Developing resiliency skills: using the Relationship Skills Map (RSM) with military couples in high stress environments.
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Nelson, Darwin B.
Nelson, Kaye Welch
|Publication:||Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2012 American Psychotherapy Association ISSN: 1535-4075|
|Issue:||Date: Spring, 2012 Source Volume: 15 Source Issue: 1|
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|Organization:||Government Agency: United States. Army; United States. Army Organization: American College of Forensic Examiners International|
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This article examines the use of the Relationship Skills Map (RSM) as a positive assessment and reflective learning model for developing the core resiliency skills that protect and enhance the marital relationships of active duty military couples. The RSM provides scale-specific measurement of 10 operationally defined resiliency skills that are significantly related to relationship satisfaction and adjustment, effective and healthy communication, experiential intelligence (constructive thinking), and personal well-being. Congruent validation studies with the Dyadic Adjustment Inventory, the NEO and the Constructive Thinking Inventory (CTI) are briefly presented to clarify and expand the meaning and interpretation of RSM scale scores. The RSM has found to be a valuable and practical tool for experienced clinicians and serves as an efficient foundation and focus in relationship enhancement and marital therapy services with highly stressed military couples served by the Scott & White Military Homefront Services Program.
The Scott & White Military Homefront Services' operations are housed in Killeen, Texas, the home of Fort Hood (U.S. Army)--the epicenter of military deployments, the front and back door to the Middle East. The forward-mechanized battle group model embraced by the Army for the Global War on Terror has required every-other-year deployments (12-15 month separations) for those married military members. Currently at Fort Hood there are 50,000 active duty officers and enlisted personnel. According to the 2008 Department Of Defense (DOD) profile of the military community, 55.1% of all active duty military members are married. A majority (70.1%) of officers and over half (52.2%) of enlisted personnel reportedly are married. In addition, 6.7% of DOD active duty members are in dual-military marriages. The Army has the largest number of dual-military marriages at 4.9%. Military couples facing frequent deployments of long duration experience high and destructive levels of distress. Long periods of physical separation involving one or both partners places high levels of stress on marital relationships. The couples often do not have the time and energy resources to benefit from couples therapy and extended counseling. The Scott & White Military Homefront Services' counselors have counted on the RSM to provide an effective and efficient foundation and focus for building resilience skills in these marital relationships.
The use of the RSM as a practical, preventive intervention for increasing resiliency skills with military couples before, during, and after deployment has been a primary means of service delivery for the therapists in the Scott & White Military Homefront Services Program. The RSM was selected as the measure to quantify the specific resiliency skills that each individual couple member would develop, strengthen, or enhance. The Homefront therapist used the RSM as a reflective learning tool to assist couples in identifying their current strengths and targeting specific resiliency skills to learn and develop. A collaborative action plan for resiliency-skills development was co-created by the therapist and the couple. The RSM provides a cohesive language in therapy and a cognitive model for healthy relationship skills development. This language became the foundation for an environment of empowerment and enhancement, a positive focus for the development of healthy relationship skills before, during, and after deployment.
The military community has been exhausted by the past eight years of wartime conflict and the accelerated tempo of deployments. The design and implementation of a practical and preventive intervention program to develop resiliency skills that military couples could use to protect, maintain, and strengthen their marital relationships was the primary program focus.
The Scott & White Military Homefront Services Program provides individual, marital, and family therapy services that are free, unlimited, and confidential, serving Operation Enduring Freedom (Afghanistan/ or Operation Iraqi Freedom (Iraq) personnel and their families. Homefront, which is grant funded, also provides resilience workshops and educational internships. From January 2008 to July 2010 the program provided 7,117 patient contacts.
Background of the Problem
Wolin and Wolin (1993) define resiliency as "the capacity to rise above adversity and forge lasting strengths in the struggle." Epstein (1993) points out that resilient children "became precocious, constructive thinkers with a problem oriented approach to living, an accepting attitude toward themselves and others, and an optimistic and hopeful attitude about the future." Constructive thinking (Epstein's central construct) is seen as a prerequisite to resilient attitudes and behaviors. Adolescents and adults who survive in extremely difficult conditions develop coping skills and display these characteristics: accepting of self, self-confident, flexible and adaptable, accepting and understanding of others, optimistic and a positive attitude towards life, independent in thoughts and actions, realistic and takes reasonable risks, resilient (bounces back quickly after frustrations and adversity), reaches out to others and accepts appropriate help, maintains hope and a personal sense of purpose.
Resiliency skills were operationally defined in this project as the RSM constructive thinking skills of self-esteem, stress management, assertion, empathy, comfort, positive influence, goal setting, time management (self-management), decision making (problem solving), commitment ethic, and intimacy. Anger and anxiety-management skills were linked to the RSM scale measures of Aggression and Deference and a program focus on building the resiliency skill of emotional self-control. The RSM scale measurements of Relationship Satisfaction and Change Orientation were used as estimates of relationship satisfaction and openness to change.
The Relationship Skills Map (RSM) was selected as the positive self-assessment instrument to actively engage the couples in exploring, identifying, and understanding their current relationship behaviors and to serve as a cognitive/behavioral model for resiliency skills training.
The RSM scales are significantly correlated with constructive thinking patterns (Cox, 2010), and constructive thinking skills are prerequisite to developing resiliency skills. The 10 RSM skill scales were used as the program model for building resiliency skills in the marital relationships of military couples facing frequent and long-term deployments. The program focus was on emotional learning for relationship enhancement with an emphasis on building identified and couple-specific resiliency skills.
