Our speakers were not able to answer all the questions put to them during the conference due to time constraints, so they have given us their answers in writing. We will add extra responses to questions through time.
Why the need for the walking/treadmill? Does this not preclude some of more seriously disabled?
Prof Jonathan Bisson: It is hypothesised that motion is an important component of 3MDR. As we discussed, walking could preclude some people and we have discussed possible solutions, e.g. a static cycle and achieving motion in a wheelchair, to allow access to more people.
Do you focus on one particular trauma? how do you tackle multiple traumas?
Prof Jonathan Bisson: Multiple traumas are focused on but only really one at a time, through the selection and consideration/walking towards different photos.
Would using VR open this up to those that would find using a treadmill difficult?
Prof Jonathan Bisson: Possibly but would need to consider how best to include the motion component to remain faithful to the hypothesis behind how 3MDR might work.
Did Prof Jonathan consider other triggering senses as part of the treatment as well as sight and sound? Anecdotally we know that smell is very evocative and triggering as can be taste and feel for those affected.
Prof Jonathan Bisson: People are asked to consider different senses but I am not aware of using others, e.g. smell, as a triggering stimulus. Good idea though and one to think about.
For the 3MDR study were the PTSD treatment resistant candidates screened for moral injury?
Prof Jonathan Bisson: They were not formally screened for moral injury but I think that would be a good idea in the future.
Is there a follow up planned to measure the effectiveness of the implementation of the recommendations accepted to drive forward and institutionalise these changes to embed the success into the future?
Prof Jan Walker: We recommended (recommendation 110) that there should be an independent review of the recommendations, noting progress made and ensuring public accountability, every six months. The Government response has accepted this in part, and said that a new Service Families Steering Group will be set up within the MOD and will monitor the recommendations. In other words there will be internal reviews but not independent reviews at this stage. We will continue to track progress ourselves on the implementation of the recommendations.
Recent research from The Female Lead highlighted the issue of the Entitlement Gap and in particular, the issue of the “unentitled mindset”, which seems really relevant for Service spouses/partners who often feel they have to undertake part-time or flexible work and the “mental load” to enable them to fit in wiith the nature of, and support Service life. Would you welcome further research to explore the impact of this on Service spouses and also how Defence recognises the resource they receive from spouses/partners?
Prof Jan Walker: More research on the ways in which Service partners adapt their own careers/working life to accommodate the military lifestyle would always be welcome. We know from the review that many partners felt that their own work and career had been compromised by the specific features of repeated mobility and long periods of deployment by the Serving partner. We believe that the MOD understands the compromises non-serving partners make and has introduced some programmes to specifically support them. Increasingly, large employers who have signed up to the Armed Forces Covenant are supporting partners into work with training in skills that are portable. Barclays Bank is a good example of this which we highlight in the report. But continuing monitoring of this is issue is essential.
What were the biggest challenges faced for each of the research projects?
Prof Jan Walker: The Living in our Shoes team had to contact military families via the Serving personnel…there is no mechanism to invite families directly to participate in research and this is frustrating for researchers, and disempowering for families. One of our recommendations, endorsed by the Chain of Command in all three Services, is that there should be ways in which families can make their own decisions about being contacted and not have to depend on the Service partner to give permission. The agency of Service partners should be respected…they should not be regarded as ‘dependents’.