Research Studies Non-Recruiting Studies

Non-Recruiting Studies

The Atlas Institute’s research studies are designed to ensure that Veterans, their Families, service providers and our research partners have access to the latest evidence. Some of the studies we’re involved in are not open to participants, but we offer summaries and information about each project.

Peer Support

Supporting Veterans during COVID-19: A tiered/layered peer support training and delivery model

Lay summary

A layered peer-support-training model was created to increase Veterans’ access to quality peer support during COVID-19. This model provides Veteran peer supporters with guidance and training from licensed clinicians. Through this “layer” of clinical support, Veteran peer supporters are equipped with evidence-based practices as they provide support to fellow Veterans.
This purpose of this project is to evaluate the effectiveness of this approach. Based on the findings, a proof of concept for this sustainable and evidence-based model will be created. The results of this study will help to increase the effectiveness and accessibility of peer support for Veterans.

Scientific summary

The purpose of this research is to evaluate the outcomes and effectiveness of a structured, tiered approach to peer support (the “tiered peer-support model”) for both those providing and receiving that peer support during the COVID-19 pandemic.

In the Veteran’s Transition Network’s (VTN) tiered model, Veteran peer-supporters (the “Veterans”) are trained and then supported by licensed clinicians to provide peer support to fellow Veterans (the “peers”). The training instructs the Veterans in evidence-based practices for supporting their peers. The clinical support provides the Veterans with the opportunity to debrief, seek advice and refer peers who are in need of professional counselling support.

This research evaluates the impact of both the training and structured approach on the self-reported level of confidence, stress and drop-out rate of Veteran peer supporters. In addition, the outcomes of the peer-support provided are measured through the treatment satisfaction scale (TSS).

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Led by Veteran’s Transition Network (VTN)In Partnership With University of British Columbia, Atlas Institute for Veterans and Families

Health and well-being Post-Traumatic Stress Disorder

Mental health and well-being of Afghan-Canadian language and cultural advisors (LCAs) who supported Canadian Forces abroad

Lay summary

During Canada’s mission in Afghanistan, local Afghan interpreters were hired to work with the CAF for translation and guidance on local cultures and customs.
Along with these local interpreters, Afghan-Canadian citizens were also recruited to work as language and cultural advisors (LCAs). LCAs accompanied CAF soldiers and were exposed to potentially traumatic experiences and morally injurious events (events that don’t align with or violate one’s moral or ethical beliefs and lead to important emotional responses) during their work.
The aim of this project is to help improve the health and well-being of Afghan-Canadian LCAs through improved understanding of their unique experiences, needs and perspectives.
To accomplish this, we will use two types of data collection methods: interviews and questionnaires. The interviews will help us understand LCAs’ perceptions of their work, their transition to civilian life, and the impact of these experiences on them and their family. The questionnaires will give us a more complete picture of their current health status, especially as it relates to PTSD.
The results of this study will inform us about the experience of LCAs and could help guide the future development of services and resources for this group.

Scientific summary

During Canada’s mission in Afghanistan, local Afghan interpreters were hired to work with the Canadian Armed Forces for translation and guidance on local cultures and customs. Along with these local interpreters, Afghan-Canadian citizens were also recruited to work as language and cultural advisors (LCAs). These LCAs accompanied soldiers and were exposed to potentially traumatic experiences and morally injurious events during the course of their work. The ultimate aim of this project is to help improve the health and well-being of Afghan-Canadian LCAs through better understanding of their unique experiences, needs and perspectives. Individual semi-structured interviews guided by an interpretive phenomenological analysis approach will be conducted with approximately 15 former LCAs. These interviews will help improve the understanding of LCAs’ perceptions of their work and transition to civilian life, how, if at all, these experiences have impacted them and their family, and how they would currently like to and would have liked to be supported upon their return. Questionnaires pertaining to symptoms of PTSD will also be completed in order to get a more complete picture of their current health status. The results of this study will build a foundation of evidence about the experience of LCAs and could help inform the future development of adapted services and resources for this group.

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Led by Atlas Institute for Veterans and Families

Moral Distress Moral Injury Moral Resilience

Interventions to reduce moral distress and moral injury and promote moral resilience in healthcare workers, first responders and military personnel: A scoping review

Lay summary

Healthcare workers, first responders, and military personnel often experience situations that place an emotional strain on their moral beliefs and values.
There is growing concern about moral distress and moral injury, both in research and in the media. The COVID-19 pandemic highlighted the need for healthcare institutions to support healthcare workers affected by moral distress and moral injury.
Moral resilience refers to one’s ability to uphold or restore personal integrity, transforming despair and powerlessness into hope. One way to lessen the impact of situations that threaten personal or professional ethics is through building moral resilience.
Research on programs aimed at improving moral resilience shows an increase in ethical confidence and competence, mindfulness, resilience and work engagement, and a decrease in depression, anger and intent to leave a job.
While there is less research about programs that prevent or reduce moral dilemma and moral injury, looking at research on these factors for first responders and military personnel can help understand how they can apply to healthcare workers.
To address this gap, researchers will conduct a scoping review to assess programs that address moral dilemma, moral injury and moral resilience; identify similar patterns; and compare with results across subject groups.