The purpose of this program was to assist military couples in exploring, identifying, and understanding the role of resiliency skills in protecting and strengthening their marital relationships during the high-stress situations arising from frequent and long-term deployments. Program therapists were introduced to the applications and limitations of the RSM, and guidelines were established for its use. The RSM provided scale-specific measures of 10 constructive thinking skills that were used as operational definitions for the resiliency skills emphasized in the program and as a measure of relationship health and satisfaction.
The RSM scale definitions have been expanded and clarified by congruent validation studies with traditional measures of personality, emotional intelligence, and relationship satisfaction and adjustment (Cox, 2010). The RSM scale definitions that follow were provided to the program therapists, and experiential learning activities were designed to involve the participants in relationship skills development. The 10 RSM skill scales that follow were operationally defined as "resiliency skills," and these research-derived skill definitions were developed based on the congruent validation studies with the scale measures provided by the NEO, CTI, and Dyadic Adjustment Scale.
The NEO (Costa and McCrae, 1985) is a widely accepted measure of the "Big 5" personality factors constituting "normal" personality. The Constructive Thinking Inventory (Epstein, 2001) is a measure of emotional (experiential) intelligence and provides a measure of the central construct in Cognitive Experiential Self Theory (CEST), Global Constructive Thinking (GCT). The Dyadic Adjustment Scale (Spanier, 2001) is an accepted measure of relationship satisfaction and adjustment. By establishing the congruent validity of the RSM with these instruments, the meaning of the RSM scales were expanded and redefined as follows:
1. Self-Esteem (SE)
Self-esteem skills are extremely important at a personal and relationship level. Your score on this scale is a reflection of how you are currently evaluating your worth as a person. Positive self-esteem (skill strength) is an indication that you like and value how you are as a person. A low score (skill strength) on this scale indicates that you may be out of touch with your strengths as a person and currently focused on negative aspects of your attitudes and behavior.
The RSM Self-Esteem scale is significantly and positively correlated with the NEO scales of Conscientiousness (r = .44**) and Extraversion (r = .33*) and significantly and negatively correlated with Neuroticism (r = -.42**).
RSM Self-Esteem is significantly and positively related to relationship satisfaction and adjustment as measured by the DAS (r = .66**).
RSM Self-Esteem is significantly and positively correlated with Global Constructive Thinking (r = .43**), Emotional Coping (r = .38**), and Behavioral Coping (r = .41**) as measured by the Constructive Thinking Inventory (CTI).
INTERPRETATION: Self-Esteem as measured by the RSM is significantly related to healthy personality, relationship satisfaction and adjustment, and global constructive thinking.
2. Interpersonal Assertion (IA)
Your score on this scale indicates your current level of skill in communicating and solving problems with your partner. A high score (skill strength) indicates that you see yourself communicating in a straightforward and direct manner with your partner. A skill change on this scale may indicate that you are not currently communicating assertively with your partner. Assertive communication is a key relationship skill that makes it possible to communicate strong feelings in a respectful and constructive way to your partner. Check your scores on Aggression and Deference to identify your primary and secondary communication styles.
RSM Interpersonal Assertion [IA) is significantly and positively correlated with the NEO scales of Extraversion (r = .42**) and Conscientiousness (r = .45**) and significantly and negatively correlated with Neuroticism (r = -.42**). RSM IA is significantly and positively correlated with relationship satisfaction and adjustment (r = .47**) as measured by the DAS. IA on the RSM is significantly and positively correlated with Behavior Coping (r = .33*), Action Orientation (r = .26*) and Conscientiousness (r = 39**) as measured by the CTI.
INTERPRETATION: Interpersonal Assertion (IA) as measured by the RSM is an action of conscientiousness important to relationship satisfaction and adjustment and behavioral coping.
3. Interpersonal Comfort (IC)
Your score on this scale indicates your skill in judging appropriate emotional and physical distance in your relationship. Skill strength would indicate an ability to express feelings appropriately and spontaneously and to be comfortable, self-assured, and relaxed with your partner. Skill change would suggest discomfort or awkwardness in your current relationship and a hesitancy or reluctance to seek closeness with your partner.
RSM Interpersonal Comfort (IC) is significantly negatively correlated with Neuroticism (r = -.55**) and significantly positively related to Conscientiousness (r = .52**) as measured by the NEO. The RSM scale IC is significantly positively correlated with relationship satisfaction and adjustment (r = .74**) as measured by the DAS. The RSM IC scale is significantly positively correlated with Global Constructive Thinking (r = .44**) and all other positive thinking patterns measured by the CTI.
INTERPRETATION: The Interpersonal Comfort (IC) scale of the RSM is significantly related to healthy personality, relationship satisfaction and adjustment, and global constructive thinking.
4. Empathy (E)
Your score on this scale reflects your sensitivity to the feelings and thoughts of your partner. Skill strength indicates that you see yourself accurately understanding and responding to the feelings, thoughts, and behaviors of your partner (being a good listener). Skill change indicates difficulty in understanding thoughts, feelings, and behaviors from your partner's point of view.
RSM Empathy (E) is significantly and positively correlated with relationship satisfaction and adjustment (r = .68**) as measured by the DAS. The RSM Empathy (E) scale seems to be more a measure of feeling sensitivity rather than the skill of accurate empathy.
INTERPRETATION: The Empathy (E) scale of the RSM is a measure that is significantly related to relationship satisfaction and adjustment and reflects feeling sensitivity to the thoughts, emotions, and behaviors of others.
5. Interpersonal Influence (II)
Your score on this scale reflects your perceived skill and ability to impact your partner in positive ways. Skill strength indicates a positive and nonmanipulative influence in your relationship with your partner. A skill change on this scale may indicate a hesitancy to let your partner know what you really want to do about relationship decisions (lack of confrontation and negotiation skills).
