Psychological Support for Military Personnel on Operations



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Psychological Support for Military Personnel on Operations
Dominique Laffittan and Yves Biville

Centre d'Etudes Sur la Selection du Personnel de l'Armée de Terre

Compiegne Cedex, France

The French troops and particularly the French Army have been deployed in several operation theatres for years. The multiplicity and wide range of peacekeeping interventions have been the subject of numerous analyses by the French staff headquarters. The soldiers' protection has been reinforced and at the same time the necessity of developing the psychological support for military personnel on operations has emerged. Such support has already been given in numerous foreign armies for years.


The first part will deal with the role of the various parties on operation theatres. Then, we will show and explain the surprising and trivial role still played by psychology in this context, in spite of the staff headquarters determination to develop the concept of psychological support and make the collaboration and division of tasks between the various parties easier.
PART ONE: THE ROLE OF THE VARIOUS PARTIES
1/ On the operation theatre :
France has a long tradition of foreign intervention and troops deployment in numerous continents.
This tradition resulted in the international recognition of lots of skills. In particular, the French defence system is deployed, to a larger extent, compared to the USA, in intervention zones. This attitude rests on a long colonial tradition which makes it necessary for the High Command to leave subordinates (captain and first lieutenants or non-commissioned officers) a larger margin of initiative and the possibility to make contacts with the population as a whole.
This plan of action on the field requires a particular adaptation of the troops and explains the differences noticed in the factors of stress between the various contingents of peace keeping forces in Bosnia, Somalia or Central Africa (for instance, such factors of stress as * travel restrictions + or * feeling confined + are not always the same between French forces and US forces).
The French High Command pays great attention to the moral and mental factors but the fragmented information and the affective implication of the troops in contact with different populations can also be sensitive to the rumors and contradictory plans of action (to help or not to help the population according to the periods of engaging).
Note: the views of the author do not necessarily reflect those of the department of the Army, or the department of Defence.

To help, treat or understand combatants and provide them with a medical, psychological or spiritual support, various parties concur to the High Command's action.
The Health Support :
It surrounds the troops with efficiency. Here again, it is part of an old colonial tradition and of a legal and ethical choice: doctors, and not only nurses, remain close to the soldiers. Thus, there are one or two doctors per regiment and sometimes a military surgeon (captain) per company or for isolated platoons.
These doctors, who were appropriately trained for treating the soldiers on the front line, are an integral part of the troops. The soldiers personnel often confide in them, even if the military psychiatrists acknowledge the lack of training as far as psychological support is concerned.
The presence of military chaplains :
As numerous foreign units, France employs military chaplains to support its troops. Serving in uniform and often in a regiment or battalion service, they are well-received by the soldiers and officers. Their presence is usual and their action often takes a psychological, rather than spiritual, aspect.
Three religions are represented: the catholic chaplains, the Protestant clergymen and the rabbis.

Though Islam is the second religion in France, there is not any representative in the field. This is mainly due to the absence of official representative of the Muslim religion (no clergy).



Besides, there is no military Academy for chaplains in France, unlike in the USA.
The psychiatrists :
As the psychiatrists are not traditionally well represented in the field in France as well as in operations, their number have nevertheless been increased since the Lebanon, the Gulf War and the traumatizing events in Rwanda and particularly in Bosnia.
The role of the psychiatrists, who are in charge of mental health, has not always been fully acknowledged within the forces. Thus, the enlightenment of slight or deep psychic troubles during the last engagements accounts for a come-back and a dominant will for intervention as far as psychological support is concerned.
In this way, as they are doctors and specialists in mental care, psychiatrists fully claim that their presence on the operation scene is a priority, thus excluding any action from the psychologists out of the sphere of the army health service.


