Show Summary Details

Page of

PRINTED FROM the OXFORD RESEARCH ENCYCLOPEDIA, CRIMINOLOGY AND CRIMINAL JUSTICE (oxfordre.com/criminology). (c) Oxford University Press USA, 2019. All Rights Reserved. Personal use only; commercial use is strictly prohibited (for details see Privacy Policy and Legal Notice).

date: 20 May 2019

Critical Challenges to Police Officer Wellness

Summary and Keywords

Police officers face unique challenges in the line of duty that threaten their health and well-being. Officers experience organizational, operational, community-related, and personal stressors ranging from shift work and critical incident response to public pressures related to police-community relations and social media. Exposure to police stress and trauma presents external challenges to wellness which makes officers vulnerable to experiencing compassion fatigue, moral injury, and burnout. Compassion fatigue, resulting from caring for those who suffer, is associated with feelings of anger, anxiety, guilt, hopelessness, and powerlessness. Other symptoms may include emotional instability, diminished self-esteem, self-harm, inability to concentrate, hypervigilance, disorientation, rigidity, apathy, perfectionism, and preoccupation to trauma. Furthermore, moral injury occurs when officers witness or take part in acts that violate their deeply held moral beliefs, which in turn carries implications for psychological and spiritual well-being. The interconnectedness of challenges to officer wellness are detrimental to physical, cognitive, emotional, spiritual, behavioral, and social health. Negative health outcomes include risk for sleep disorders, cardiovascular disease, destructive coping, posttraumatic stress disorder, and suicide.

Implications from prior research with police, other frontline professionals, veterans, and military personnel have led to a number of interventions and techniques that can potentially promote wellness and effective stress management for police officers. Training related to stress management and wellness promotion have been found to significantly improve officers’ performance in the line of duty and overall health. This includes viewing wellness as a perishable skill, requiring ongoing practice, updated training, and numerous outside resources (e.g., psychological services, posttrauma intervention, peer support, and chaplaincy). Stress management techniques, gratitude and appreciation letters, mindfulness, and other community-oriented programs are some examples of effective strategies to promote the health of the law enforcement community. Furthermore, compassion satisfaction, emotional intelligence, and emotional regulation play a significant role in helping officers maintain stability in their personal and professional lives while capably serving their communities.

Keywords: stress, trauma, compassion fatigue, moral injury, wellness, health, police

Overview of Police Stress and Trauma

Police work has consistently been identified as a very challenging profession due to the plethora of stressors officers experience over the course of their career. These stressors are multifaceted, ranging from shift work, exposure to violent crimes, life-threatening situations, and other atrocities in the line of duty to stress associated with organizational factors. Prolonged, consistent exposure to these stressors carries consequences for the health and wellness of officers that can sometimes be fatal. Findings from studies that examined how police stress impacts officers’ health and job performance have confirmed that work-related stress in policing leads to negative health outcomes if left unaddressed (Berg, Hem, Lau, & Ekeberg, 2006; Mohr et al., 2003; Regehr, LeBlanc, Jelley, & Barath, 2008).

Duty-related distress can produce psychological symptomatology and neurohormonal imbalances. For instance, untreated traumatic stress symptoms (e.g., intrusive thoughts, hyperarousal, and avoidance) can negatively impact an officer’s job performance and personal life (Davidson & Moss, 2008; Stephens & Long, 1999; Taverniers, Smeets, Van Ruysseveldt, Syroit, & von Grumbkow, 2011; Violanti et al., 2007). Similarly, trauma-related dysregulation of stress-related hormones (e.g., cortisol) can increase the prevalence of physical and mental health issues among police officers (Violanti et al., 2007). Moreover, previous findings have shown that police officers have higher probabilities of death and shorter life expectancy compared to the general population (Violanti et al., 2013). Although the high mortality rate for police officers is associated with stress-related health complications, such as cardiovascular disease, certain types of cancer, and diabetes, it is also the product of higher than average suicide rates (Stuart, 2008; Violanti, 2004), as well as fatalities while in the line of duty. For instance, the National Law Enforcement Officers Memorial Fund reported that, as of the end of December 2017, 128 federal, state, and local law enforcement officers in the United States had died while on duty (National Law Enforcement Officers Memorial Fund, 2018).

Nevertheless, it should be noted that police officers are substantially more resilient compared to the general population (Pietrzak et al., 2014). This means that police officers tend to be able to recover well from adversity (American Psychological Association, n.d.). This resilience is critical as some scholars estimate that officers may experience hundreds of potentially traumatic incidents over the course of their career (Manzella & Papazoglou, 2014). These estimates do not include the many stressors that officers experience in other domains of their lives. Despite this abundance of stressors, most officers continue to perform duties effectively and maintain peace and order in the communities they serve. However, organizational, operational, and personal stressors remain a potential hazard to the health and well-being of officers. Therefore, to fully understand the breadth and depth of challenges to police officers’ health, it is essential to raise awareness of the complex stressors they frequently experience throughout their careers.

Operational Stress

Operational stressors are aspects inherent within the occupation and arise from the content of the job (Shane, 2010). Some examples of operational stressors in policing include uncertainty of danger, variability in the nature of calls for service, vehicle pursuits, and felony arrests (Slate, Johnson, & Colbert, 2007; Violanti & Aron, 1993). A major source of operational stress in policing comes from critical incident response. Critical incidents are events that carry the potential to overwhelm normal stress and coping abilities that are usually sudden or unexpected, disrupt core beliefs, feel emotionally or psychologically overwhelming, strip psychological defenses, and frequently involve perceptions of death/threat to life or involve bodily injury (Digliani, 2012). Operational stressors are not solely related to critical incidents. Rather, operational stressors are ever-present in the line of duty because even the most routine calls for service have the potential to be life-threatening. Over the last decade, the use of cell phone and video footage by the pubic to record officers while on duty has risen as a modern operational stressor in policing.

As a result of pervasive operational stressors, responding officers will often, consciously or unconsciously, begin to experience the psychological and physiological effects of anticipatory anxiety while en route to a call. Research on military and police street survival has demonstrated that anticipatory stress can have a debilitating effect on officers’ health and job performance (Galatzer-Levy et al., 2013; McCarroll, Ursano, Fullerton, & Lundy, 1995). Operational stress accompanies situations wherein officers must make split-second decisions (e.g., need to escalate force or use deadly force), which could potentially endanger the lives of themselves, civilians, other officers, or the suspect(s). A mistake in application of lethal force may result in fatal injury for innocent bystanders. Conversely, if an officer mistakenly perceives a situation as nonthreatening, injuries or fatalities may result. Operational decision-making requires officers to use knowledge of best practices to resolve situations effectively, which includes decisions to apply reasonable force when necessary (e.g., level of force ranging from officer presence and verbal commands to deadly force). However, technological advancements in the social milieu mean that officers must now be conscious that their actions are likely being recorded by bystanders for any number of reasons (e.g., it was something “cool” to share with friends, wanting to publicize police errors, etc.). The knowledge of being watched and possibly recorded can exacerbate operational stress, as any documented errors could lead to disciplinary action against the responding officer and public criticism.

Organizational Stress

Contrasting with operational stressors, organizational stressors originate from the context of the job and include characteristics of the organization or behaviors of people within the organization that may produce stress (Shane, 2010; Violanti & Aron, 1993). Contemporary police departments make every effort to recruit and hire the most capable applicants and to continuously improve training methods in order to produce competent police officers (Blumberg, Griffin, & Jones, 2014; Cochrane, Tett, & Vandecreek, 2003; Sarafino, 2010). As such, police organizations conduct extensive background investigations and interviews of suitable applicants. They also administer rigorous assessments, such as pre-employment psychological evaluations, to ensure that applicants are properly motivated and possess the capability to become competent police officers.