RSM Interpersonal Influence (II) is significantly positively correlated to Conscientiousness as measured by the NEd (r = .38*) and the CTI (r = .27*).
INTERPRETATION: Interpersonal Influence (II) as measured by the RSM is related to positive action initiated in the relationship with your partner.
6. Drive Strength (DS)
High Drive Strength (skill strength) indicates a skill and ability to effectively direct your energy to accomplish personal goals within your relationship with your partner. Low Drive Strength (skill change) indicates a lack of personal motivation and energy in the present and a perceived inability to accomplish meaningful personal goals.
RSM Drive Strength (DS) is significantly negatively correlated to Neuroticism (r = -.41**) and significantly positively related to Extraversion (r = .39**) and Conscientiousness (r = .58**) as measured by the NEd. RSM Drive Strength (DS) is significantly positively correlated with Global Constructive Thinking (r = .32**), Behavioral Coping (r = .53**), Positive Thinking (r = .27*), Action Orientation (r =.46**) and Conscientiousness (r = .53**) as measured by the CTI.
INTERPRETATION: RSM Drive Strength (DS) is a measure of personal goal setting and achievement within your relationship. Drive Strength reflects focused and positive action to accomplish meaningful personal goals within a relationship context and is related to constructive thinking patterns.
7. Decision making (DM)
Skill strength on this scale indicates your ability to initiate and follow through with effective problem solving and decision-making procedures in your relationship. A skill change may indicate difficulty in effectively solving personal and relationship problems in your current relationship with your partner.
RSM Decision Making (DM) is significantly negatively correlated with Neuroticism (r = -.42) and significantly positively correlated with Extraversion (r = .37*) and Conscientiousness (r = .52**) as measured by the NEO. The RSM Decision Making (DM) scale is significantly positively correlated with relationship satisfaction and adjustment (r = .48**) as measured by the DAS. RSM Decision Making (DM) is significantly positively correlated with the CTI positive thinking scales of Global Constructive Thinking (r = .29**), Absence of Dwelling (r = .24*), Behavioral Coping (r = .51**), Positive Thinking (r = .26*), Action Orientation (r= .46**) and Conscientiousness (r = .53**).
INTERPRETATION: RSM Decision Making (DM) is a measure of healthy personality, relationship satisfaction and adjustment, and constructive thinking patterns that involve effective and decisive problem solving skills.
8. Time Management (TM)
Skill strength reflects your ability to effectively organize and use time in the present to accomplish relationship goals. A skill change indicates an inability to meaningfully organize time, difficulty in efficiently completing daily tasks, and a tendency to be overwhelmed by relationship responsibilities.
RSM Time Management (TM) is significantly negatively correlated with Neuroticism (r = -.43**) and significantly positively correlated with Extraversion (r = .40**) and Conscientiousness (r = .62**) as measured by the NEO. Time Management (TM) as measured by the RSM is significantly positively correlated with the CTI positive thinking scales of Global Constructive Thinking (r =.25*), Behavioral Coping (r = .41**), Action Orientation (r = .39**) and Conscientiousness (r = .45**).
INTERPRETATION: RSM Time Management (TM) is a measure of your perceived ability to organize relationship responsibilities and complete them within a specified time frame.
9. Commitment Ethic (CE)
Your score on this scale indicates your ability to follow through and complete tasks in a dependable manner. Skill strength reflects self-directed and dependable behavior in completing personal responsibilities. A skill change indicates a tendency to begin projects without strong personal commitment and a lack of follow-through on personal and relationship projects.
RSM Commitment Ethic (CE) is significantly negatively correlated with Neuroticism (r = -.45**) and significantly positively related to Conscientiousness (r = .55**) on the NEO. Commitment Ethic (CE) as measured by the RSM is significantly positively correlated with the CTI constructive thinking patterns of Global Constructive Thinking (r =. 29**), Behavioral Coping (r = .46**), Positive Thinking (r = .27*), Action Orientation (r = .42**), and Conscientiousness (r = .46**).
INTERPRETATION: RSM Commitment Ethic (CE) is a measure of your perceived ability to responsibly and dependably complete relationship responsibilities.
10. Stress Management (SM)
Skill strength indicates your ability to positively manage personal stress and anxiety. A skill change reflects a current inability to positively manage daily stressors and a tendency to develop negative (emotional and physical) reactions to life stress.
RSM Stress Management (SM) is significantly negatively correlated with Neuroticism (r = .51**) and significantly positively correlated to Conscientiousness (r = .55**) on the NEO.
Stress Management (SM) as measured by the RSM is significantly, positively correlated with relationship satisfaction and adjustment as measured by the DAS. RSM Stress Management (SM) is significantly positively correlated with all the positive thinking patterns measured by the CTI; Global Constructive Thinking (r = .43**), Emotional Coping (r = .36**), Absence of Negative Overgeneralizations (r = .28*), Non Sensitivity (r = .32**), Absence of Dwelling (r = .46**), Behavioral Coping (r = .36**), Positive Thinking (= .25*), Action Orientation (r = .36**) and Conscientiousness (r = .46**).
INTERPRETATION: RSM Stress Management (SM) is a measure of your ability to positively manage distress and to think constructively and behave effectively in high stress situations.
These 10 RSM skill scales are significantly related and together provide a general factor measure of Emotional Intelligence (EI), resiliency, and relationship health and satisfaction. The congruent validation of RSM scale measures was an essential procedure in this study. Additional RSM research is needed to clarify the role of these healthy relationship skills in personal well-being.
Relationship Satisfaction (RS): Your score on this scale reflects your current level of satisfaction with your relationship. Skill strength indicates personal satisfaction with your current relationship. A skill change indicates dissatisfaction and a focus on relationship problems.
