Experiential/Motivational Intervention: Changing Beliefs & Behaviors in Stress Management

1. Experiential/Motivational Intervention:Changing Beliefs & Behaviors in Stress Management AAHE Presentation Tampa, Florida April 3, 2009

2. Session Goals • Demonstrate that a one-time intervention can make a difference • Outline the COMPLEX model process including its theoretical basis • Demonstrate the COMPLEX model as an effective method of experiential learning

3. Session Objectives Attendees will gain a greater appreciation for: • The significance of critical incident stress experienced by EMS providers • The importance of pre-incident preparation for learning ways of proactive coping

4. Background Using the COMPLEX Model to Change Beliefs Regarding Proactive Coping Behaviors in Emergency Medical Service Trainees by Dale Maughan RN, EMT-P, PhD Submission for publication pending.

5. Why? “In over 25 years in EMS, the thing that is painfully obvious to me is the fact that we make a great effort to protect ourselves from infectious diseases, blood spatters, and hazardous materials. All the while, the most insidious and widespread problem out there for EMS practitioners, their families, and friends is the inability to leave EMS at the station. This eventually gets to the point of sacrificing close and meaningful relationships in our zeal for professional gratification. You need to make sure to take care of yourself while you are taking care of others.” Paul A.Werfel NREMT-P, Director, Paramedic Program Assistant Professor of Clinical Emergency Medicine, State University of New York at Stony Brook

6. Emergency Medical Service Stress

7. Emergency Medical Service Stress

8. Proposed Model Beliefs Goals Values Attitudes Perceptions Consequences Physical Mental Emotional Spiritual Social Critical Incident Primary Appraisal Secondary Appraisal Coping Behaviors Pre-Incident Preparation Realistic Expectation Development Wellness Education Proactive Coping Behavior Training

9. Coping Behaviors

10. Results/Recommendations • The COMPLEX model was effective in changing outcome expectancy and self-efficacy beliefs regarding the use of select proactive coping behaviors in EMS trainees. • The next step is to evaluate actual adoption of behaviors.

11. COMPLEX Model • A model for experiential learning • Authors: • Gary D. Ellis • Catherine Morris • Eric P. Trunnell • World Leisure & Recreation, V. 37, 1995

12. COMPLEX Model • Create Goals • Orient • Motivate • Participation • Log-Off • Edify • Examine

13. COMPLEX Model Theoretical Basis • Arousal ( Berlynne, 1960; Ellis, 1873; Eysenck, 1982; Festinger, 1957) • Expectancy Valence (Rotter, 1975) • Self-Efficacy (Bandura, 1986) • Attribution (Abramson, Seligman & Teasdale, 1978; Heider, 1958; Russell, 1992)

14. COMPLEX Model • Create Goals • Orient – Arousal • Motivate – Expectancy-Valence, Self-Efficacy • Participation – Self-Efficacy • Log-Off • Edify - Attribution • Examine

15. COMPLEX Model Arousal People strive to maintain a level of alertness/activity/interest (arousal) that is appropriate to their circumstance.

16. COMPLEX Model Self-Efficacy Decisions to participate or not are dependent on one’s efficacy and outcome expectations. • Performance • Vicarious experience • Verbal persuasion • Arousal

17. COMPLEX Model Expectancy-Valence Decisions to participate or not are dependent on one’s desire for specific benefits and how much value are placed on them.

18. COMPLEX Model Attribution Causes identified for outcomes • Internal vs. External • Stable vs. Unstable • Global vs. Specific

19. COMPLEX Model Blueprint

20. COMPLEX Model Key Components • Experience • Ordered messages • Flexibility • Processing • Reflection • Generalization • Application

21. Questions?