Despite the efforts to vet and prepare officers for line of duty experiences, police officers nevertheless encounter stressors that stem from the organization and from working within the criminal justice system. Examples of organizational stressors in policing include the hierarchical organization within police agencies and lack of organizational support, rotating shift work, extensive paperwork, organizational politics, inconsistencies within the court system, lack of resources, and restrictive organizational policies (Shane, 2010; Slate et al., 2007; Violanti & Aron, 1993). In addition to operational duties, police officers must contend with an extensive amount of paperwork that is subsequently scrutinized by supervisors and other professionals in the criminal justice system (e.g., attorneys, judges). Furthermore, police departments are hierarchical in nature, meaning officers often work with supervisors who have varying management styles. Authoritarian supervisors, or supervisors who employ a micro-management approach, may significantly increase organizational stressors among police personnel (Cohen, 2016; Stephens & Long, 2000). Moreover, the lack of necessary personnel, budgetary cuts, and the absence of healthy communication among departmental personnel can all increase organizational stress.

As such, it is unsurprising that previous research has not only discovered a distinct difference between organizational stress and operational stress, but that organizational stress can also have a significant negative effect on officers’ job performance (Shane, 2010). It has also been shown that organizational stress makes officers susceptible to professional burnout, compassion fatigue, and other mental and physical health issues (Gershon, Barocas, Canton, Li, & Vlahov, 2009).

Community-Related Stressors

Law enforcement agencies are faced with somewhat of a dilemma, which forces their officers to confront additional types of stressors. The dilemma revolves around the policing models agencies utilize and the subsequent reaction officers face from community members. In the traditional model of policing, officers’ distress stems from responding to numerous radio calls with little chance to follow-up. Therefore, in the traditional model of policing officers may not believe they are making positive connections with the community or they may have limited opportunities to make positive connections. Agencies continue to use this model of policing out of necessity, as most do not have the resources (i.e., the manpower), to help officers make such positive connections. Officers’ stress stems from feelings of frustration and a sense of disconnection from the people whom they serve.

The other model of policing is community-oriented policing. The goal of this model is to develop enforcement priorities based on input from the community, which comes from collaborative relationships between the police and the community. Officers are encouraged to spend nonenforcement time in the community, attend and participate in community events, and engage community members on a personal level. This model emphasizes procedural justice whereby community members experience police officers as fair and their actions as legitimate. The model is associated with greater violent crime arrests (Tillyer, 2018), most likely due to the active involvement of the community. At the same time, officers working within this model are faced with additional stressors. By developing relationships with community members, officers face difficulties in remaining emotionally detached from their work. Their stress derives from feelings of helplessness that they cannot do more to improve the lives of the people whom they serve.

Personal Stress

When their shifts end, officers go back to their roles as parents, siblings, spouses, friends, and neighbors. However, the transition from a highly stressful environment, such as police work, to a domestic context can often be challenging. In his seminal book, Emotional Survival for Law Enforcement, clinical psychologist and former police officer, Dr. Kevin Gilmartin (2002) uses the image of a biological rollercoaster to depict how officers oscillate between the experiences of excitement, tension, threat, and stress while on shift and the experience of exhaustion, fatigue, dysphoria, and even apathy once their shift has ended (p. 47). When left unaddressed, this repetitive cycle poses a serious threat to officers’ relationships with family members and friends. For example, officers may attempt to alleviate intrusive thoughts about an atrocity experienced in the line of duty by engaging in excessive alcohol consumption or other maladaptive behavior to numb themselves following the traumatic incident, thereby placing additional stress on the family system.

Challenges to Wellness

The multitude of stressors involved with policing are external threats to officer wellness. Exposure to traumas experienced by others, life-threatening and potentially dangerous encounters, and the routine cumulative external stressors mentioned previously precipitate internal challenges to officer wellness. Specifically, the job puts the physical, cognitive, emotional, spiritual, social, and behavioral health of officers at risk. In this section, the external and internal challenges to officer wellness are discussed at length, including the insidious and potentially destructive consequences of compassion fatigue, burnout, and moral injury.

External Challenges

Trauma experiences in the line of duty present external challenges to officer wellness. Officers experience direct trauma in the line of duty when trauma happens to them or they physically witness a traumatic event. Secondary trauma is experienced when officers hear firsthand accounts of the adverse experiences of another person. Direct trauma exposure occurs during critical incidents and secondary exposure occurs when officers are exposed to graphic images or hear victim accounts of violent crimes (Tehrani, 2010). Furthermore, an officer may directly experience trauma when responding to a crime that necessitates use of force and subsequently experience secondary trauma while responding to a crime victim. Complexities arise from the frequency and duration of trauma experienced in policing (Papazoglou, 2013).

Police are exposed to single incident trauma as well as repeated traumas, which have a accumulating effect over time. Acute trauma is time-specific, time-limited, and occurs at a single point in time while chronic trauma is repeated or cumulative in nature. Acute trauma exposure runs the gamut of what police officers encounter in the line of duty. It ranges from vehicular fatalities and gruesome crime scenes to terrorist attacks and mass shootings. In addition to witnessing and responding to the suffering of others, officers are exposed to the trauma of line of duty injuries and deaths of their partners and peers. The extent of trauma exposure among police officers has been compared to that of the military in combat (Violanti & Paton, 2001). Specifically, the trauma exposure of veterans or active duty military going on numerous deployments and returning home from war parallels that of police officers returning home at the end of their shifts. However, police officers have the additional complication of chronic trauma exposure; they are routinely exposed to trauma over the length of their careers. Whether from a single incident or cumulative exposure, trauma manifests physically and psychologically to threaten officer wellness.

Constant exposure to the suffering of others is a form of secondary trauma for officers. Exposure to suffering, and the emotional labor required to care for those who are suffering, has been conceptualized as “compassion fatigue” or the cost of caring (Figley, 1995). The presentation of compassion fatigue in police officers can result from cumulative trauma exposure or exposure to a single traumatic event (Stamm, 2002). Some groups of officers are at increased risk for compassion fatigue due to the nature of specialized job duties. It has been found that higher levels of burnout and secondary trauma are associated with extensive work with sexual assault and child victims (Gehrke & Violanti, 2006; Turgoose, Glover, Barker, & Maddox, 2017).

In addition to direct and secondary trauma exposure, additional pathways to traumatization exist. Moral suffering, a concept that has been explored in military and veteran samples, may influence police traumatization (Papazolgou & Chopko, 2017). Moral suffering occurs when officers witness or become involved with acts that transgress their moral beliefs. One such type of moral suffering is moral injury, which is defined as, “Perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations” (Litz et al., 2009, p.700). Police moral injury may occur when officers question their response to critical incidents or when they are faced with moral dilemmas, which cause them to question their ethical decision-making. Moral injury carries feelings of guilt, shame, and difficulties with forgiveness (Shay, 2014; Tangney, Stuewig, & Mashek, 2007).

Long-term exposure to work-related stress, particularly to organizational stress, can lead to burnout among police officers (Kohan & Mazmnian, 2003; McCarty & Skogan, 2013). Burnout is defined as psychological and emotional exhaustion, along with feelings of hopelessness and difficulty dealing with one’s work (Stamm, 2010). Work demands, coupled with inadequate resources, can lead to burnout, which is characterized by emotional exhaustion, cynicism, and low professional efficacy (Burke, 1993; Martinussen, Richardsen, & Burke, 2007; Maslach, 1982; Turgoose et al., 2017). Law enforcement burnout can undermine the health of officers and their police organizations due to officer retention issues or negative police-community interactions resulting from burnout (Kop, Euwema, & Schaufeli, 1999; McCarty & Skogan, 2013).

Internal Challenges

Internal challenges to wellness arise depending on officers’ individual reactions to external challenges and impede optimal physical, cognitive, emotional, spiritual, behavioral, and social health. Chronic exposure to stressors, along with shift work, is related to difficulty sleeping, headaches, orthopedic problems (e.g., back pain), diabetes, and poor heart health to include high blood pressure and metabolic syndrome, which increase the risk for cardiovascular disease (Charles et al., 2007; Cross & Ashley, 2004; Mohr et al., 2003; Violanti et al., 2006, 2007). Overactivation of an officers’ stress response system and elevated stress hormones leads to the myriad of aforementioned negative health outcomes. Disruptions to physiological processes, such as immune system suppression resulting from stress and shift work, also makes officers susceptible to disease. Factors such as immune system suppression, exposure to carcinogens in the line of duty (e.g., airborne carcinogens from traffic), and utilization of unhealthy coping strategies such as smoking and alcohol consumption place officers at risk for certain types of cancer. Results of external exposures, like those affected by 9/11, increase one’s risk for depression and even suicide. Research has shown that officers have increased mortality risk for Hodgkin’s disease, colon cancer, kidney cancer, esophagus cancer, male breast cancer, testicular cancer, and increased rates of skin cancer. (Violanti et al., 2007; Wirth et al., 2014).