Their statement is clear: * compared to psychologists whose academic knowledge, according to them, cannot be but general, the psychiatrists action appear to be a real therapy insofar as their status and position give them the possibility to establish privileged relations with their patients.
They are thus fully integrated in the medical team as soon as the operation begins.
- On the front line : they are integrated into the health group which plays a central part in relation to the deployment of the various units. His role is to ensure the treatment of reactions after the fight.
- On the back line : they receive, treat in emergency and evacuate to France the psychiatric cases from the front line. Moreover, they take part in all the actions concerning mental health and command advice.
In order to keep the High Command informed of the problems which could affect the soldier's morale, another party has appeared in the field. It is the officers in charge of studies of the * Centre de Relations Humaines (CHR) + of the French Army.
At first, this Centre included psychologists and sociologists. However, no psychologist has worked or been assigned in this centre since 1983. But in our centre which is   the Centre d'Etudes Sur la Selection de l'Armée de Terre.
This Human Relations Centre was first created to keep the Army staff commander informed of the apparition of psychological or sociological traumas within the forces. Once the psychologists were discharged, this mission has remained and it has become usual to call it * moral force + or simply * morale +. This conjuring trick has led to the eviction of the very few army psychologists from the psychological support action.
The officers in charge of studies of the Human Relations Centre get a one-year training in sociology pass a master's degree. They do not receive any training in clinical or social psychology though they often use the concepts of psychology.
Their role, while spending three weeks in the field, is to gather any information or clues that could affect the troop's morale. Their methodology assumes the concepts of sociology organisations, and especially the strategic analysis developed by Michel Crozier in France. It is based on a technique using interviews and questionnaires.
Their analysis, which are most of the time judicious and relevant, are based on a series of factors which international literature (Stouffer and Janowitz) studied a long time ago and corroborated in the field.

The morale evaluation of humane component can be described in six points :


-The unity cohesion

-The reliance on the chief

-Self-confidence/reliance

-The reliance on the means

-A feeling of justifiability of the action

-Personal situation


When informed, the command can take measures in order to maintain, correct or improve a unit's morale.
The last expected parties, the psychologists :
At the present time, no psychologists are dispatched on external operations. Our intervention in Bosnia (Colonel Y. Biville and Lieutenant Colonel Laffitan) in 1995-1996 was inscribed within a specific research contract conducted in collaboration with two researchers from the University of Aix-en-Provence on a Mountain Infantry Battalion based on the Ingman mountains over Sarajevo.
During that stay, we could compare the French and American action methods on psychological support with Major Paul Bartone as a liaison officer.
While most western countries employ front line psychologists on external operation scenes, France has not yet acknowledged the utility of psychologists in the field.

We will come back to that situation in a moment.


2/The back line parties
Every deployment implies family support as an important element of the fighter's moral.

For a few years, the French Army have gradually developed adapted structures.

Among these ones you can quote :
- The organization of family support which is centered round the * family support group + whose missions and means were the subject of a memento.

Five departments: the high command, the administration, the jurisdictional, the information and the social action departments in order of appearance deal with unit echelons, the administrative, financial, material needs, the information needs and finally the psychological and moral needs.


- The implementation of a solidarity agreement between the army and the district councils and the creation of a * solidarity defence + association which aims at showing to the personnel sent on an assignment abroad the support given to their action (donations, parcels, relaxation stays...).

- Lastly an after-care department for the wounded of the Army has been created (CABAT: Cellule d=Association aux BlessJs de L=ArmJe de Terre).Though this department still has a very reduced personnel, it is the only one for the moment in the French armies. Its goal is to accompany the wounded soldiers and their families by responding to the material difficulties encountered (reception of the families during the hospitalization). It also deals with the problems of reintegration in working life.


- Whereas the US Army employs in operations officers specialized in social problems (that is social workers) as well as psychologists or psychiatrists its * combat stress detachment + units, the French Army does not use for the moment its social workers on external operations..

The professionalization and the increasing number of women in the French armies allows us to think we should consider it in the near future.


As described below, the posts of everyone seem well defined for command.
- The health assistant (unit doctor for the front line forces) treats, gives account of the sanitary conditions and visits the unit first aid posts.
- The psychiatrist, in addition to the specific actions which have been defined, informs the high command and make suggestions according to his analysis of the situations.
- The high command helped by its * moral assistant + take decisions in terms of command by using the front-line officer's observation by taking into account the analyses of the officers of the Humane Relations Centre.

PART TWO :THE ROLE PLAYED BY PSYCHOLOGY AND THE LIKELY EVOLUTION
1/ The role of psychology
At this stage of analysis, it is important to take into account the reasons explaining the absence of psychologists.
First of all, the number of qualified psychologists in the armed forces is very low: between five and ten persons. Then, most of the psychologists are officers belonging to such arms as infantry, military engineering ...
In France like in most countries, the title of psychologist is protected, follows a professional code of ethics, and requires at least five years to be fully acquired.

