started in the fall of 2010 and the interviews were conducted over 2 months in the summer of 2011. FINDINGS: Two polarized themes were identified in the narratives, clustering around negative and positive thoughts. The "dark" theme centered on marginalization and the oppressiveness of shelter life. The "light" theme centered on stress relief, feeling socially included, and personal change. CONCLUSION: The gardening experience interrupted the participants' negative ruminations, offering stress relief and elements of social inclusion and self-actualization. Gardening is an inexpensive and positive intervention for a population with a high incidence of mental illness and distress.