Collateral consequences of stress and trauma also include a barrage of internal challenges to cognitive and emotional wellness. Psychological strain comes with competing role demands that require officers to be both warriors and guardians (e.g., Rahr & Rice, 2015). The oscillation in role demands, combined with the uncertainty of danger that calls for constant psychological readiness, can be emotionally and cognitively depleting for officers. Officers’ emotional reactions to trauma commonly include anger, guilt, fear, hopelessness, or desensitization and emotional numbing (Atkinson-Tovar, 2003; Cross & Ashley, 2004; Violanti et al., 2007). The cost of continued exposure to stress and trauma takes a toll on officers’ cognitive and emotional health and gives rise to mental health problems, such as anxiety and depression.

Spiritual wellness is also compromised by external threats to wellness. Spirituality generally refers to meaning, purpose, and connectedness to what one considers sacred and how one aligns with that sacredness (Charles, Travis, & Smith, 2014). On one hand, spirituality can facilitate healthy coping in officers who have experienced stress and trauma through the meaning-making process of stressful or traumatic incidents. It can also provide much-needed solace to officers who are routinely exposed to human suffering. However, exposure to stress, trauma, and suffering has also been connected to spiritual pain. Exploration into spiritually, such as questioning why bad things happen to good people, children, elderly, animals, or vulnerable populations, among law enforcement officers has demonstrated the co-existence of spiritual wellness and spiritual distress (Patton, 1998). Increases in spiritual growth have been associated with elevated levels of psychological distress (Chopko, Facemire, Palmieri, & Schwartz, 2016). Research has shown that stress levels increase when officers are unable to reconcile line of duty experiences with their spiritual beliefs (Sigler & Thweatt, 1997). For example, officers may begin to question the goodness of people and the fairness of the world after continual exposure to tragedy and suffering. Self-identity, meaning, and purpose may be called into question following exposure to human suffering as officers reflect on their purpose in law enforcement and, more generally, on the decency of humanity.

Similar to physical, psychological, and spiritual health, behavioral health is negatively impacted by conditions of occupational stress. Officers engage in behaviors that are detrimental to their overall wellness. Fluctuating shift work, long hours, and secondary employment causes fatigue, which lends itself to overreliance on caffeine, unhealthy eating habits, and overall poor nutrition. Poorly managed stress, through maladaptive coping behaviors, further demonstrates a lack of officer wellness. Examples of maladaptive coping behaviors among law enforcement include self-medication, alcohol and nicotine use, caffeine use, substance dependency, sexual promiscuity, and gambling (Atkinson-Tovar, 2003; Cross & Ashley, 2004). Research suggests that officers engage in maladaptive coping in an attempt to avoid the stigma associated with seeking mental health or clinical support in the law enforcement culture. This resistance to engage in help-seeking behaviors results from the perceived pressure to uphold the “cop image” of authority, protection, and service (Cross & Ashley, 2004; Reiser & Geiger, 1984).

Accompanying behavioral challenges, social challenges are prevalent among police officers. Social challenges arise due to the social isolation, mistrust, and withdrawal associated with police trauma as well as difficulties in separating work life from home life (Gilmartin, 2002; Patterson & Violanti, 2001; Tuttle, Giano, & Merten, 2018). The tendency for police to reduce their social circles to only other officers can be damaging to social health. Constantly seeing others at their worst can create an “us versus them” mentality among officers that causes them to only trust those who understand their unique experiences. Officers who have experienced work-related stress withdraw from others and show a loss of interest in activities that they formerly found pleasurable (Brodie & Eppler, 2012; McCaslin et al., 2006). This results in challenges to maintaining relationships with those outside of the police subculture, such as previously existing friendships with civilians.

Families are not immune to the challenges presented in policing either. Characteristics that lend themselves to the police role such as emotion control and rigidity are at odds with characteristics promoting healthy familial and social relationships. Additionally, disruption in family schedules puts strain on law enforcement families. It is not uncommon for officers to get “called out” for service or work mandatory holiday shifts, causing them to miss family activities or their children’s birthdays. Social isolation and withdrawal, the inability to “leave the badge at work,” and scheduling strains on families can impede social wellness by undermining the health of familial and social relationships, which are important sources of support for officers dealing with residual stress and trauma from the line of duty.

Special Risks to Officer Wellness

In addition to common internal reactions to stress and trauma, special risks to wellness accompany secondary trauma of compassion fatigue, moral injury, and burnout. Negative emotions, anxiety, and feelings of hopelessness and powerlessness are associated with compassion fatigue. Symptoms of compassion fatigue may include decreased self-esteem, inability to concentrate, hypervigilance, rigidity, apathy, and self-harm. Repercussions of compassion fatigue include depression, destructive coping, and post-traumatic stress disorder (Bride, Radey, & Figley, 2007; Cicognani, Pietrantoni, Palestini, & Prati, 2009; Figley, 1995). Similar to compassion fatigue, moral injury carries feelings of guilt and shame and impacts how officers view themselves and the world (Tangney et al., 2007). The interplay of challenges to officer wellness are demonstrated by the link between cumulative exposure to moral dilemmas and traumatization which makes officers vulnerable to compassion fatigue and posttraumatic stress disorder (PTSD; Papazoglou & Chopko, 2017). Likewise, compassion fatigue and officer burnout create vulnerabilities to mental health conditions such as depression and PTSD (Conrad & Kellar-Guenther, 2006).

The accumulation of internal challenges to wellness leads to diagnosable psychological disorders like PTSD, depression, anxiety, and substance use disorders. Evidence of the interconnectedness of the aforementioned challenges to wellness is seen in elevated rates of subclinical cardiovascular disease in police officers, which is associated with PTSD symptoms (Violanti et al., 2006). Symptoms of PTSD include intrusive thoughts such as flashbacks; avoidance of people, places, or situations that are reminders of the trauma; negative thoughts and feelings; and arousal and reactive symptoms such as irritability or difficulty concentrating (American Psychiatric Association, 2013). The issue of PTSD among officers has given rise to current suicide rates that plague the law enforcement community. Suicide is among the common causes of death for officers and is estimated at a rate two to three times higher than the general population (Miller, 2005; Violanti et al., 2013). Not only does the suicide rate among police officers greatly exceed the rate of suicide in the general population, more officers took their own lives compared to line of duty deaths in 2017 (Hayes, 2018). The deleterious effects of stress and trauma on officer health carry grave consequences. Therefore, wellness promotion and health risk prevention play an important role in combatting health disparities in the occupation of policing.

Organizational Responsibility for Officer Wellness

Although officer wellness requires dedication from the individual, staying healthy should be considered a team sport. In fact, it would not be an overstatement to assert that officer wellness begins with an organization’s commitment to a healthy workforce. This starts with hiring the best people for the job. Not everyone who wants to be a police officer has the intrapsychic resources and/or the interpersonal skills to competently handle the psychological demands of the profession. Despite its hiring needs, it is the organization’s responsibility to ensure that only properly suitable applicants are hired. This requires a strict adherence to screening-in criteria (Blumberg et al., 2014). Rather than only focusing on screening-out unsuitable applicants, agencies with an eye toward long-term employee wellness hire candidates who have demonstrated the capacity to cope with the psychological demands of the job. This can be verified through a thorough background investigation, which assesses, for example, the extent to which applicants have experienced coping with adversity, deescalating volatile situations, effectively dealing with difficult people, showing fairness and a lack of bias, and making mature and responsible decisions.

The California Commission on Peace Officer Standards and Training (2014) described 10 psychological characteristics necessary for competent police performance: Social Competence, Teamwork, Adaptability/Flexibility, Conscientiousness/Dependability, Impulse Control/Attention to Safety, Integrity/Ethics, Emotional Regulation/Stress Tolerance, Decision-Making/Judgment, Assertiveness/Persuasiveness, and, Avoiding Substance Abuse and Other Risk-Taking Behavior. Officers who possess these traits and demonstrate them at high levels will perform their jobs competently. In doing so, they will also display healthy functioning. In other words, when officers begin to show counterproductive behaviors in one or more of these job dimensions, they are performing at less than optimum levels of wellness.