It does mean that an officer, even trained in a military Academy, who gets in this way, has to take up entirely new specialized studies and also give up every hopes of command, if the Army wants to make his formation profitable.


On the contrary, the title of sociologist is not protected, so one year is enough to graduate in sociology, as soon as an officer has been trained in the military Academy. The training allows them to become at the same time specialists in social science and also preserve their military career and they can attend courses at the War College too.
This situation combined with the lack of knowledge of the headquarters staff about the differences between psychologists and sociologists results in the mixture between various subjects and in employing only sociologists, who belong to a centre whose aim is historically and officially to * detect the appearances of psychological or sociologic phenomena in the Army +.
Adding that this centre directly depends on headquarters staff and that its function is to dispatch social science specialists in the field, the ability of psychologists to intervene is very limited..

This position is reinforced by the systematic attitude of the psychiatrists of the health service, who use their prerogatives and their status of doctors to ensure an exclusive intervention in the psychological domain.


2/ The likely evolution
Can or should this situation be continued ?
The situation is now as follows: the psychologists of the Air Force are exclusively in charge with the selection and depend on the high command of the training schools of the Air Force which do not deal with the psychological support.
The Navy has a certain number of applied psychology centres based in ports but the command of those centres is delegated to a psychiatrist.
The Gendarmerie has at its disposal a centre exclusively devoted to the selection of the personnel and a committee linked to the personnel management.
The Army has at its disposal a centre of studies for the selection of its personnel, but this centre will be dissolved within the next few weeks. The few psychologists are dispatched in various places where their specialty is not much valued.
Unlike the Army, the three other armies employ their psychologists to analyze the troops morale exclusively in France, but never on operations, while it is normal and usual practice in foreign armies.

The Army traditionally entrusts this task to the CHR, which is also in charge with defining and analyzing the Army's needs in specialists in social science. It is quite obvious that the French Army will not resort to psychologists in the field, for it would * undermine + the sociologist's role.
This situation, often denounced, raises our foreign friends misunderstanding.
However, a tendency is now becoming apparent: the Headquarters staff, determined to develop the psychological support of the troops, set up a commission for studies. Our centre attended this Commission but unfortunately our counterparts of the Navy, Air Force and Gendarmerie did not.
One year of reflection, exchanges, clashes of powers and abilities, led to a scheme aiming at dividing tasks.
In the slides, you will notice that the specialists of the human factor are once again mixed up. The tasks of the officers-experts in human factor were mainly established by psychologists but it was not quite possible to differentiate the roles of each party, here again for reasons of power.
It must be noted that psychiatrists have kept * individual support to people and groups confronted with difficulties + which is in their book the responsibility of the Health service, and especially that of the psychiatrist himself.
The psychiatrists have also kept both the psychopathological selection and the examination of critical incidents and accidents.
The USAMRU, the crisis psychological centre of the Belgian army or the psychological services of the Croatian army have however in this domain knowledge and skills that come from their experience as psychologists.
It is a problem of competencies and the Headquarter staff do not want to decide between one solution and the other and prefers to let the specialists take themselves the good decision. It is like squaring the circle !
This maybe too long of a bird's eye view of the existent procedures for psychological support in France shows that a lot of work still remains to be done in the French Army in order :
- to recruit and train on the spot psychologists
- to make people aware of their competence and the part they have to take in psychological support
- to profusely give away the experience accounts on both a national and individual level
- to utterly make them recognized as both officers and psychologists.
During the latest meeting on the International Army psychological symposium that was held in Vienna in May 1997, a Swedish college considered creating an International association for military psychology.
Maybe it is the line to follow in order to share our * interests and our problems +.
I think we are in a position to justify a psychological support...
My deepest thanks for your attention.
ANNEX 1
CONCEPT OF PSYCHOLOGICAL SUPPORT
The psychological support is a command coordinated action that enables the fulfillment of the mission given to the committed forces in a specific zone of operations by integrating all the aspects of the human factors.
That action works on the following spheres:
- combat effectiveness
- prevention, management and solution to distressing and unstable situations
- individual and collective psychological stability
- mental health care
It exerts permanently from the personnel preparation for engagement up to his accompaniment after he gets back.
Both the committed element and the reach in its global environment are involved
ANNEX 2
SUPPORT PSYCHOLOGICAL IN THE FRAMEWORK

OF PERSONNEL TRAINING





RESPONSIBLE




ACTIONS TO CARRY OUT



Command

Officers

* Human factor +

Physical and technical training as well as moral strength in the units, accordingly to the regulation.


