Objectives:The aim of this study was to test an intervention modifying officer physiology to reduce lethal force errors and improve health.Methods:A longitudinal, within-subjects intervention study was conducted with urban front-line police officers (n = 57). The physiological intervention applied an empirically validated method of enhancing parasympathetic engagement (ie, heart rate variability biofeedback) during stressful training that required lethal force decision-making.Results:Significant post-intervention reductions in lethal force errors, and in the extent and duration of autonomic arousal, were maintained across 12 months. Results at 18 months begin to return to pre-intervention levels.Conclusion:We provide objective evidence for a physiologically focused intervention in reducing errors in lethal force decision-making, improving health and safety for both police and the public. Results provide a timeline of skill retention, suggesting annual retraining to maintain health and safety gains.

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Leading police scholars and practitioners were asked to reflect on the most urgent issues that need to be addressed on the topic of use of force. Four themes emerged from their contributions: use of force and de-escalation training needs to improve and be evaluated; new ways of conceptualizing use of force encounters and better use of force response models need to be developed; the inequitable application of force, and how to remediate biases, needs to be more fully understood; and misconceptions

Stress has a pervasive, global, and negative influence on individual health. Stress also has negative effects on families, organizations, and communities. Current models of stress are either too general or too detailed to guide effective interventions across the spectrum of medical and social conditions that are stress-related. A new model is needed that explains how stress can have such varied effects and describes how to reduce its harm. The model must also capture both the dynamic nature of stress and its ability to persist and cause chronic effects. The model must guide those who use it in selecting effective interventions and in developing more effective interventions. Ideally, the model will be helpful to people who are experiencing stress and do not have access to professional help. The authors propose a model in an attempt to address the above concerns. The proposed model is called the Unease Modulation Model (UM Model). Briefly, the UM Model separates stress into several elements common to people’s experience. The model describes how these elements interact and how those interactions lead to recurring states that are associated with health or illness. Finally, the model enables the person under stress to identify the elements where they will have the most leverage to evoke change and apply specific, effective techniques for that purpose. While the model is experiential, it is also based on mathematical theories of perception, nonlinear dynamics, neurophysiology, and cognitive psychology. In spite of this underlying sophistication, it can be used by those without a medical education. The proposed model has been taught successfully to patients in a clinical setting. The model is now being used in an international training program with police officers to address the long-term stress associated with the career and reduce decision-making errors regarding use of force. This article introduces the model by defining components based on patient descriptions of stress and integrating those into a formal structure. We then demonstrate how the model can be applied to a number of medical and psychiatric conditions. The article concludes by briefly discussing the model’s application to family and societal stress-related difficulties.