Fundamentally, officer wellness should be viewed as a perishable skill, like firearms proficiency, which requires ongoing practice to maintain optimal performance. Once hired, there are numerous factors that can negatively impact performance and compromise officers’ wellness (e.g., Papazoglou & Blumberg, in press). Therefore, organizations that are committed to officer wellness will infuse academy training and advanced officer training with psychological skill building. While training focuses on mandated instructional blocks, such as defensive tactics, crimes against children, and arrest and control, it can be delivered in a manner that teaches and reinforces the 10 psychological job dimensions. For example, while learning techniques necessary to safely place someone under arrest, recruits should be taught how to conduct this in a socially competent way with excellent impulse control and judgment. This is facilitated when academy training simultaneously teaches recruits how to maintain effective emotional regulation and stress tolerance, even during the most stressful parts of the job.

To maintain a healthy workforce, law enforcement agencies train first-line supervisors to identify early warning signs of distress. Rather than waiting for problems to reach levels where discipline is necessary or where negative media attention is paid to officers’ actions, it is advantageous to improve supervisors’ skills through an early detection protocol. Although this will not prevent all problems, it is an effective defense against problems attributed to officers’ lack of psychological wellness. Supervisors know their officers and establish a baseline of typical performance. Then they are able to identify a change from baseline and spot early warning signs of physical problems (e.g., excessive fatigue, self-medication with legal substances, like caffeine), emotional difficulties (e.g., irritability, apathy, guilt), cognitive issues (e.g., inattentiveness, forgetfulness), and behavioral indicators of distress (e.g., social withdrawal, recklessness). Intervention is far easier and more successful when these types of problems are identified and addressed at their early stages than when they escalate to the point at which discipline is required.

Once a problem is recognized, organizations committed to officer wellness make a variety of options available for officers in need. These options take several forms, because no single intervention would be capable of addressing all of the various problems faced by officers. There are three primary types of resources offered by law enforcement agencies for their officers’ wellness needs: psychological services, peer support, and chaplaincy. For each of the three, interventions can either be preventative or in response to an acute problem (e.g., post–critical incident).

Psychological services are provided by licensed mental health practitioners (Reese, 1995). Some larger law enforcement agencies employ therapists who deliver in-house services within psychological services units. Other agencies contract with providers who offer services at no cost to the officers. This can be set up through an Employee Assistance Program (EAP) where officers have limited access to a certain number of sessions or through a fixed contract arrangement where officers have unlimited access to a psychotherapist. Last, some agencies provide no direct psychological services to their employees but ensure that adequate mental health benefits are covered in employees’ health insurance plans.

In each of these configurations, officers can seek assistance for any work or non-work-related concerns that they may have. However, organizations vary in the extent to which officers’ spouses and children are able to utilize the psychological services. Some agencies provide access to psychological services only for the officer (and other employees of the organization). Progressive organizations make unlimited psychological services available to the officers, their spouses, and their children. These organizations recognize the importance of addressing non-work-related stressors, which significantly impact officers’ job performance. Moreover, officers’ work-related stress is often expressed at home, which causes additional difficulties for the officers and their families.

Police officers have always relied informally on peers for support. However, many organizations, especially those that emphasize officer wellness, maintain a formal peer support program (Grauwiler, Barocas, & Mills, 2008). These programs utilize officers who volunteer to serve a collateral assignment as a peer support officer. Peer volunteers receive training and ongoing supervision from a licensed mental health provider. They are there for officers who want more than a friend or coworker with whom to talk but who do not want to seek professional guidance; they want to talk with someone to whom they relate (Benner, 2000). Often, the peer support officers have experience with various life and/or work stressors for which other officers may seek support (e.g., divorce, financial challenges, or problems with a supervisor). Some agencies limit peer support officers to provide assistance only after an officer-involved shooting or other traumatic event (Greenstone, 2000). Other agencies establish a program with peers in a broader role, where officers can contact a peer support officer at any time for any reason, such as support for a drinking problem or for input on how to deal with financial difficulties (Madonna & Kelly, 2002). Most of these organizations establish guidelines, mandating that conversations between officers and peer support volunteers are confidential.

EAPs are benefit programs for employees that were developed to help employees with personal or work problems that impact their health and wellness, as well as job performance. Generally, EAPs provide assessments, referrals, and very brief counseling for employees. While the availability of EAP counselors is beneficial in police organizations, barriers to utilizing EAP programs among officers include the notion that EAP counselors may not fully understand the law enforcement culture, practices, and unique challenges of policing. These concerns, coupled with the stigma of receiving mental health counseling, can prevent officers from utilizing EAPs.

As mentioned previously, police work leaves officers vulnerable to a variety of psychological injuries. Among these outcomes, many officers experience challenges to their moral beliefs. Organizations that maintain a culture of wellness provide a robust chaplaincy program for their employees. Although this has historically been to support officers following exposure to trauma (Jungen, 2012), the role of department chaplains can expand to provide support during any conflict of conscience. Chaplains do not promote religion per se; they simply reinforce the importance of developing and maintaining a strong sense of spirituality, which insulates officers from the potentially damaging effects of regular exposure to human suffering. Chaplains may attend pre-shift briefings, go on ride-alongs, and make themselves available for officers to contact at any time. The more visible the chaplains make themselves, the more comfortable officers are contacting them for support and spiritual guidance.

Beyond the traditional resources, organizations can go one step further to promote officer wellness. Innovative agencies establish and staff a dedicated wellness unit (Creighton & Blumberg, 2016). In this case, the unit communicates to all officers that the agency is committed to an organizational culture of wellness; resources are allocated so that officers and their families can receive help navigating the often difficult balance between work life and home life. The unit reminds officers that officer safety and officer effectiveness are dependent on officer wellness (Police Executive Research Forum, 2018).

Promoting Officer Wellness

In addition to the services described already, organizations can actively encourage officer wellness through various proactive measures. These are, ideally, organized by the staff of a wellness unit. In the absence of such a unit, organizations rely on human resources staff or another designated “wellness” coordinator (often a training lieutenant) to schedule and implement ongoing wellness-related programming. These efforts include in-service training seminars by subject matter experts in health-related fields, email newsletters that include wellness reminders and health-related tips, presentations to officers’ family members during academy orientations, regular morale-boosting video messages from the chief to officers during pre-shift briefings, and routine wellness “check-ups.” Additionally, organizations dedicated to officer wellness require health-related content included in all leadership development courses and promotional panels. In this way, supervisors become better ambassadors of wellness for their subordinates and are encouraged to maintain their own effective stress management programs.

Although organizations can implement a variety of health-promoting initiatives and provide numerous resources for officers, ultimately, the responsibility for wellness resides in the individual. Officers who are committed to maintaining healthy functioning can take steps to strengthen their ability to effectively manage the psychological demands of the job. Of course, the first step is to actively take advantage of the organization’s services, for example, by following the newsletter’s tips, practicing the information presented during in-service trainings, and reaching out for professional support at the earliest signs of distress. Beyond this, there are specific techniques, which officers can learn and practice, to optimize healthy functioning.

Every police officer should develop a personalized stress management program. At the forefront of such a plan is a commitment to maintaining balance in one’s life. This starts with never allowing the job to define oneself. A common refrain is: “This may be what I do, but it’s not who I am.” To accomplish this, officers maintain relationships with friends who are not in law enforcement. They regularly participate in recreational activities and hobbies, enjoy a variety of restful activities, and use their accrued vacation time to get away and relax.

Comprehensive wellness plans involve taking care of oneself on many levels. Physically, officers need to maintain a fitness routine, good nutritional habits, and adequate sleep hygiene. They also need to avoid self-medication (i.e., limit use of caffeine, nicotine, alcohol, and over-the-counter medications). These practices are essential for officers to keep their bodies as healthy as possible in order to cope with the physical demands of the job. At the same time, good physical health is fundamental to good psychological health and vice versa.