Participate in the detection of individuals who show behavior disorders or having social difficulties.
A wide participation and an increased cohesion within formation.



Psychiatrists and first line doctors

- Detection of the personnel that shows behavior disorders.


- In the formation schools, awareness campaigns about the various psychological expressions of individual crisis situation.







Officers, experts, sociologists and psychologists

Initial psychotechnical and psychological individual selection plus competence evaluation


Education in the spheres of mental and affective individual functions; command psychology, psychosociological approach of an organization and team work; detection of the stress signs in operation; stress management; techniques of negotiation and solution to conflicts; awareness to the phenomena linked to the intercultural psychology.
Keep informed and heighten the managerial staff and family awareness




ANNEX 3
THE PSYCHOLOGICAL SUPPORT JUST BEFORE DEPLOYING





RESPONSIBLE




ACTIONS TO CARRY OUT



Command and officer * human factor +

Setting up * family care + cells to support the families of personnel on operations.


Eviction of non-available personnel because of family or social reasons.
Intensification of actions liable to increase cohesion (Information, meetings with families, briefings and dinners, contests, cohesion maneuvers ...) and preparation duties in all spheres.



Psychiatrists and first line doctors

- Common personnel steady and health preparation.


- Physical and medical examination
- Visits during the cohesion camp







Officers, expert sociologists, psychologists

Specific visits according to the type of mission at the cohesion camp


Homogenization of knowledge and common use in the previous spheres, as well as in helping the commands in the formation team for special operations
Preparation to the family separation and family information about the existence of structures that could handle.



ANNEX 4
PSYCHOLOGICAL SUPPORT DURING THE MISSION




RESPONSIBLE




ACTIONS TO CARRY OUT


Command

Officer  * human factor +

Personnel control in liaison with the health service.


Put life into the * rear base + and the * family care calls + in liaison with the health service and the different experts and specialists in human and social science.
- Moral estimation.
Prospective identification of the risk factors.
- Steady, assessment and synthesis of the questions linked to the human factors, backed by the health service and the officers coming from the setting up cell in the G1 section of the Joint theatre HQ.




Psychiatrists and first line doctors


Direction, treatment in their content or * medevac + the individuals at risk or those who show behavior disorders. (On a mental security basis) Intervention on the command staff.









Officers, experts sociologists and psychologists



On operations
- Synthesis given to the command staff about work and life standards; a new light on the stress factors and their probable consequences.
- Human environment factors evaluation (population and belligerents behavior; psychological action, misinformation).

Individual and collective soldier support, check the vulnerable people; provide help to end inter or intra group conflicts. Analyze the incidents and collect information in order to take into account the experiences and situation that will help in the selection of personnel and forces preparation.


In the rear

Their role is to support the families in liaison with the command staff.






ANNEX 5
PSYCHOLOGICAL SUPPORT AFTER THE MISSION




RESPONSIBLE




ACTIONS TO CARRY OUT


Command

Officer  * human factor +

- Rewards


- Organize a parade for the disbanding of the unit, back from the operation
- Follow through the personnel that has been taken in charge by the "wounded help cell"
- Information and take the drama out of postponed effects
- Detection of unadapted behaviors in liaison with the medical branch and the officers experts, sociologists and psychologists
- Analysis of the encountered dysfunction and proposals to higher command
- Analysis of the problems and adaptation of the actions to carry out in the sphere of: psychological preparation in order to improve the combat effectiveness of the units
- Steady, check up and synthesis of the questions relatives to the human factor




Psychiatrists and first line doctors


- To help the command staff means to participate in the debriefings and exhibit the balances and synthesis of teachings







Officers, experts, sociologists and psychologists

- Supporting the personnel is done by after-mission interviews and by professional family and social reinsertion of the soldiers


- A check up of competencies and a professional restreaming could be suggested
- The acquired teachings expertise are grouped , capitalized, issued and exchanged inland or abroad
- It leads on to the preparation of future missions








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