THE WARRIOR PROGRAMME

Summary report of the Warrior programme, May 2008

Prepared by John Barry, Independent Statistician

Background

The Warrior programme is a 4-day non-residential group therapy treatment aimed as helping improve the psychological functioning of people suffering from the effects of traumatic experiences, especially those ex-army services personnel suffering from combat stress. The treatment utilises techniques from a range of schools of therapy. Previous Warrior programmes have found that participants report significant benefits, but it has not been until the May 2008 programme that these benefits have been measured using scientifically validated questionnaires.

Participants and assessment

Twelve people completed the programme, six Ex-Services participants and six Non-Services. In the Ex-Services group all were men; in the Non-Services group 3 were men and 3 were women. The participants rated various aspects of their psychological state immediately before and immediately after the programme. Their ratings were analysed using the Wilcoxon statistical test to see whether there was a significant improvement as a result of the programme.

Results

1/ There were very significant improvement in Current Mood (WPCM), Current Anxiety (HADS) (see figure 1), Current Depression(HADS), Wellbeing (CORE), Psychological Problems(CORE), Psychological Functioning(CORE), Overall Psychological State(CORE) (see figure 2).

2/ There was no improvement in feelings about Relationships (WPR) with others.

Figure 1. Improvement in anxiety levels for the Ex-Services (left columns) and other participants (right columns).

Figure 2. Improvement in overall psychological state (CORE) for the Ex-Services (left columns) and other participants (right columns).

These changes indicate a clinical improvement for the participants. The improvements in the HADS Anxiety scale represents an improvement from moderate levels of anxiety to normal levels, and this is clearly of clinical significance. The HADS depression scores improved from mild to normal. All of the CORE outcomes improved strongly; the overall score pre-Warrior (1.7) to post-Warrior (0.5) represents a shift from clinical levels of psychological dysfunction (the cut off is 1.25) to normal levels of functioning.

The lack of improvements in the Relationships ratings is explained mainly by the fact that one of the four questions related to relationships with the WP helpers, and because this was already very high (8.3/10) the relatively small improvement (8.9/10). The Friends ratings also showed only a very small improvement (5.7 to 7), and the two non-significant ratings diluted the impact of the larger improvements on two of the other three questions (Family, and Colleagues) causing the overall improvement to be non-significant.

Ex-Services participants

In general the improvement in this group was slightly (but not significantly) smaller than for the non services group, and this may be because the Ex-Services group have more chronic (long-term) and widespread issues (e.g. homelessness) to deal with. This group also filled out an additional questionnaire asking about various aspects of aggression (the Aggression Questionnaire). There were significant improvements in various aspects of the specifically Verbal aggression, Physical aggression, Anger, and the overall aggression rating. The only measure that did not show a significant improvement was the Hostility scale. This scale measured feeling of having had a “raw deal” from life, feeling others “get the breaks”, and feeling “bitter about things”, and it is perhaps understandable that people who have been injured in the course of serving their country and who feel vilified rather than rewarded might have a level of bitterness that improves only slowly, and will be monitored over the course of the follow-up support meetings.

Conclusion

The fact that there were statistically significant improvements in the vast majority of measures used (9 of 10 for the Non-Services group, and 13 of 15 for the Ex-Services) clearly indicates that the Warrior Progamme has been of immediate benefit to the participants. Ongoing evaluation will be carried out to assess the level to which these benefits are maintained (or perhaps improved) over the course of time.