Police work involves routine exposure to human suffering and a variety of traumatic events. Officers can take a preventative approach in an effort to mitigate the deleterious impact of this exposure. A strategy to cope successfully with adversity is for officers to develop resilience. One approach, which has shown some promise, is stress inoculation training (Rosmith, 2016; Varker, & Devilly, 2012), whereby officers learn controlled breathing, mental preparation, and rehearsal techniques to reduce their reactions to stressful conditions.

To combat the effects of moral injury, officers can learn to practice self-forgiveness. Even though their behavior may have been appropriate, rational and irrational feelings of guilt and shame are common symptoms of moral injury. These feelings are commonly denied and avoided, which can lead to myriad other problems (e.g., self-medication, withdrawal). Self-forgiveness is a technique to confront the guilt and shame and to begin to heal from moral injury (Snider, 2017). It has been shown to be effective with veterans returning from combat (Griffin et al., 2017) and, more generally, with individuals struggling with feelings of moral transgressions in the workplace (Woodyatt, Cornish, & Cibich, 2017).

Similarly, compassion fatigue can be ameliorated when officers practice compassion satisfaction. This technique helps officers to focus on the pride and gratification derived from the aspect of their job that involves helping people in need (Andersen & Papazoglou, 2015). Compassion satisfaction has been shown to correlate positively with work commitment and negatively with job burnout (Chiappo-West, 2018).

To prevent the insidious effects of burnout, as well as other posttrauma reactions, officers can learn to express gratitude. By focusing on the aspects of their life for which they are appreciative (e.g., social support, family, health, employment), officers insulate themselves from some of the psychological risks of trauma exposure (Leppma et al., 2018; McCanlies, Mnatsakanova, Andrew, Burchfiel, & Violanti, 2014). This involves writing gratitude letters, expressing appreciation to loved ones, participating in community events where the police are honored, and developing mindfulness to stay anchored in the present. Recent research suggests that these strategies increase resilience and improve the brain’s ability to control stress reactions (Tabibnia & Radecki, 2018).

A specific technique to minimize impulsive stress reactions is emotion regulation. For example, police officers who do not successfully manage anxiety tend to fire their weapon more often and more inaccurately than officers who are better able to control anxiety (Nieuwenhuys, Savelsbergh, & Oudejans, 2012). Beyond managing the expression of one’s emotions to avoid potentially destructive outbursts, emotion regulation involves keeping the intensity of one’s emotions within tolerable levels to function appropriately in any situation. To achieve better emotion regulation, officers practice mindfulness, breathing exercises, journaling, positive self-talk, and other cognitive-behavioral techniques. These skills can be acquired and mastered through individual and/or group training sessions, individual counseling sessions, and self-help readings. Officers who demonstrate excellent emotion regulation tend to be psychologically healthier than their more emotionally volatile peers (Berking, Meier, & Wupperman, 2010). Brain imaging studies showed that police officers with good emotion regulation are more resilient and cope better following trauma exposure than those with poorer levels of emotion regulation (Van der Werff, Elzinga, Smit, & van der Wee, 2017).

Emotion regulation is seen as a component of emotional intelligence, which has been identified as a protective factor against psychological injuries. Emotional intelligence involves the ability to recognize one’s emotions, control one’s impulses, recognize others’ emotional cues, and use emotions to effectively manage relationships (Brackett, Mayer, & Warner, 2004). Police officers with higher emotional intelligence reported greater well-being than those with lower levels of emotional intelligence (Dar, Alam, & Lone, 2011). Police officers with higher emotional intelligence performed their jobs better than those with lower levels of emotional intelligence (Ebrahim Al Ali, Garner, & Magadley, 2012). An argument can be made that it is as important for police officers to have high levels of emotional intelligence as it is for them to be competent in any other part of their job (Brunetto, Teo, Shacklock, & Farr-Wharton, 2012). Fortunately, research has shown that emotional intelligence can be improved through training (Schutte, Malouff, & Thorsteinsson, 2013).

Police officers who recognize the need to improve their emotional intelligence have to take an active role in developing these skills. Sitting in a lecture or an advanced officer training class on emotional intelligence will provide some pointers but will do little to increase one’s level of emotional intelligence. Similarly, reading any number of self-help books (e.g., Bradberry, & Greaves, 2009) is a good place to start but requires the commitment to practice the strategies outlined in the book. An effective way to boost emotional intelligence is to utilize the services of a professional coach who is skilled in this area. In this setting, the officer will be guided through rehearsals, given exercises to try at home and on the job, and reinforced to continue practicing. In the end, all of the wellness strategies designed to maintain optimal functioning require officers to make their physical, psychological, and spiritual health a top priority and to regularly practice these techniques.

Review of the Literature and Primary Sources

Police work is recognized as a stressful and challenging occupation (Reese, 1995; Regehr et al., 2008; Slate, Johnson, & Colbert, 2007; Violanti et al., 2007). Contributions from leading scholars in the field, representing both researchers and police psychologists (many of whom have prior law enforcement experience), have resulted in the wide acceptance that law enforcement is an occupation that takes a toll on the health of officers (Shane, 2010; Slate et al., 2007; Violanti & Aron, 1993).

Police Stress and Health

Extant, empirical research on police stress and wellness has clearly established links between work-related stress and trauma exposure and negative health outcomes due to overactivation of the stress response system and subsequent psychological, behavioral, and social reactions to stress. Common negative health outcomes include sleep disorders, cardiovascular disease, depression, PTSD, and suicide rates which exceed the general population (Cross & Ashley, 2004; Marmar et al., 2006; Mohr et al., 2003; Violanti et al., 2007; Violanti et al., 2013). An important empirical investigation into the physiological and psychological risks associated with policing is the Buffalo Cardio-metabolic Occupational Police Stress Study (BCOPS). The first study of its kind, BCOPS revealed officer vulnerabilities to metabolic syndrome, poor sleep quality, elevated risk for Hodgkin’s lymphoma, and suicide rates eight times higher in working officers compared to retired officers. (Fekedulegn et al., 2017; Violanti et al., 2006, 2007). Unhealthy coping, such as drug use, alcohol use, sexual promiscuity, and gambling, combined with social isolation and withdrawal, are indicators of lack of wellness among officers who are dealing internally with stress and trauma (Atkinson-Tovar, 2003; Cross & Ashley, 2004; Gilmartin, 2002; Paton, Violanti, Burke, & Gerhke, 2009).

Conceptualization of Special Risks to Wellness

Conceptual and theoretical contributions have advanced the study of police stress and wellness. Concepts previously applied to military, veteran, and social service populations, such as compassion fatigue and moral injury, have been applied to the line of inquiry around law enforcement stress and wellness. Compassion fatigue reflects the exposure to suffering and emotional labor required to care for others and has been cited as a secondary trauma in policing leading to depression, destructive coping, and PTSD (Bride et al., 2007; Cicognani, Pietrantoni, Palestini, & Prati, 2009; Figley, 1995; Tehrani, 2010). Likewise, police moral injury, which is the transgression of morals in the line of duty, has recently been applied to policing and challenges the spiritual, cognitive, and emotional health of officers (Litz et al., 2009; Papazoglou & Chopko, 2017). Burnout, or the psychological and emotional exhaustion associated with one’s work, is common across occupations yet has important implications for officers (Burke, 1993; Maslach, 1982; McCarty & Skogan, 2013; Stamm, 2010). The interplay between these special risks to officer wellness creates vulnerabilities to mental health conditions such as depression and PTSD (Conrad & Kellar-Guenther, 2006). The recent conceptual contribution of “compassionate warrior mindset” has been offered to describe the duality that accompanies competing role demands for officers to be warriors and caregivers (Chopko, 2011). Furthermore, police complex spiral trauma has been offered as a framework from which to examine the complex, intense, and cumulative form of police trauma (Papazoglou, 2013). These conceptual contributions are expected to inspire future directions of research to add depth to the understanding of the law enforcement stress experience and its impacts on health and wellness.

