Rapid Response to Acute Stress Reaction

Pilot Test of iCOVER Training for Military Units

Adler, Amy B.
Start, Amanda R.
Milham, Laura
Allard, Yvonne S.
Riddle, Dawn
Townsend, Lisa
Svetlitzky, Vlad

Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
Naval Air Warfare Center Training Systems Division, Orlando, Florida
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research
Naval Air Warfare Center Training Systems Division
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research

Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting true views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70-25.

This research was supported by a grant from the U.S. Army Medical Research and Materiel Command, Joint Program Committee 1 (JPC-1).

Portions of this article have been presented at the Military Health System Research Symposium.

We thank Richard Gonzales, Susannah Knust, Jason Nolet, Rob Wolf, Joan Johnston, Debra Patton, Karen Costello, Lauren Hallal-Kirk, Paul Butler, Mark Evans, and Devin Hobby for their support of this project.

Amy B. Adler, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 [email protected]

Received November 17, 2018

revised March 23, 2019

Accepted June 6, 2019

Psychological Trauma: Theory, Research, Practice, & Policy 12(4):p 431-435, May 2020. | DOI: 10.1037/tra0000487

Objective: The purpose of this study was to pilot the iCOVER curriculum—a training product designed to teach service members how to recognize and respond to acute stress reactions (ASRs) using a simple, 6-step procedure, iCOVER. Three goals guided the pilot: (a) assess training acceptability, (b) assess impact of training on knowledge and performance of the iCOVER procedure, and (c) explore the effects of in-person and computer-simulated practical exercises. Method: Six military squads (N = 66) were randomly assigned to 3 conditions: iCOVER Standard (iCOVER instruction with an in-person practical exercise), iCOVER Tech (iCOVER instruction with a computer-simulated practical exercise), or Control (no iCOVER instruction). Squads in the iCOVER conditions received iCOVER instruction, completed a knowledge test and practical exercise to which they were assigned (i.e., Standard or Tech), demonstrated their iCOVER skills in live-action scenarios, and reported their perceptions of the training. Results: iCOVER training was acceptable to most participants and associated with improved knowledge about iCOVER (M_pre = 3.33 vs. M_post = 5.15; t[42] = −7.61, p < .001, d = 1.41); iCOVER Standard resulted in more iCOVER behaviors during a live-action scenario compared with the other conditions, F(2, 35) = 13.36, p < .001, η² = 0.43. Compared with iCOVER Tech, iCOVER Standard had greater acceptability and resulted in better performance of iCOVER. Conclusions: This is the first U.S. demonstration of a training program designed to address ASRs during high-risk operations and offers a potential way ahead for preparing military teams to manage ASRs.