Intimacy (I): This scale reflects your current level of intimacy (emotional and physical comfort and closeness) in the relationship. Skill strength indicates satisfaction and personal comfort with the emotional and physical closeness in your relationship. A skill change indicates a perceived lack of emotional and physical closeness with your partner.
The RSM scales of Relationship Satisfaction (RS) and Intimacy (1) provide valid measures of relationship satisfaction and adjustment. The RSM scale of Relationship Satisfaction (RS) is positively and significantly correlated with relationship satisfaction and adjustment as measured by the DAS (r = .73**). The RSM Intimacy (I) scale is significantly positively correlated with relationship and satisfaction as measured by the DAS (r= .83**).
Scale by scale correlations of RSM scales with the NEO, DAS, and CTI are presented in the Professional Manual (Nelson, Nelson and Cox, 2010). Professionals using the RSM in clinical practice and research may consult the RSM Professional Manual to review the demonstrated psychometric parameters of the instrument and its established limitations and applications.
The purpose of the Scott & White Military Homefront Services Program was to design and deliver intervention strategies and resiliency skills training for military couples functioning in high-stress environments. In-depth and long-term psychotherapy or counseling was not feasible for this population because of the limitation of time resources. The resiliency skills training program was designed to promote emotional learning and specific relationship skills development. The RSM was used to engage participants by completing the instrument as a structured exercise in reflective thinking. Individual RSM profiles were constructed as a map or guide for targeted skill development, and a collaborative action plan was developed for each participant.
The participants in the program were active duty military couples in the U.S. Army. Ali participants were facing frequent long-term deployments in war zones and functioning in a highly stressful environment. (See table 1, page 21)
ANOVAs were used to compare each of the RSM scales to the means of the categories: No Children, Children Age 2-6, and Children Age 7-17.
* For Self-esteem, Assertion, Comfort, Influence, Relationship Satisfaction, and Intimacy, the category Age 7-17 was significantly lower than either of the other two.
* For Empathy, all three age categories are significantly different from each other.
* For Decision Making, 7-17 is lower than 2-6, and Time Management also shows this pattern.
* For Aggression, Deference, Change Orientation, Drive Strength, and Commitment Ethic, none of them are significantly different from the others.
* For Stress Management, 7-17 is significantly lower than No Children. It does seem to indicate that teen-agers are more of a source of relationship stress than are younger children.
The Relationship Skills Map (Nelson and Nelson. 2009) was used as a positive self-assessment to identify the perceived relationship skill levels of the participants. The RSM is a valid and reliable instrument (Cox, 2010) and provides a measure of higher order thinking skills that are closely linked to constructive thinking patterns and skilled behaviors. Congruent validation studies with the RSM (Cox, 2010) indicate significant correlations with Behavioral Coping, Emotional Coping and Global Constructive Thinking as measured by the Constructive Thinking Inventory (Epstein, 2002).
The RSM model of healthy relationships is an extension of the Transformative Theory of Emotional Intelligence (EI) (Nelson and Low, 2010) and provides a positive and practical method for quantifying resiliency skills in marital relationships. Doctoral research completed using the RSM has demonstrated that "distressed" couples (in counseling) achieve a significantly lower level of skills than do "non-distressed" couples (Webb, 1991).
The major use of the RSM in this program was to provide a structured, reflective thinking exercise that linked participants' perceived needs to specific skills contributing to resiliency in high stress environments. The RSM skills profile provided a cognitive model and common language between the therapists and the participants so that an individual action plan could be developed for each participant. Participants identified current relationship strengths and specific skills to learn, develop, and strengthen.
The RSM is a sound psychometric instrument with acceptable levels of validity and reliability. More importantly the RSM is a positive-structured interview to engage the client in reflective thinking and personal goal setting. The results provide a map, or guide, for emotional skill development. The RSM is relationship oriented both in content and theory. It is the skill of the therapist and the quality of the relationships established with the participant that was the important consideration.
The RSM is based on a relationship-focused and integrated theory of human behavior that is most closely related to Cognitive Experiential Self-Theory (Epstein) and his extensive research on his central construct, global constructive thinking. Cognitive-Behavioral Techniques are often the treatment of choice for developing emotional self-control and stress management skills that build resiliency. The RSM skills profile provides a personal link between thinking patterns and behavioral skills that is meaningful to the individual completing the assessment.
The core-resiliency skills emphasized in the Scott & White Military Homefront Services Program were the 10 RSM skill scales of Self-Esteem, Assertion, Interpersonal Comfort, Empathy, Interpersonal Influence, Drive Strength, Decision Making, Time Management, Commitment Ethic and Stress Management. The program therapists developed an "RSM Tool Box" of cognitive behavioral interventions and experiential learning experiences to develop resiliency skills. A brief Self-Mentoring and Coaching Version of the RSM was developed based on a factor analysis (Cox and Cox, 2010) to improve the appropriateness of the instrument for program specific use. An integrated intervention program (The Relationship Enhancement Process) was developed that included constructive thinking, creative problem solving, and action goal setting.
The PSM was perceived as a valuable and helpful tool for identifying resiliency-skill-development priorities. The major purpose of this action research study was to answer the question of how resiliency skills could be conceptualized and developed in a brief intervention program with distressed couples. The major perceived value of the RSM was that it linked participants' perceived needs to specific resiliency skills. (See table 2, page 22)
The Scott & White Military Homefront Services' research sample differed significantly from the RSM standardization sample. The high stress environments experienced by these active duty military personnel are reflected in significantly lower scores in Self-Esteem, Interpersonal Comfort, Empathy, Drive Strength, Time Management, Commitment Ethic, Stress Management, Relationship Satisfaction, and significantly higher scores in Aggression and Change Orientation. The EI Total score comparison indicates that the Homefront sample was significantly lower in EI skills (resiliency skills). The Relationship Total (Intimacy plus Relationship Satisfaction) indicates a significantly lower level of relationship satisfaction and adjustment in the Homefront sample.
Therapists used the RSM profile results to provide effective emotional mentoring and positive support for the couples and to have a common language to construct strength-focused individual action plans for developing resiliency skills. The Self Mentoring and Coaching Version of the RSM was created to improve the quality of measurement provided by the instrument and to make administration and interpretation more consistent for use in self-directed coaching and emotional mentoring. Therapists of Scott & White Military Homefront Services provided valuable experiential exercises that liked the RSM measures to the development of specific cognitive/ behavioral skills in a practical and systematic emotional learning system.
The use of the RSM results as a self-mentoring and coaching guide provided participants with a relationship-enhancement process that they could use daily. One of the primary goals of Scott & White Military Homefront Services was to provide emotional learning that could be transferred over time and distance. Many of the couples would be physically separated for months during deployment and needed specific ways to protect their relationship during stressful times.
Case Example: (Contrived Composite)
Joe and Mary have been married 17 years--nine years as civilians, eight as military. Joe has been deployed three times to Iraq and once to Korea. His deployments were for 12 months, except for his second to Iraq which was for 15 months. Joe is on orders to deploy to Afghanistan in approximately four months from the date of the initial counseling intake. The couple have five children, ages 16, 14, 13, 11, and 5.
Joe and Mary state that they are coming to marital counseling due to difficulties with communication and intimacy. Both state they believe they have had a good marriage and, in fact, state it was a "great marriage" prior to the last two deployments. Since that time, they say they are having "stupid" arguments and do not "feel as close."
The RSM was given to the couple as a tool to assist them in cognitively identifying areas of strengths and skills-development opportunities. Mary identified areas of development as self-esteem and interpersonal comfort. Joe identified areas of development as empathy and stress management. Both scored high on commitment ethic and overall relationship satisfaction.
The therapist then utilized the scale definitions to explore with Joe and Mary their RSM scores. They were given a copy of each scored RSM to examine. Mary and Joe were asked to create a "Strategic Homefront Action Plan" and come to the next session with two ideas on how to assist their partner and one way they could help themselves with their self-identified area of development.
The next two sessions were focused on the strategic plan for before, during, and after the impending deployment.
Mary's plan included a scheduled exercise time to increase her self-esteem and decrease stress. She stated that she realized she had stopped emotionally sharing with Joe because she did not want to "upset him," and when she did talk to him about family issues, she was hesitant and unsure. Her plan was to talk with him in the mornings after PT when they drank coffee together, prior to the day starting. While Joe was deployed, she would e-mail him once a week with the family "growth opportunities" (therapist reframe) and family solutions. If there was time for suggestions, she would consult with him, if not, she would inform him of the action she had taken. After deployment, he would co-facilitate the family meetings that collectively identify and resource growth opportunities.
Joe's plan included a step that he would take before talking to Mary. He would think about how grateful he is that Mary has been a steady faithful partner and would remember how he felt the last time he was left to care for the five children while she went to visit her mother. Before deployment he would focus on what she had to say during morning coffee, after he exercised (PT). During deployment he would work to tell her how proud he was of her for doing all that needed to be done while he was gone and he would also share with her his sadness at not being there with her. After deployment he would remember morning coffee and turn off his phone, the television, and the computer while they talked. Joe's stress-management-skills development was to listen to a relaxation CD every evening before, during, and after deployment. Joe also stated he was going to his unit's stress-management-skills-development class.
The fourth session was spent going through the skills they had identified as strengths and empowering them to communicate about the core feelings of sadness, fear, and uncertainty that they identified as a result of the back-to-back deployments.
Mental health professionals perceived the Relationship Skills Map (RSM) as a helpful reflective learning tool in Scott & White's Military Homefront Services Program. The personal well-being of active duty military personnel serving in war zones is the priority of the U.S. Army. Resiliency skills training was the focus of this intervention program, and services were extended to couples redeployment as well as post deployment. The RSM skills profile of the couples served by the program indicated high levels of distress and an expressed awareness of the need for change and improvement in their relationships.
This action research study answered the question of how to operationally define "resiliency skills" and how to implement a brief intervention program to protect and strengthen the marital relationship of active duty Army couples facing frequent and long deployment to war zones. It is important to note that the RSM was an effective tool in this process. The skill and the quality of the helping relationships created by the program therapists were the crucial factors in developing resiliency skills important to these highly stressed couples. Assessment instruments are crude and imperfect tools, and it is the skill of the professional using the instrument that is the most important variable in program effectiveness.
Relationships that facilitate positive change provide protection, permission, and potency (empowerment). The Scott & White Military Homefront Services Program is an example of best practices for the use of the RSM. Collaborative research and practical feedback from the therapists improved the instrument, and the Self-Mentoring and Coaching Version became a more useful tool in terms of measurement quality and ease of use.
Traditional assessment approaches to personality and relationship adjustment tend not to provide results that can be translated into specific skill-building interventions. The RSM was designed for professionals and is continually strengthened by ongoing research. The major value and intended use of the RSM is as a personalized guide or map that an individual can follow in developing specific skills that contribute to relationship satisfaction and personal well-being. The RSM is a personal guide for emotional learning and relationship skill development and is not a "test."
The U.S. Army and Air Force spend millions of dollars on training and development. Resiliency training for active-duty military couples is an important and essential priority. There is a need to develop systematic intervention programs that can be evaluated, revised, and improved to improve the quality and effectiveness of services. This article describes a beginning attempt to personalize resiliency training in a way that engages couples in active and focused skill development. The favorable acceptance and professional use of the RSM in the Scott & White Military Homefront Services Program is the first and important step in designing an intervention program that can be evaluated by a sound research design.
The use of the RSM in the program is being expanded, and additional research and program development are in progress. The emphasis can now be placed on strengthening the intervention and skills-training exercises, with the aim of evaluating their effectiveness.
The Scott & White Military Homefront Services Program is expanding services to meet the growing needs of active-duty Army couples who leave and return from long deployments in war zones. The effectiveness of the various skill-development interventions and training sequences need to be continually reviewed and evaluated in studies with sound designs. The best way to evaluate and demonstrate program effectiveness statistically is the use of an experimental design with adequate controls. Multiple outcome criteria should be used to demonstrate the effectiveness of the program in developing resiliency in marital relationships with prolonged exposure to high-stress environments.
The RSM was an effective tool for identifying and operationally defining resiliency skills targeted as skill-development priorities in this program. Additional RSM research is needed to determine the predictive validity of the instrument in identifying marital couples in severe crisis who need more individualized and long-term therapy. Previous RSM research (Webb, 1991) has demonstrated the discriminate validity of the instrument in identifying general levels of distress in marital relationships.
High scores on the RSM scales of Aggression, Deference, and Change Orientation are accurate indicators of problematic behaviors. High Aggression, accompanied by low skill scores on Empathy and Assertion, indicates the need for an individual to develop anger management, empathic communication, and empathy. High Change Orientation and Low Relationship Satisfaction indicate current dissatisfaction in the relationship and an awareness of the need to make changes. Additional research needs to be completed to determine the predictive value of RSM problematic indicators and the significance of low skill scale scores.
A very program-specific recommendation would be to use the RSM Form A as a pretest and RSM Form B (a parallel research form) as a post-test to indicate changes and gains in self-perceived relationship skills. Other outcome criteria such as Resiliency Scales and behavioral checklists completed by the therapists could be used to begin to examine program results and effectiveness. A sound experimental research design using valid and reliable instruments could be developed and implemented to statistically demonstrate program effects.
The RSM proved to be a valuable and effective tool for operationally defining "resiliency skills" in the Scott & White Military Homefront Services Program. The collaborative research and program development activities completed as a part of the program led to improvement in the RSM (Self-Mentoring and Coaching Version) and the design of couple-specific relationship skill development activities to build resiliency. Well-designed research studies with multiple outcome criteria need to be completed to demonstrate the effectiveness of resiliency skills training for military couples facing high stress environments. This action research study was a first step in developing improved instrumentation and skill development interventions that are essential components in quality program design and delivery.
This article is approved by the following for 1.5 continuing education credits:
This organization, The American College of Forensic Examiners International approval number 1052, is approved as a provider for continuing education by the Association of Social Work Boards 400 South Ridge Parkway, Suite B, Culpepper, VA 22701. www.aswb.org. ASWB Approval Period: 09/15/2010 to 09/15/2013. Social workers should contact their regulatory board to determine course approval. Social workers will receive 1.5 continuing education clock hours in participating in this course. The American College of Forensic Examiners International is an approved provider of the California Board of Behavioral Sciences, approval PCE 1896. Course meets the qualification for 1.5 hours of continuing education credit for MRs and/or LCSWs as required by the California board of Behavioral Sciences.
The American College of Forensic Examiners International is an NBCC-Approved Continuing Education Provider (ACEP[TM]) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.
The American Psychotherapy Association[R] provides this continuing education credit(s) for Diplomates and certified members, who we recommend obtain 15 credits per year to maintain their status. Learning Objectives
1. Define resiliency skills from a research standpoint.
2. Utilize a new relationship assessment instrument that is valid, reliable and appropriate for applied clinical practice
3. Demonstrate the relationship of resiliency skills and scale specific measures provided by the Relationship Skills Map (RSM)
KEYWORDS: Resiliency Skills, Relationship Skills Map, Healthy Relationship Skills, Emotional Intelligence Skills
TARGET AUDIENCE: The article may be of interest to therapists, counselors and mental health professionals who design and deliver brief, preventive intervention programs focused on developing resiliency and coping skills. The specific focus is on developing healthy relationship skills that positively buffer stress and build resiliency.
PROGRAM LEVEL: Basic
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In order to receive 1.5 CE credits, each participant is required to
1. Read the continuing education article.
2. Complete the exam by circling the chosen answer for each question. Complete the evaluation form.
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CE ACCREDITATIONS FOR THIS ARTICLE
This article is approved by the following for 1.5 continuing education credits:
This organization, The American College of Forensic Examiners International approval number 1052, is approved as a provider for continuing education by the Association of Social Work Boards 400 South Ridge Parkway, Suite B, Culpepper, VA 22701. www.aswb.org. ASWB Approval Period: 09/15/2010 to 09/15/2013. Social workers should contact their regulatory hoard to determine course approval.
Social workers will receive 1.5 continuing education clock hours in participating in this course.
The American College of Forensic Examiners International is an approved provider of the California Board of Behavioral Sciences. approval PCE 1896. Course meets the qualification for 1.5 hours of continuing education credit for MFFs and/or LCSWs as required by the California board of Behavioral Sciences.
The American College of Forensic Examiners International is an NBCC-Approved Continuing Education Provider (ACEP[TM]) and may' offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.
The American Psychotherapy Association[R] provides this continuing education credit(s) for Diplomates and certified members, who we recommend obtain 15 credits per year to maintain their status.
KEYWORDS: resiliency skills, Relationship Skills Map, healthy relationship skills, emotional intelligence skills
TARGET AUDIENCE: therapists, counselors, and mental health professionals
PROGRAM LEVEL: Basic
DISCLOSURE: The authors have nothing to disclose.
After studying this article, participants should be better able to do the following:
1. From a research standpoint, define resiliency skills.
2. Utilize a new relationship assessment instrument that is valid, reliable and appropriate for applied clinical practice.
3. Demonstrate the relationship of resiliency skills and scale specific measures provided by the Relationship Skills Map (RSM).
POST CE TEST QUESTIONS
(Answer the following questions after reading the article)
1. The best working definition of "resiliency" is:
a. Bouncing back
c. A specific behavior or skill that can be learned to protect an individual from the negative effects of high stress
d. A survival skill
2. The Relationship Skills Map (RSM) measures:
a. Emotional intelligence
b. Healthy relationships
c. Healthy relationship behaviors
d. Self-reported current thinking about relationship behaviors
3. The Relationship Skills Map (PSM) can be considered a valid and reliable measure of resiliency because of:
a. Established validity and reliability coefficients
b. Demonstrated value for designing program interventions
c. Professional use
d. Item level factor loadings
4. Congruent validation studies demonstrate:
a. The consistency of a test measure
b. How a test can predict a behavior
c. The relationship of scale measurements obtained from two different instruments
d. Specific applications for use
5. Resiliency skills can be operationally defined as RSM skills because of:
b. Program needs
c. Supporting research
d. Face validity
6. The best way to statistically demonstrate the efficacy of
a resiliency skills training program for the military is:
a. Program evaluation studies
b. In-depth interviews with participants
c. Self-report data
d. Experimental studies with adequate controls
Circle one (1=Poor 2=Below Average 3=Average 4=Above Average 5=Excellent)
If you require special accommodations to participate in accordance with the Americans with Disabilities Act, please contact the CE Department at (800) 592-1399.
Costa, P. T. & Mc Crae, R. R. (1992) NEO-PI-R, Professional manual, Lutz, FL: PAR
Cox, J. (2010) Quantifying Emotional Intelligence in Relationships: The Validation of the Relationship Skills Map, Unpublished doctoral dissertation, Texas A&M University-Kingsville,
Epstein, S. (2001) CTI/Constructive thinking inventory, Professional manual, Lutz, FL: PAR.
Nelson, D. and Low, G. (2010) Emotional intelligence, achieving academic and career excellence. Upper Saddle River NJ. Prentice Hall.
Nelson, D. & Nelson, K. (2010) The Relationship Skills Map, Emotional Intelligence Learning Systems, Corpus Christi, TX.
Nelson, D., Nelson, K., & Cox, J. (2010) The Relationship Skills Map, Professional Manual, Emotional Intelligence Learning Systems, Corpus Christi, TX.
Spanier, G. B. (200 I) Dyadic adjustment scale, North Tonawanda, NY: MHS.
Webb, J. B. (1991) Patterns of social skills in a typology of marital systems. Unpublished doctoral dissertation, The Fielding Institute, Santa Barbara, CA.
Wolin, S. J. & Wolin, S. (1993) The resilient self: How survivors of troubled families rise above adversity, New York: Villard Books.
EARN CE CREDIT
To earn CE credit, complete the exam for this article on page 75 or complete the exam online at www.americanpsychotherapy.com (select "Online CE")
By Darwin B. Nelson, PhD, Kaye Welch Nelson, EdD, and Maxine Trent, MS, LPC, LMFT
DARWIN B. NELSON is an author and consulting psychologist who has created, researched, and published positive assessment instruments and emotional learning systems that are used worldwide for the assessment of Emotional Intelligence (EI) and healthy relationship skills.
KAYE WELCH NELSON Before her retirement this past summer, Kaye W. Nelson, EdD, was a Professor in the Department of Counseling and Educational Psychology at Texas A&M University-Corpus Christi where she served as Coordinator of the Couple, Marriage, and Family Counseling Program. She is a Clinical Member and Approved Supervisor in the American Association for Marriage Family Therapy and a Licensed Marriage and Family Therapist and Licensed Professional Counselor in Texas.
MAXINE E. TRENT, MS is the Program Manager at Killeen Mental Health Services and Scott & White Military Homefront Services. She received her Bachelors Degree in Human Development Family Studies from Texas Tech University and her Masters Degree in Science from Texas A & M Corpus (previously Corpus Christi State University). She has been blessed with 20+ years of therapy skill development in which to draw from, in partnering with clients and families whom seek new solutions to old problems.
1. Information was relevant and applicable 1 2 3 4 5 2. Learning objective 1 was met 1 2 3 4 5 3. Learning objective 2 was met 1 2 3 4 5 4. Learning objective 3 was met 1 2 3 4 5 5. You were satisfied with the article 1 2 3 4 5 6. ADA instructions were adequate 1 2 3 4 5 7. The author's knowledge, expertise, and clarity were appropriate 1 2 3 4 5 8. Article was fair, balanced, and free of commercial bias 1 2 3 4 5 9. The article was appropriate to your education, experience, and licensure level 1 2 3 4 5 10. Instructional materials were useful 1 2 3 4 5
Table 1 Demographics of the Homefront Research Sample HOMEFRONT SAMPLE: DEMOGRAPHICS FREQUENCY COUNT PERCENT EDUCATION LEVEL LESS THAN HS 2 8 HIGH SCHOOL 4 16 SOME COLLEGE 17 68 BACHELORS DEGREE 12 8 HISPANIC ETHNICITY HISPANIC 9 36 BLACK 2 8 OTHER INCLUDING WHITE 14 56 MARITAL STATUS MARRIED 21 84 SINGLE 3 12 MISSING 1 4 RELIGION PROTESTANT 5 20 CATHOLIC 6 24 OTHER 14 56 GENDER MALE 13 52 FEMALE 12 48 DISTRESSED COUPLES YES 11 44 NO 9 36 N/A 5 20 AGE CATEGORIES OF ADULTS 0-20 1 4 21-30 17 68 31-40 6 24 41-50 1 4 N = 25 for Killeen Frequency Data RSM--Data is for individuals not couples ANOVAs were used to compare each of the RSM scales to the means of the categories No Children, Age 2-6, and Age 7-17. For Self-Esteem, assertion, comfort, influence, relationship satisfaction, and intimacy the category Age 7-17 was significantly lower than either of the other two. For Empathy, all three age categories are significantly different from each other. For Decision Making, 7-17 is lower than 2-6, and time management also shows this pattern. For Aggression, Deference, Change Orientation, Drive Strength and Commitment Ethic, none of them are significantly different from the others. For Stress Management, 7-17 is significantly lower than No Children. It does seem to indicate that teen-alters are more a source of relationship stress than are younger children. Table 2 Means, Standard Deviations, Standard Errors, & t Test for Equality of Means SCALE MEANS Disst. (a) Soldier (b) SELF-ESTEEM 78.51 69.80 ASSERTION 32.18 30.04 COMFORT 30.75 26.16 EMPATHY 19.88 16.36 INFLUENCE 25.03 23.00 DRIVE STRENGTH 43.51 38.88 DECISION MAKING 21.85 21.76 TIME MANAGEMENT 20.45 16.96 COMMITMENT ETHNIC 24.91 22.60 STRESS MANAGEMENT 61.54 52.48 RELATIONSHIP SATISFACTION 35.04 29.88 INTIMACY 25.33 23.80 AGGRESSION 21.85 30.28 DEFERENCE 21.41 23.48 CHANGE ORIENTATION 17.29 21.00 EI TOTAL 58.62 318.04 RELATIONSHIP TOTAL 60.37 53.68 STANDARD SCALE DEVIATIONS Disst. (a) Soldier (b) SELF-ESTEEM 10.58 12.95 ASSERTION 5.38 6.33 COMFORT 4.82 5.37 EMPATHY 3.46 4.55 INFLUENCE 3.26 5.45 DRIVE STRENGTH 6.36 6.22 DECISION MAKING 3.20 4.24 TIME MANAGEMENT 4.35 4.60 COMMITMENT ETHNIC 3.13 5.08 STRESS MANAGEMENT 9.77 9.66 RELATIONSHIP SATISFACTION 6.53 6.87 INTIMACY 4.69 5.39 AGGRESSION 7.52 8.39 DEFERENCE 5.70 8.18 CHANGE ORIENTATION 4.96 4.52 EI TOTAL 41.55 54.39 RELATIONSHIP TOTAL 10.77 11.74 STANDARD SCALE ERRORS OF MEAN Disst. (a) Soldier (b) t SIG SELF-ESTEEM .76 2.59 3.774 0.000 ASSERTION .38 1.27 1.839 0.067 COMFORT .34 1.07 4.430 0.000 EMPATHY .25 .91 3.726 0.001 INFLUENCE .23 1.09 1.818 0.080 DRIVE STRENGTH .46 1.24 3.439 0.001 DECISION MAKING .23 .85 0.122 0.903 TIME MANAGEMENT .31 .92 3.752 0.000 COMMITMENT ETHNIC .22 1.02 2.222 0.035 STRESS MANAGEMENT .70 1.93 4.370 0.000 RELATIONSHIP SATISFACTION .47 1.37 3.701 0.000 INTIMACY .34 1.08 1.513 0.132 AGGRESSION .54 1.68 -5.209 0.000 DEFERENCE .41 1.64 -1.231 0.229 CHANGE ORIENTATION .36 .90 -3.558 0.000 EI TOTAL 2.98 10.88 4.426 0.000 RELATIONSHIP TOTAL .77 2.35 2.896 0.004 EQUAL SCALE MEANS VARIANCE DIFFER? ASSUMED? SELF-ESTEEM YES YES ASSERTION NO YES COMFORT YES YES EMPATHY YES NO INFLUENCE NO NO DRIVE STRENGTH YES YES DECISION MAKING NO YES TIME MANAGEMENT YES YES COMMITMENT ETHNIC YES NO STRESS MANAGEMENT YES YES RELATIONSHIP SATISFACTION YES YES INTIMACY NO YES AGGRESSION YES YES DEFERENCE NO NO CHANGE ORIENTATION YES YES EI TOTAL YES YES RELATIONSHIP TOTAL YES YES (a) Dissertation group: N = 195 (b) Soldier group: N = 25 df = 218 NOTE: The Scott & White Military Homefront Services research sample differed significantly from the RSM standardization sample. The high stress environments experienced by these active duty military personnel are reflected in significantly lower scores in Self-Esteem, Interpersonal Comfort, Empathy, Drive Strength, Time Management, Commitment Ethic, Stress Management, Relationship Satisfaction and significantly higher scores in Aggression and Change Orientation. The El Total score comparison indicates that the Homefront sample was significantly lower in EI skills (resiliency skills). The Relationship Total (Intimacy plus Relationship Satisfaction) indicates a significantly lower level of relation ship satisfaction and adjustment in the Homefront sample. Resiliency skill training is a promising intervention strategy for protecting and strengthening the marital relationships of active duty military personnel facing frequent deployments to war zones. In this study, the RSM was found to be helpful in quantifying resiliency skills and providing a cognitive model for exploring, identifying, and understanding specific relationship skills that build resiliency in marital relationships.
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