Effectiveness of Prevention and Resilience Training Programs

Applied science has also advanced current research by examining the effectiveness of various resilience and psychoeducational training programs to promote officer wellness and protect against negative health outcomes associated with work-related stress and trauma. Training on psychological techniques to reduce anxiety and enhance job performance during critical incidents was found to improve the health and coping of police cadets with effects lasting through the first two years on the job (Arnetz, Arble, Backmna, Lynhc, & Lublin, 2013). When adapted and replicated with specialized weapons and tactics (SWAT) officers, a similar training program yielded positive results for officer health such that officers were able to reduce their physiological stress responses during simulated training scenarios (Andersen et al., 2015). Positive effects on officers’ health were also found in the evaluation of a resilience-building training program that sought to improve social and emotional well-being as well as work performance through building self-regulation skills in officers. Results showed that targeting officer self-regulation through resilience training reduces stress, negative emotions, and depression, as well as improves communication and family relationships (McCraty & Atkinson, 2012).

Empirical studies, theoretical contributions, and applied research have collectively resulted in a breadth of research on law enforcement stress and wellness. Recent, high-profile events that have impacted police officers and the larger first-responder community, such as mass shootings, natural disasters, officer-involved shootings, and subsequent public criticism of police, lend themselves to deeper exploration of officer stress and wellness. It is expected that future research will be inspired by recent conceptual and theoretical contributions to the field toward the examination of multiple pathways to police wellness.

Further Reading

California Commission on Peace Officer Standards and Training. (2014). Peace officer psychological screening manual. Sacramento, CA: Author.Find this resource:

Chopko, B. A. (2011). Walk in balance: Training crisis intervention team police officers as compassionate warriors. Journal of Creativity in Mental Health, 6(4), 315–328.Find this resource:

Figley, C. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York, NY: Bruner/Mazel.Find this resource:

Gilmartin, K. M. (2002). Emotional survival for law enforcement. Tucson, AZ: ES Press.Find this resource:

Gravel, S. (2012). 56 seconds [Kindle DX version]. Cork, Ireland: BookBaby.Find this resource:

Grossman, D., & Christensen, L. (2008). On combat: The psychology and physiology of deadly conflict in war and in peace. Millstadt, IL: Warrior Science.Find this resource:

Herman, J. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. New York, NY: Basic Books.Find this resource:

Kirschman, E. (1997). I love a cop: What police families need to know. New York, NY: Guilford Press.Find this resource:

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley, CA: North Atlantic Books.Find this resource:

Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model an intervention strategy. Clinical Psychology Review, 29(8), 695–706.Find this resource:

Papazoglou, K. (2013). Conceptualizing police complex spiral trauma and its applications in the police field. Traumatology, 19(3), 196–209.Find this resource:

Papazoglou, K. (2016). Listening to their voices of bravery and heroism: Exploring the aftermath of officers’ loss and trauma in the line of duty. New York, NY: Nova Science.Find this resource:

Violanti, J. M. (1996). Police suicide: Epidemic in blue. Springfield, IL: Charles C Thomas.Find this resource:

Violanti, J. M. (2014). Dying for the job: Police work exposure and health. Springfield, IL: Charles C Thomas.Find this resource:

Violanti, J. M., O’Hara, A., & Tate, T. (2011). On the edge: Recent perspectives on police suicide. Springfield, IL: Charles C Thomas.Find this resource:

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Find this resource:

American Psychological Association. (n.d.). The road to resilience. Washington, DC: Author.

Andersen, J. P., & Papazoglou, K. (2015). Compassion fatigue and compassion satisfaction among police officers: An understudied issue. International Journal of Emergency Mental Health, 17(3), 661–663.Find this resource:

Andersen, J. P., Papazoglou, K., Koskelainen, M., Nyman, M., Gustafsberg, H., & Arnetz, B. (2015). Applying resilience promotion training among special forces police officers. SAGE Open, 5(2).Find this resource:

Arnetz, B., Arble, B., Backman, E., Lynch, L., & Lublin, A. (2013). Assessment of a prevention program for work-related stress among urban police officers. International Archives of Occupational and Environmental Health, 86(1), 79–88.Find this resource:

Atkinson-Tovar, L. (2003). The impact of repeated exposure to trauma. Law & Order, 51(9), 118–123.Find this resource:

Benner, A. W. (2000). COP DOCS. Psychology Today, 33(6), 36.Find this resource:

Berg, A. M., Hem, E., Lau, B., & Ekeberg, Ø. (2006). An exploration of job stress and health in the Norwegian police service: A cross sectional study. Journal of Occupational Medicine and Toxicology, 1(1), 26.Find this resource:

Berking, M., Meier, C., & Wupperman, P. (2010). Enhancing emotion-regulation skills in police officers: Results of a pilot controlled study. Behavior Therapy, 41(3), 329–339.Find this resource:

Blumberg, D. M., Griffin, D., & Jones, O. K. (2014). Improving peace officer hiring decisions: An integrated organizational approach. Organizational Cultures: An International Journal, 13, 1–19.Find this resource:

Brackett, M. A., Mayer, J. D., & Warner, R. M. (2004). Emotional intelligence and its relation to everyday behavior. Personality and Individual Differences, 36, 1387–1402.Find this resource:

Bradberry, T., & Greaves, J. (2009). Emotional Intelligence 2.0. San Diego, CA: TalentSmart.Find this resource:

Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35(3), 155–163.Find this resource:

Brodie, P., & Eppler, C. (2012). Exploration of perceived stressors, communication, and resilience in law-enforcement couples. Journal of Family Psychotherapy, 23, 20–41.Find this resource:

Brunetto, Y., Teo, S. T. T., Shacklock, K., & Farr-Wharton, R. (2012). Emotional intelligence, job satisfaction, well-being, and engagement: explaining organizational commitment and turnover intentions in policing. Human Resource Management Journal, 22, 428–441.Find this resource:

Burke, R. (1993). Work-family stress, conflict, coping, and burnout in police officers. Stress Medicine, 9(3), 171–180.Find this resource:

California Commission on Peace Officer Standards and Training. (2014). Peace officer psychological screening manual. Sacramento, CA: Author.

Charles, G. L., Travis, F., & Smith, J. (2014). Policing and spirituality: Their impact on brain integration and consciousness. Journal of Management, Spirituality, & Religion, 11(3), 230–244.Find this resource:

Charles, L. E., Burchfiel, C. M., Fekedulegn, D., Vila, B., Hartley, T. A., Slaven, J., . . . Violanti, J. M. (2007). Shift work and sleep: The Buffalo Police health study. Policing, 30(2), 215–227.Find this resource:

Chiappo-West, G. (2018). Compassion satisfaction, burnout, secondary traumatic stress, and work engagement in police officers in Arizona. Dissertation Abstracts International, 79.Find this resource:

Chopko, B. A. (2011). Walk in balance: Training crisis intervention team police officers as compassionate warriors. Journal of Creativity in Mental Health, 6(4), 315–328.Find this resource:

Chopko, B. A., Facemire, V., Palmieri, P., & Schwartz, R. (2016). Spirituality and health outcomes among police officers: Empirical evidence supporting a paradigm shift. Criminal Justice Studies, 29(4), 363–377.Find this resource:

Cicognani, E., Pietrantoni, L., Palestini, L., & Prati, G. (2009). Emergency workers’ quality of life: The protective role of sense of community, efficacy beliefs and coping strategies. Social Indicators Research, 94(3), 449–463.Find this resource:

Cochrane, R. E., Tett, R. P., & Vandecreek, L. (2003). Psychological testing and the selection of police officers: A national survey. Criminal Justice and Behavior, 30, 511–537.Find this resource:

Cohen, A. (2016). Are they among us? A conceptual framework of the relationship between the dark triad personality and counterproductive work behaviors (CWBs). Human Resource Management Review, 26(1), 69–85.Find this resource:

Conrad, D., & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 30(10), 1071–1080.Find this resource:

Creighton, S., & Blumberg, D. M. (2016). Officer wellness is fundamental to officer safety: The San Diego Model. In Police Executive Research Forum, Critical Issues in Policing Series: Guiding Principles in Use of Force (pp. 23–24). Washington, DC: Police Executive Research Forum.Find this resource:

Cross, L. C., & Ashley, L. (2004). Police trauma and addiction: Coping with the dangers of the job. FBI Law Enforcement Bulletin, 73(10), 24–32.Find this resource:

Dar, O. H., Alam, S., & Lone, Z. A. (2011). Relationship between emotional intelligence and psychological wellbeing of male police personnel. Journal of the Indian Academy of Applied Psychology, 37(1), 47–52.Find this resource:

Davidson, A. C., & Moss, S. A. (2008). Examining the trauma disclosure of police officers to their partners and officers’ subsequent adjustment. Journal of Language and Social Psychology, 27(1), 51–70.Find this resource:

Digliani, J. (2012). Law enforcement critical incident handbook. Loveland, CO: Author.

