Squad Interpretation and Meaning Making (SIMM): First stage intervention for combat stress reaction among United States Army soldiers

The soldier's warrior ethos creates a sense of invincibility where soldiers attend to physical wounds and neglect psychological wounds. Soldiers returning from Operation Iraq Freedom were diagnosed with PTSD (10--19.9%), depression, or anxiety (13--28%) (AMHAT, 2005; Hoge, Castro, Messer, McGurk, Cotting, & Koffman, 2004). The Army offers a CISD-style Critical Event Debriefings to combat the increased reaction to combat stress. Despite their popularity, CISD programs do not have the empirical data to show their effectiveness (i.e.: Hobbs, Mayou, Harrison, & Warlock, 1996; McFarlane, 1988). The following program, Squad Interpretation and Meaning Making (SIMM), is based on the PIES model and provides therapeutic intervention to the squad immediately after the trauma. This program utilizes the strength of leadership to guide the squad though meaning making for the traumatic event. Meaning making can be difficult while still in a combat environment, so coping skills are joined with meaning making throughout the program to introduce vital tools that will help soldiers continue to making meaning of traumatic events when returning from deployment. This program increases unit integrity by increasing the soldiers' social support systems, reduces stigma of mental health by using unit leadership instead of mental health personnel, and maintains unit strength by increasing mental health with in the theatre of war. SIMM's design requires continuity of instruction to incoming officers at Basic Officers Leadership Course. The incoming lieutenants teach the program to squad leaders at their first duty assignment.