Scientific summary

Healthcare workers (HCWs), first responders (FRs), and military personnel (MP) are regularly confronted with moral adversity that can create tensions among their ethical values, threaten their integrity or violate their professional oaths or commitments. The growing level of concern about this is not only discussed in professional journals, it has also been highlighted in the lay media. In recent days, for example, COVID-19 has shone a light on the pressing need for healthcare institutions to support HCWs who are at increased risk of or who are suffering from moral distress (MD) and moral injury (MI). Moral resilience (MR), the capacity of an individual to sustain or restore their integrity in response to moral adversity, has been raised as a potential way to mitigate moral adversity through transforming the profound despair and powerlessness associated with morally distressing situations. Studies on MR have focused on building capacities, such as self-regulation and awareness, buoyancy, moral efficacy and self-stewardship that restore or preserve integrity in HCWs. Interventions based on these capacities have demonstrated improvements in ethical confidence and competence, mindfulness, resilience and work engagement, and decreases in depression, anger and intent to leave a job. Much less has been published about interventions to prevent or reduce MD and MI. It is therefore important to also examine the existing literature on interventions for MD and MI among FRs and MP to understand how these interventions may be applied to HCWs. The objective of this scoping review is to develop a comprehensive repository of interventions to address MD, MI, and MR among HCWs, FRs and MP, so that these interventions can be mapped thematically and compared, including across these different groups.

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Led by University of Ottawa Institute of Mental Health ResearchIn Partnership With Atlas Institute for Veterans and Families

Cognitive-Behavioural Conjoint Therapy Peer Support Post-Traumatic Stress Disorder Relationships

Mobilizing Couple HOPES: A Guided, Internet-Delivered Couples Intervention for PTSD, to Peer- Support Providers for Canadian Military and Veteran

Lay summary

Couple HOPES (Helping Overcome PTSD and Enhancing Satisfaction) is an online program that aims to address both PTSD symptoms and relationship issues.
The online nature of this program reduces key issues to receiving support such as stigma, financial strain, or geographic location.
Couple HOPES is adapted from a successfully tested treatment called Cognitive-Behavioural Conjoint Therapy (CBCT), developed by Dr. Candice Monson.
The program includes seven online learning modules with brief accompanying assignments. Each person, along with their chosen partner (e.g., spouse, adult child, parent), is assigned a coach who helps them understand and use new coping skills. Couple HOPES has been successfully delivered to Canadian military members,
Veterans and first responders, as well as U.S. Veterans.
For the first time, Couple HOPES coaches will be Veterans or Veteran Family members who have formal training in peer support.
One aim of this project is to examine whether the virtual training for the Couple HOPES coaches is successful or not. Another aim is to measure the impact of the program across multiple areas. These include the use and delivery of the program (‘implementation’), success of the program (‘effectiveness’), as well as coach and client-specific results such as satisfaction.

Scientific summary

Post-Traumatic stress disorder (PTSD) is a common and debilitating condition that can affect a number of Canadian military personnel; PTSD is additionally associated with relationship problems. Recognizing the need to provide services that can address more than one issue at a time, Couple HOPES (Helping Overcome PTSD and Enhancing Satisfaction) is an online program that aims to address both PTSD symptoms and relationship issues (www.couplehopes.com). The online nature of this program also addresses identified barriers in receiving support such as stigma, accessibility, geographic dispersion, financial constraints, and logistical barriers. Based on the demonstrated efficacy of Cognitive-Behavioural Conjoint Therapy (CBCT) developed by Dr. Candice Monson, this Couple HOPES consists of 7 online educational and interactive modules with brief accompanying assignments. Each person using Couple HOPES, with their chosen partner (e.g., spouse, adults child, parent), is assigned a coach who helps them understand and use the new skills taught in each module. Couple HOPES has been successfully delivered to Canadian military members, Veterans and first responders, as well as U.S. Veterans.For the first time, Couple HOPES coaches (those supporting the dyads) will be Veterans or Veteran Family members who have formal training in peer support. The aim of this project is to evaluate the effectiveness of training these peer support providers (PSP) virtually to be coaches and to measure the resulting impacts on a variety of outcomes, including implementation outcomes (e.g., setting acceptability, feasibility), service outcomes (e.g., effectiveness), coach outcomes (e.g., competence, consultation satisfaction), and client outcomes (e.g., program satisfaction, symptomatology).

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Led by Ryerson UniversityIn Partnership With Atlas

Media Analysis

Veterans’ Mental Health and Media Analysis Study

Lay summary

Evidence shows military Veterans are a group that experiences high rates of suicide. The purpose of this project is to assess the tone and content of media coverage of Veterans’ mental health and suicide over multiple years.
The project will create resources to help educate and inform journalists about Veterans’ mental health and suicide issues. The project will examine and measure changes in reporting over time that result from these resources.

Scientific summary

Evidence suggests that the media plays a critical role in forming wider public attitudes and beliefs. As such, a two-year action-research study to assess the tone and content of media coverage of Veterans in Canada, with a focus on mental health and suicide, is being conducted. To this end, research articles from various Canadian media about Veterans will be systematically collected, coded and analyzed to discern patterns of reporting over a two-year period. Moreover, interventions targeted at journalists to help educate and inform them about Veterans’ issues, with a focus on Veteran mental health and suicide, will be developed. These interventions will be implemented in year two, allowing us to compare media coverage before and after the rollout of interventions. It is hoped that these activities will promote fair, balanced and accurate reporting of Veterans, as well as responsible reporting of Veterans’ mental health issues and suicide.

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Led by Douglas Research Centre – McGill UniversityIn Partnership With Recovery Advocacy Documentary Action Research, Atlas Institute for Veterans and Families

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