Ebrahim Al Ali, O., Garner, I., & Magadley, W. (2012). An exploration of the relationship between emotional intelligence and job performance in police organizations. Journal of Police and Criminal Psychology, 27(1), 1–8.Find this resource:

Fekedulegn, D., Burchfiel, C. M., Ma, C. C., Andrew, M. E., Hartley, T. A., Charles, L. E., . . . Violanti, J. M. (2017). Fatigue and on-duty injury among police officers: The BCOPS study. Journal of Safety Research, 60, 43–51.Find this resource:

Figley, C. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York, NY: Bruner/Mazel.Find this resource:

Galatzer-Levy, I. R., Brown, A. D., Henn-Haase, C., Metzler, T. J., Neylan, T. C., & Marmar, C. R. (2013). Positive and negative emotion prospectively predict trajectories of resilience and distress among high-exposure police officers. Emotion, 13(3), 545–553.Find this resource:

Gehrke, A., & Violanti, J. M. (2006). Gender differences and posttraumatic stress disorder: The role of trauma type and frequency of exposure. Traumatology, 12(3), 229–235.Find this resource:

Gershon, R. R., Barocas, B., Canton, A. N., Li, X., & Vlahov, D. (2009). Mental, physical, and behavioral outcomes associated with perceived work stress in police officers. Criminal Justice and Behavior, 36(3), 275–289.Find this resource:

Gilmartin, K. M. (2002). Emotional survival for law enforcement. Tucson, AZ: ES Press.Find this resource:

Grauwiler, P., Barocas, B., & Mills, L. (2008). Police peer support programs: Current knowledge and practice. International Journal of Emergency Mental Health, 10(1), 27–38.Find this resource:

Gravel, S. (2012). 56 Seconds [Kindle DX version]. Cork, Ireland: BookBaby.Find this resource:

Greenstone, J. L. (2000). Peer support in a municipal police department: Doing what comes naturally. The Forensic Examiner, 9(3–4), 33–36.Find this resource:

Griffin, B. J., Worthington, E. J., Danish, S. J., Donovan, J., Lavelock, C. R., Shaler, L., . . . Davis, D. E. (2017). Self-forgiveness and military service: Equipping warriors to combat moral injury. In L. Woodyat, E. J. Worthington, M. Wenzel, B. J. Griffin, L. Woodyat, E. J. Worthington, . . . B. J. Griffin (Eds.), Handbook of the psychology of self-forgiveness (pp. 221–233). Cham, Switzerland: Springer International.Find this resource:

Grossman, D., & Christensen, L. (2008). On combat: The psychology and physiology of deadly conflict in war and in peace. Millstadt, IL: Warrior Science.Find this resource:

Hayes, C. (2018, April 11). “Silence can be deadly”: 46 officers were fatally shot last year. More than triple that —140— committed suicide. USA Today.Find this resource:

Herman, J. (1992). Trauma and recovery: The aftermath of violence- from domestic abuse to political terror. New York, NY: Basic Books.Find this resource:

Jungen, A. (2012, July 23). Chaplains support police officers, victims in times of tragedy, stress. La Crosse Tribune.Find this resource:

Kirschman, E. (1997). I love a cop: What police families need to know. New York, NY: Guilford Press.Find this resource:

Kohan, A., & Mazmanian, D. (2003). Police work, burnout, and pro-organizational behavior: A consideration of daily work experiences. Criminal Justice and Behavior, 30(5), 559–583.Find this resource:

Kop, N., Euwema, M., & Schaufeli, W. (1999). Burnout, job stress and violent behaviour among Dutch police officers. Work & Stress, 13(4), 326–340.Find this resource:

Leppma, M., Scott, O., Mnatsakanova, A., Sarkisian, K., Adjeroh, L., Andrew, M. E., . . . Violanti, J. M. (2018). Stressful life events and posttraumatic growth among police officers: A cross-sectional study. Stress & Health: Journal of the International Society for the Investigation of Stress, 34(1), 175–186.Find this resource:

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley, CA: North Atlantic.Find this resource:

Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model an intervention strategy. Clinical Psychology Review, 29(8), 695–706.Find this resource:

Madonna, J. J., & Kelly, R. E. (2002). Treating police stress: The work and the words of peer counselors. Springfield, IL, US: Charles C Thomas.Find this resource:

Manzella, C., & Papazoglou, K. (2014). Training police trainees about ways to manage trauma and loss. International Journal of Mental Health Promotion, 16(2), 103–116.Find this resource:

Marmar, C., McCaslin, S., Metzler, T., Best, S., Weiss, D., Fagan, J., . . . Neylan, T. (2006). Predictors of posttraumatic stress in police and other first responders. Annals of the New York Academy of Sciences, 1071(1), 1–18.Find this resource:

Martinussen, M., Richardsen, A. M., & Burke, R. J. (2007). Job demands, job resources, and burnout among police officers. Journal of Criminal Justice, 35(3), 239–249.Find this resource:

Maslach, C. (1982). Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice Hall.Find this resource:

McCanlies, E. C., Mnatsakanova, A., Andrew, M. E., Burchfiel, C. M., & Violanti, J. M. (2014). Positive psychological factors are associated with lower PTSD symptoms among police officers: Post Hurricane Katrina. Stress & Health: Journal of the International Society for the Investigation of Stress, 30(5), 405–415.Find this resource:

McCarroll, J. E., Ursano, R. J., Fullerton, C. S., & Lundy, A. (1995). Anticipatory stress of handling human remains from the Persian Gulf War: Predictors of intrusion and avoidance. Journal of Nervous and Mental Disease, 183(11), 698–703.Find this resource:

McCarty, W., & Skogan, W. (2013). Job-related burnout among civilian and sworn police personnel. Police Quarterly, 16(1), 66–84.Find this resource:

McCaslin, S. E.Metzler, T. J., Best, S. R., Liberman, A., Weiss, D. S., Fagan, J., & Marmar, C. R. (2006). Alexithymia and PTSD symptoms in urban police officers: Cross-sectional and prospective findings. Journal of Traumatic Stress, 19(3), 361–373.Find this resource:

McCraty, R., & Atkinson, M. (2012). Resilience training program reduces physiological and psychological stress in police officers. Global Advances in Health and Medicine, 1(5), 44–66.Find this resource:

Miller, L. (2005). Police officer suicide: Causes, prevention, and practical intervention strategies. International Journal of Emergency Mental Health, 7, 101–114.Find this resource:

Mohr, D., Vedantham, K., Neylan, T., Metzler, T. J., Best, S., & Marmar, C. R. (2003). The mediating effects of sleep in the relationship between traumatic stress and health symptoms in urban police officers. Psychosomatic Medicine, 65(3), 485–489.Find this resource:

National Law Enforcement Officers Memorial Fund. (2018). Preliminary 2017 law enforcement officer fatalities report. Washington, DC: Author.

