The Resilience at Work (RAW) Mindfulness Program: The development and evaluation of an online mindfulness based training program aimed at enhancing psychological resilience and wellbeing among Emergency Workers

INTERVENTION: The intervention involves a 6‐8 week online mindfulness‐based resilience program for emergency workers. The intervention will be delivered via IPADs and comprises 6 interactive online modules running for about 20 minutes each. Each week a new module will be made available online to participants. They will have the opportunity to opt‐in for text‐message reminders or email reminders to practice the skills in the program. The program will provide participants with quick access to a range of adaptive skills, which could enhance their ability to manage stress and cope with trauma more effectively. These core skills are derived from the principles underpinning a number of evidence based cognitive therapies including Acceptance and Commitment Therapy (ACT), Compassion focused Therapy (CFT) mindfulness based Cognitive Therapy (mBCT) and Mindfulness based Stress Reduction (MBSR). Adherence to the program will be assessed by the sum total number of sessions completed by each participant. This information will be collected by the backend IT programming system. CONDITION: Psychological resilience alcohol usage general well‐being psychological symptoms associated with post traumatic stress psychological symptoms of anxiety psychological symptoms of depression psychological symptoms of stress PRIMARY OUTCOME: The primary outcome of this intervention is psychological resilience as measured by the Connors‐Davidson Resilience Scale (CDRISC‐10). Primary outcome 1 : Difference between intervention group and control group on the CDRISC‐10 immediately post intervention and at 6‐month follow‐up.. The second primary outcome is bounce‐back resilience as measured by the Brief Resilience Scale (BRS) (Smith et al., 2008). SECONDARY OUTCOME: Alcohol usage as measured by The Alcohol Use Disorders Identification Test (AUDIT‐C) (Bush, K., Kivlahan, D.R.,McDonell, M.B., et al., (1998). The AUDIT alcohol consumption questions (AUDIT‐C): an effective brief screening test for problem drinking. Alcohol Use Disorders Identification Test. Archives of International Med. 14;158(16):1789‐95). General well‐being as measured by The WHO (Five) Well Being Index ( Bech P, Olsen LR, Kjoller M. Measuring well‐being rather than the absence of distress symptoms: a comparison of the SF‐36 Mental Health subscale and the WHO‐Five Well‐Being Scale. International Journal of Methods in Psychiatric Research. 2003; 12: 85–91.) ; ; ; ; The Posttraumatic Stress Disorder Checklist for DSM V(PCL‐5) (Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM‐5 (PCL‐5). ; Trauma outcomes will also be measured by the Posttraumatic Growth Inventory (PTGI), (Cann, A., Calhoun, L. G., Tedeschi, R.G., et al., (2010) 'A short form of the Posttraumatic Growth Inventory', Anxiety, Stress & Coping, 23: 2, 127 — 137). INCLUSION CRITERIA: Inclusion criteria ‐Participant is currently employed as a permanent firefighter within FRNSW ‐Participant is permanently based at a Primary Rescue Station ‐Participant is not currently engaged in any regular individual psychological therapy i.e., weekly or fortnightly sessions with a Psychologist and/or Psychiatrist ‐Good English comprehension ; Longer term changes to resilience as measured by the CDRISC‐10 and BRS Perceived stress as measured by the Perceived Stress Scale (PSS) (Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the U.S. In S. Spacapam & S. Oskamp (Eds.), The social psychology of health: Claremont Symposium on Applied Social Psychology. Newbury Park, CA: Sage.) Psychological symptoms associated with Depression and Anxiety as measured by the Hospital Anxiety and Depression Scale (HADS). (Zigmond, A. S.; Snaith, R. P.. The hospital Anxiety and Depression Scale, Acta Psychiatrica Scandinavica, Vol 67(6), Jun 1983, 361‐370). Rumination and worry as measured by the Cognitive Fusion Questionnaire (CFQ) (Gillanders, D.T., Bolderston, H., Bond, F.W., et al., (2014). The Development and Initial Validation of the Cognitive Fusion Questionnaire. Behavior Therapy, 45 : 83 – 101.) Trauma outcomes including symptoms of post traumatic stress and post traumatic growth as measured by: