The Army’s Comprehensive Soldier Fitness program has been widely promoted as an urgently-needed response to an alarming reality: the increasing rates of post-traumatic stress disorder, suicide and other adverse psychological reactions among soldiers exposed to combat in Iraq, Afghanistan and elsewhere around the globe.
A recent article in The Daily Pennsylvanian, offered a rosy, one-sided account of this positive psychology-based resilience program. This latest entry in the ongoing over-hyping of CSF is regrettable, because the program deserves careful scrutiny and is actually quite controversial in many ways.
First, CSF was instituted as a mandatory training program for over one million United States soldiers without the standard pilot testing crucial for assessing both the program’s effectiveness and its potential risks to participants. This is a serious concern, especially since CSF is based on a group intervention program, the Penn Resiliency Program, primarily designed to prevent depressive symptoms in school-age children — a very different population from soldiers facing combat. PRP itself has produced conflicting and inconsistent results. Indeed, the authors of a meta-analysis of 17 PRP studies concluded that it is “difficult to give an overall appraisal of the program’s effectiveness.”
Second, there has been little acknowledgment that universal prevention programs like CSF have a mixed and disappointing track record (DARE — Drug Abuse Resistance Education — is a prime example).
Experts have highlighted a range of potential adverse effects from participating in these interventions. In the specific case of CSF, some soldiers may take unwarranted risks based on the belief that they have received some form of preventive protection. Some may suffer from heightened stigma and shame — and therefore avoid seeking professional help — if they fail to effectively handle a stressful event after CSF training. And some CSF techniques may disrupt the natural resilience and successful coping strategies that many soldiers have already learned to employ when exposed to potentially traumatic events. It is important here to recognize that CSF is not designed for individuals who have been identified as “at-risk.” All soldiers are required to participate.
Third, thus far, the research produced by the Army evaluating the CSF program has been unimpressive and seriously flawed. In particular, the most recent CSF research report (mentioned in the DP article as documenting the effectiveness of the Master Resilience Training component of CSF) suffers from multiple inadequacies, including problems with methodology (for example, non-comparable treatment and control groups), data analysis and the interpretation of findings.
This study also failed to include any validated measures of PTSD, depression or other psychological disorders — the very problems that have been repeatedly cited as the basis for the rushed roll-out of CSF. In sum, the verdict is still out on whether or not CSF “works.”
Finally, there are other complex issues associated with CSF that warrant broader discussion. For example, in describing CSF, Martin Seligman, one of Penn’s faculty members actively involved in the program’s development and implementation, has said, “We’re after creating an indomitable Army.”
But profound ethical questions are raised by efforts to create invincible soldiers. What psychological reactions should the horrors of war elicit in a human being? How might such indomitability play out when soldiers leave the battlefield and return home? What different choices might our national leaders make if military invulnerability became a reality?
Although questions like these have no easy answers, they should be part of the CSF conversation — and those who ask them should not be dismissed as unpatriotic or unconcerned about our troops.
The adverse psychological effects on our soldiers of multiple and lengthy deployments and high levels of combat exposure are well-documented. As a nation it is incumbent upon us to better meet the challenge of serving, protecting and mending the sons and daughters we place in harm’s way. But the decision by CSF’s proponents to aggressively promote and prematurely celebrate an unproven intervention program does little to advance either the public interest or our soldiers’ welfare.
Roy Eidelson is a clinical psychologist and the president of Eidelson Consulting, where he studies, writes about and consults on the role of psychological issues in political, organizational and group conflict settings. He co-authored a detailed critique of the latest CSF research report, available online at ethicalpsychology.org. His email address is email@example.com.