Nieuwenhuys, A., Savelsbergh, G. P., & Oudejans, R. D. (2012). Shoot or don’t shoot? Why police officers are more inclined to shoot when they are anxious. Emotion, 12(4), 827–833.Find this resource:

Papazoglou, K. (2013). Conceptualizing police complex spiral trauma and its applications in the police field. Traumatology, 19(3), 196–209.Find this resource:

Papazoglou, K. (2016). Listening to their voices of bravery and heroism: Exploring the aftermath of officers’ loss and trauma in the line of duty. New York, NY: Nova Science.Find this resource:

Papazoglou, K., & Blumberg, D.M. (in press). A brief introduction to multiple psychic wounds in police work. Frontiers in Public Health.Find this resource:

Papazoglou, K., & Chopko., B. (2017). The role of moral suffering (moral distress and moral injury) in police compassion fatigue and PTSD: An unexplored topic. Frontiers in Psychology, 8.Find this resource:

Paton, D., Violanti, J. M., Burke, K., & Gerhke, A. (2009). Traumatic stress in police officers: A career-length assessment of posttraumatic stress in police officers. Springfield, IL: Charles C Thomas.Find this resource:

Patterson, G. T., & Violanti, J. M. (2001). Spillover among the police: The relationship between stressful events at home and stressful events at work. The Australasian Journal of Disaster and Trauma Studies, 2001–2.Find this resource:

Patton, G. (1998). A qualitative study of spirituality with veteran law enforcement officers (Doctoral dissertation). Available from ProQuest Dissertations and Theses database.Find this resource:

Pietrzak, R. H., Feder, A., Singh, R., Schechter, C. B., Bromet, E. J., Katz, C. L., . . . Harrison, D. (2014). Trajectories of PTSD risk and resilience in World Trade Center responders: An 8-year prospective cohort study. Psychological Medicine, 44(1), 205–219.Find this resource:

Police Executive Research Forum. (2018). Building and sustaining an officer wellness program: Lessons from the San Diego Police Department. Washington, DC: Office of Community Oriented Policing Services.Find this resource:

Rahr, S., & Rice, S. K. (2015). From warriors to guardians: Recommitting American police culture to democratic ideals. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.Find this resource:

Reese, J. T. (1995). A history of police psychological services. In M. I. Kurke & E. M. Scrivner (Eds.), Police psychology into the 21st century (pp. 31–44). Hillsdale, NJ: Lawrence Erlbaum.Find this resource:

Regehr, C., LeBlanc, V., Jelley, R. B., & Barath, I. (2008). Acute stress and performance in police recruits. Stress and Health, 24(4), 295–303.Find this resource:

Reiser, M., & Geiger, S.P. (1984). Police officer as victim. Professional Psychology: Research and Practice, 15(3), 315–323.Find this resource:

Rosmith, E. S. (2016). Mental toughness training for police officers: The impact of a stress inoculation program on police stress. Dissertation Abstracts International Section A, 76.Find this resource:

Sarafino, G.F. (2010). Fundamental issues in police psychology assessment. In P. A. Weiss (Ed.), Personality assessment in police psychology: A 21st century perspective (pp. 29–55). Springfield, IL: Charles C Thomas.Find this resource:

Schutte, N. S., Malouff, J. M., & Thorsteinsson, E. B. (2013). Increasing emotional intelligence through training: Current status and future directions. The International Journal of Emotional Education, 5, 56–72.Find this resource:

Shane, J. M. (2010). Organizational stressors and police performance. Journal of Criminal Justice, 38(4), 807–818.Find this resource:

Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182–191.Find this resource:

Sigler, R. T., & Thweatt, D. R. (1997). Religiosity and stress for police officers. Journal of Police and Criminal Psychology, 12(1), 13–24.Find this resource:

Slate, R., Johnson, W., & Colbert, S. (2007). Police stress: A structural model. Journal of Police and Criminal Psychology, 22(2), 102–112.Find this resource:

Snider, J. J. (2017). Moral injury: Repair through self-forgiveness. Dissertation Abstracts International Section A, 78.Find this resource:

Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the Compassion Satisfaction and Fatigue Test. In C. R. Figley (Ed.), Treating compassion fatigue (pp. 107–119). Psychosocial Stress Series No. 24. New York, NY: Brunner-Routledge.Find this resource:

Stamm, B. H. (2010). The concise ProQOL manual. Pocatello, ID: ProQOL.org.Find this resource:

Stephens, C., & Long, N. (1999). Posttraumatic stress disorder in the New Zealand police: The moderating role of social support following traumatic stress. Anxiety, Stress, and Coping, 12(3), 247–264.Find this resource:

Stephens, C., & Long, N. (2000). Communication with police supervisors and peers as a buffer of work-related traumatic stress. Journal of Organizational Behavior, 21, 407–424.Find this resource:

Stuart, H. (2008). Suicidality among police. Current Opinion in Psychiatry, 21(5), 505–509.Find this resource:

Tabibnia, G., & Radecki, D. (2018). Resilience training that can change the brain. Consulting Psychology Journal: Practice and Research, 70(1), 59–88.Find this resource:

Tangney, J. P., Stuewig, J., & Mashek, D. J. (2007). Moral emotions and moral behavior. Annual Review of Psychology, 58, 345–372.Find this resource:

Taverniers, J., Smeets, T., Van Ruysseveldt, J., Syroit, J., & von Grumbkow, J. (2011). The risk of being shot at: Stress, cortisol secretion, and their impact on memory and perceived learning during reality-based practice for armed officers. International Journal of Stress Management, 18(2), 113–132.Find this resource:

Tehrani, N. (2010). Compassion fatigue: Experiences in occupational health, human resources, counseling, and police. Occupational Medicine, 60(2), 133–138.Find this resource:

Tillyer, R. (2018). Assessing the impact of community-oriented policing on arrest. Justice Quarterly, 35(3), 526–555.Find this resource:

Turgoose, D., Glover, N., Barker, C., & Maddox, L. (2017). Empathy, compassion fatigue, and burnout in police officers working with rape victims. Traumatology, 23(2), 205–213.Find this resource:

Tuttle, B., Giano, Z., & Merten, M. (2018). Stress spillover in policing and negative relationship functioning for law enforcement marriages. The Family Journal: Counseling and Therapy for Couples and Families, 26, 246–252.Find this resource:

Van der Werff, S. A., Elzinga, B. M., Smit, A. S., & van der Wee, N. A. (2017). Structural brain correlates of resilience to traumatic stress in Dutch police officers. Psychoneuroendocrinology, 85, 172–178.Find this resource:

Varker, T., & Devilly, G. J. (2012). An analogue trial of inoculation/resilience training for emergency services personnel: Proof of concept. Journal of Anxiety Disorders, 26(6), 696–701.Find this resource:

Violanti, J. M. (1996). Police suicide: Epidemic in blue. Springfield, IL: Charles C Thomas.Find this resource:

Violanti, J. M. (2004). Predictors of police suicide ideation. Suicide and Life-Threatening Behavior, 34(3), 277–283.Find this resource:

Violanti, J. M. (2014). Dying for the job: Police work exposure and health. Springfield, IL: Charles C Thomas.Find this resource:

Violanti, J. M., Andrew, M., Burchfiel, C., Dorn, J., Hartley, T., Miller, D., & Carlson, J. G. (2006). Posttraumatic stress symptoms and subclinical cardiovascular disease in police officers. International Journal of Stress Management, 13(4), 541–554.Find this resource:

Violanti, J. M., Andrew, M., Burchfiel, C. M., Hartley, T. A., Charles, L. E., & Miller, D. B. (2007). Post-traumatic stress symptoms and cortisol patterns among police officers. Policing: An International Journal of Police Strategies & Management, 30(2), 189–202.Find this resource:

Violanti, J., & Aron, F. (1993). Sources of police stressors, job attitudes, and psychological distress. Psychological Reports, 72(3), 899–904.Find this resource:

Violanti, J. M., Fekedulegn, D., Hartley, T., Andrew, M. E., Gu, J., & Burchfiel, C. M. (2013). Life expectancy in police officers: A comparison with the U.S. general population. International Journal of Emergency Mental Health, 15, 217–228.Find this resource:

Violanti, J. M., O’Hara, A., & Tate, T. (2011). On the edge: Recent perspectives on police suicide. Springfield, IL: Charles C Thomas.Find this resource:

Violanti, J., & Paton, D. (2001). Police trauma: Psychological aftermath of civilian combat. Springfield, IL: Charles C Thomas.Find this resource:

Wirth, M. D., Burch, J., Shivappa, N., Violanti, J. M., Burchfiel, C. M., Fekedulegn, D., & Charles, L. E. (2014). Association of a dietary inflammatory index with inflammatory indices and metabolic syndrome among police officers. Journal of Occupational and Environmental Medicine/American College of Occupational and Environmental Medicine, 56(9), 986–989.Find this resource:

Woodyatt, L., Cornish, M. A., & Cibich, M. (2017). Self-forgiveness at work: Finding pathways to renewal when coping with failure or perceived transgressions. In L. Woodyat, E. J. Worthington, M. Wenzel, B. J. Griffin, L. Woodyat, E. J. Worthington, . . . B. J. Griffin (Eds.), Handbook of the psychology of self-forgiveness (pp. 293–307). Cham, Switzerland: Springer International.Find this resource: